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The Psychiatry Scholars Program, sponsored by the Department of Psychiatry, matches you with a faculty member (in various specialties) to work on a scholarly project that matches your research interests. You can review a list of possible projects by title, keyword, mentor name, or medical specialty. If you have another interest not listed, we’ll work with you to find a mentor and project. To get started, you can either contact your chosen mentor directly or talk to one of the contacts listed below. You can also review current and previous student projects.

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Research Project One Description
Giese, AlexisResident and Outpatient Program Evaluation
Program evaluation requires creativity, curiosity, focus, and objectivity. The purpose of this project is to assess the satisfaction of resident providers and their patients with care provided in resident outpatient psychiatry services.
 
Outpatient Psychiatry teaching clinics meet two major needs: provide care and train residents. The effectiveness of the clinics in meeting these needs requires ongoing evaluation.
 
In this project you will have the opportunity to conduct one or more of the following research methods:
  • Focus groups
  • Interviews with key stakeholders
  • Surveys - telephonic, paper-and-pencil, Web-based
  • Literature review - published standards, applicable guidelines, model programs
  • Background review - program manuals, Web site, policies and procedures, curricula
  • Data analysis - clinical outcomes, success or completion rates, competency measures, financial outcomes, comparison to benchmarks
Olincy, AnnEffects of the Alpha-7 Nicotine Agonist DMXB-A on Neuropsychological Functioning of Schizophrenia

This is a Phase II trial of the alpha-7 nicotinic receptor agonist, DMXB-A in schizophrenia. This study proposes to give this investigational new drug to people with schizophrenia while assessing efficacy in improving cognition, tolerability and safety. The trial is a double-blind placebo control design with two doses of DMXB-A and a 1 week washout period between arms. Each subject is enrolled for 15 weeks and receives placebo, DMXB-A 75 mg BID, and DMXB-A 150 mg BID each for 4 weeks. At the end of each arm, the subject has a 90 minute neuropsychological battery and a functional MRI.

The student would be involved in recruitment, screening for medical contraindications, diagnostic evaluations, clinical symptom rating scales, recording adverse events, physical examinations, laboratory examinations, toxicology screens, ECGs. They would have the opportunity to observe neuropsychological testing and functional MRI.

Giese, AlexisQuality and Effectiveness of Didactics Provided During a Psychiatry Residency Program and to Consider Alternative Approaches
To assess the quality and effectiveness of didactics provided during a Psychiatry Residency Program and to consider alternative approaches.
 
Didactics vary in their quality and effectiveness, based on the topic, the way in which information is imparted, and the quality of the speaker. Ongoing evaluation with a goal of ever-improving the didactic program is a primary goal. This program focuses on these questions related to didactics within a Psychiatry Residency Program.
 
Examples of methods used in program evaluation:
  • Focus groups
  • Interviews with key stakeholders
  • Surveys—telephonic, paper-and-pencil, web-based
  • Literature review—published standards, applicable guidelines, model programs
  • Background review—program manuals, website, policies and procedures, curricula
  • Data analysis—success or completion rates, competency measures, financial outcomes, comparison to benchmarks

Program evaluation requires creativity, curiosity, focus, and objectivity. Writing skills are helpful, as evaluation findings and recommendations are generally summarized in a written report; other communication methods such as formal oral presentations or focus groups may also be used.

Giese, AlexisWhat Type of Smoking Cessation Programs are Needed for Individuals with Severe Mental Illnesses?
Smoking is much more common in individuals with mental illness and yet smoking cessation programs designed to serve this population are uncommon. The goal would be to complete a needs assessment of both the number and types of smoking cessation programs for this population.
 
Examples of methods to be used in this needs assessment:
 
  • Focus groups
  • Interviews with key stakeholders
  • Surveys—telephonic, paper-and-pencil, web-based
  • Literature review—published standards, applicable guidelines, model programs
  • Background review—program manuals, website, policies and procedures, curricula
  • Data analysis—clinical outcomes, success or completion rates, competency measures, financial outcomes, comparison to benchmarks
  •  
    Program evaluation requires creativity, curiosity, focus, and objectivity. Writing skills are helpful, as evaluation findings and recommendations are generally summarized in a written report; other communication methods such as formal oral presentations or focus groups may also be used.
    Olincy, AnnThe Genetics of Endophenotypes in Schizophrenia – Study of Schizophrenia as a Polygenic Illness
    To find how endophenotypes sort in families, interact with each other and may identify genes associated with schizophrenia.
     
    This project identifies families that contain a person with schizophrenia. The families must contain at least one person with schizophrenia, 2 parents and another sibling without schizophrenia. The parents are used to isolate DNA from white blood cells and thus to discern patterns of inheritance. The person with schizophrenia and the sibling undergo endophenotype testing, an extensive diagnostic interview and collection of genetic material to help identify genes in schizophrenia. Endophenotypes are physiological or neuropsychological markers of carriers of disease genes that are present in those with symptoms and also in relatives who may carry the gene, but not manifest symptoms. By studying 6 of these endophenotypes, we will be able to determine what are the needed combinations of genes to manifest symptoms. The endophenotypes studied are an eye movement task, the startle response (prepulse inhibition), an auditory evoked potential deficit, verbal memory, working memory and sustained attention.
     
    The student will be involved in recruitment of families, screening, diagnostic evaluations, neuropsychological and neurophysiological testing. Furthermore, the student will have the opportunity to evaluate data quality from the auditory evoked potential measure from the 7 sites across the country.
    Olincy, AnnThe Genetics of Schizophrenia: A Comparison of a Population of People with Schizophrenia to Controls
    This is a case-control study that looks for genes associated with schizophrenia. The study goals are to collect 5000 people with schizophrenia over 3 years for comparison with a group of 10,000 people who do not have the illness to see which genes are different. This is a 10-site study across the country. Over 250 people have already been collected.
     
    The student would be involved in performing an extensive diagnositic evaluation of schizophrenia. This includes a structured genetic interview, an interview with a family member about the person with schizophrenia and review of medical records. The student would also have access to the existing database of 250 people and could generate hypotheses based on the information collected in the clinical interview and analyze these hypotheses with our existing data set.
    Wamboldt, FrederickAddressing Stress Improves Treatment Adherence in Children and Adolescents with Asthma
    The principal aim of Dr. Wamboldt's laboratory is the study of relationship development in normal, as well as highly stressed populations.  Several sets of studies are currently in progress examining what specific family factors influence medical treatment adherence and outcome in children and adolescents with asthma.  Dr. Wamboldt's laboratory is located within the Department of Medicine at the National Jewish Medical and Research Center, and is well equipped to obtain state-of-the-art relationship and family measurements including research interviewing and direct observation of marital and family interaction.
    Kelsey, KimAsthma and Obesity in Youth

    The objective of this study is to evaluate whether intervention affects asthma and obesity.

    60 children meeting our criteria for asthma with a BMI greater than 95 percentile for age will be enrolled. After one month or maximization of asthma care, subjects will be randomized to receive either 16 week intervention program, or community standard of care with added supervision of asthma. Intervention includes 3xweek group sessions for 4 weeks, followed by weekly groups for 12 weeks. Group will include cardiovascular work with PT, nutrition education, and asthma care education. We will follow weight, BMI, Pulmonary function, as well as, behavior, mood and quality of life for the two groups.

    Arciniegas, DavidAssessment of Frontally-Mediated Cognition in Healthy Adults

    Students involved in this project will help develop a normative database for the Frontal Assessment Battery (FAB), which is designed to facilitate the identification of impairments in frontally-mediated cognition. In order for the FAB to be interpreted meaningfully, age- and education-adjusted normative data is required. Interested students will work with the Neuropsychiatry Service to develop a protocol with which to begin the development of a normative database for the FAB.

    The student will participate in the following research activities:

    • protocol development;
    • IRB submission;
    • subject recruitment;
    • database development;
    • subject interview and cognitive assessment;
    • statistical analysis;
    • manuscript development and presentation

    Clinical assessment of cognition in medical practice is generally limited to the Mini-Mental State Examination (MMSE). Although this measure is useful in the assessment of persons with disorders of cognition affecting memory and language (ie, Alzheimer’s disease), it is generally regarded as a rather poor measure for the assessment of cognition among persons with neurological conditions affecting the frontal lobes (ie, frontotemporal dementia, traumatic brain injury, Parkinson’s disease, etc.). The FAB is gaining broad appeal as a bedside test of executive function, particularly in light of its ability to identify persons with clinically significant cognitive impairments that are opaque to identification using the MMSE.

    Waldo, MerilyneAtypical Antipsychotics and P50 Sensory Gating

    This project will attempt to determine the effects of 5HT3 antagonists on sensory gating in schizophrenia.

    Clozapine improves impaired P50 auditory gating to a greater extent than any other antipsychotic. This improvement correlates with clinical improvement. Why clozapine is more effective than other atypicals is not clear, especially since P50 gating is mediated by the alpha-7 nicotinic receptor, not directly acted on by clozapine. Similar atypicals do not effectively improve impaired P50 gating. However, clozapine is a more effective 5HT3 antagonist than either olanzapine or quetiapine. 5HT3 blockade releases acetylcholine, which would stimulate •7 nicotinic receptors responsible for the mediation of P50 gating. This project will test this hypothesis in schizophrenic patients on an acute basis, determining whether adding ondansetron (a specific 5HT3 antagonist) acutely to schizophrenic patients taking olanzapine or quetiapine improves P50 gating. We will be testing schizophrenic patients in a double blind crossover study. Elucidating a potential mechanism by which clozapine alleviates a neurophysiological deficit may help us design better medications in the future.

    Hagman, JenniferBody image distortion in patients with eating disorders

    Students interested in advancing the scientific knowledge of biological mechanisms underlying symptom pathology in anorexia nervosa will, in this project, develop better methods for monitoring and evaluating core symptoms of the disease. 

    This is a double-blind, placebo controlled study of Risperidone for the treatment of anorexia nervosa. The study involves a monthly assessment of body image, body satisfaction, anxiety, and severity of eating disorder symptoms while subjects are taking Risperidone or placebo.  The study includes use of the Body Image Software (BIS) program to evaluate body image distortion.  The study began in 2004 and continues with a target enrollment of 50 subjects over three years.

    Dr. Hagman is also developing a study specific to the BIS program which would be independent of the Risperidone study, and would include subjects with bulima nervosa and eating disorders not otherwise specified in males.  We are in the process of validating the “Ease of Eating Scale (EOE).  This scale was developed by Dr. Hagman to measure the severity of specific eating behaviors associated with eating disorders.

    Savin, DanielCambodian Mental Health Exchange Program

    This project will include a longitudinal, low-intensity, non-funded experience and a high-intensity, funded, international experience.

    During the longitudinal experience the student will assist in coordinating an Internet-based educational exchange between UCD and the University of Health Sciences in Phnom Penh. Activities will include teaching Cambodian Psychiatry Residents how to access and use free medical databases relevant to their theses. Students may assist their Cambodian counterparts by using databases available through the Denison library. An interest in using technology to improve medical education and medical practice is essential. Estimated time commitment for this part of the project will be 2-5 hours per month for 2-4 years.

    The funded experience will consist of a 1-2 month summer externship at the University of Health Sciences in Cambodia. Students would spend time with Cambodian counterparts at an outpatient psychiatric clinics in Phnom Penh and in an outlying province. There may be opportunities for clinical exposure to general primary care and to care for those affected by HIV/AIDS. The student would also assist residents in usiing online recources to access medical literature during their visit. The participating student will have the opportunity to complete his/her medical school requirement for completion of a scholarly activity related to this experience.

    Crowley, ThomasSubstance Dependent Adolescents: Imaging Risk-Taking

    The objective of this project is understand the brain's processing of decisions about risk-taking.

    This project developed from an NIH request for studies of decisions to use drugs in "critical periods of development (particularly adolescence)", studies of the role of striatum and prefrontal cortex in addiction, "studies to charcterize changes in brain sites and circuits throughout the addiction process," and studies of "decision-making when outcomes are uncertain or include simultaneous rewards and punishments".

    Our program, unique in the nation, simutaneously treats and studies adolescents with substance dependence (SD) and conduct disorder (CD). These conditions both reflect "behavioral disinhibition" - a failure to desist from rewarding but risky behaviors as the chance of punishing outcomes increases. BIologic, genetic mechanisms contribute to the expression of CD, SD, and behavioral disinhibition. Failures to desist from risky behavior could result from biological differences in brain processing of reward, punishment, or decision-making. We now assess behavioral disinhibition on our patients using simple computer tasks duringfunctional magnetic resonance imaging (fMRI). Our event-related design discriminates braing activity during decision-making, reward, and punishment. We do functional and morphological MRI studies, comparing control adolescents with substance-dependent patients. We also examine patients' at-risk 9-11 year-old younger siblings, and control youngsters, before any of the siblings engage in extensive substance use.

    Hopfer, ChristianCauses and Treatment of Adolescent Antisocial and Drug-Dependent Behavior

    The objective of this project is to improve our knowledge about the diagnosis, causes, treatment, and ethical underpinnings of adolescent antisocial behavior and substance abuse.

    Examples of treatment-related projects (student utilizes literature reviews, visits to clinics, attending case conferences, clinical care activities, etc.):

    1. What is the prognosis and course of adolescent conduct disorder and substance dependence? (Drs. Hopfer, Crowley)

    Examples of research-related projects (student participates in ongoing research activities of Division faculty):

    1. Where and which are the genes that contribute to the patients’ disorders? (Drs. Hopfer, Crowley, Sakai)
    2. What is the role of environment (such as abuse and neglect) in the development of patients’ disorders? (Drs. Crowley, Hopfer, Sakai).
    3. How can the severity of patients’ disorders be measured for quantitative gene searches? (Drs. Hopfer, Sakai, Crowley)
    Riggs, PaulaCauses and Treatment of Adolescent Antisocial and Drug-Dependent Behavior

    The objective of this project is to improve our knowledge about the diagnosis, causes, treatment, and ethical underpinnings of adolescent antisocial behavior and substance abuse.

    Examples of treatment-related projects (student utilizes literature reviews, visits to clinics, attending case conferences, clinical care activities, etc.):

    1. What treatments have been shown to be effective for these disorders? (Drs. Riggs, Whitmore, Sakai,)
    2. What prevention efforts may reduce the incidence of these disorders? (Drs. Whitmore, Sakai, Riggs)
    3. How should pediatricians deal with these disorders? (Drs. Whitmore, Sakai, Riggs)

    Examples of research-related projects (student participates in ongoing research activities of Division faculty):

    1. How are assessments and clinical treatment trials conducted with these complicated patients? (Dr. Riggs)
    Sakai, JosephCauses and Treatment of Adolescent Antisocial and Drug-Dependent Behavior

    The objective of this project is to improve our knowledge about the diagnosis, causes, treatment, and ethical underpinnings of adolescent antisocial behavior and substance abuse.

    Examples of treatment-related projects:

    1. What treatments have been shown to be effective for these disorders?
    2. What prevention efforts may reduce the incidence of these disorders?
    3. How should pediatricians deal with these disorders?

    Examples of research-related projects:

    1. What simple behavioral tests may capture the essence of patients’ risk-taking and lack of concern for others, and how can those tests be incorporated into genetic and brain-imaging studies of patients’ psychopathology?
    2. Where and which are the genes that contribute to the patients’ disorders?
    3. What is the role of environment (such as abuse and neglect) in the development of patients’ disorders?
    4. How can the severity of patients’ disorders be measured for quantitative gene searches?

    Examples of social-ethical-policy projects:

    1. If genetically-influenced brain abnormalities contribute to the patients’ disorders, can patients be held responsible for their behaviors, and what are the appropriate legal sanctions for their criminal behavior?
    2. If these disorders have a life-long course, is short-term treatment appropriate and ethical?
    3. Are these risk-prone adolescents able to protect themselves properly when giving consent or assent to participate in research projects?
    Whitmore, ElizabethCauses and Treatment of Adolescent Antisocial and Drug-Dependent Behavior
    The objective of this project is to improve our knowledge about the diagnosis, causes, treatment, and ethical underpinnings of adolescent antisocial behavior and substance abuse. Examples of treatment-related projects (student utilizes literature reviews, visits to clinics, attending case conferences, clinical care activities, etc.):
    1. What treatments have been shown to be effective for these disorders? (Drs. Riggs, Whitmore, Sakai,)
    2. What prevention efforts may reduce the incidence of these disorders? (Drs. Whitmore, Sakai, Riggs)
    3. How should pediatricians deal with these disorders? (Drs. Whitmore, Sakai, Riggs)
    Proctor, WilliamCellular and Molecular Mechanisms Underlying Neuronal Adaptation to Drugs of Abuse

    We design and conduct original research to elucidate the neuronal mechanisms of alcohol and nicotine addiction, which are important mental health issues.  The goal of our research is to determine the molecular targets for the development of efficacious agents for treating the conditions of drugs abuse.

    Our ongoing investigations involve studies of the functional changes in brain neurotransmitter systems that occur during exposure to these drugs of abuse.  We use viable rodent brain slices to study how GABAergic and glutamatergic synaptic neurotransmitter activities are modified by ethanol and/or nicotine during acute and chronic drug treatment.  These electrophysiological studies require monitoring intracellular or whole-cell recordings in individual neurons during ethanol or nicotine application.

    We utilize techniques including evoked responses, paired-pulse stimulation, direct local drug application, and spontaneous neuronal activity to determine presynaptic and postsynaptic mechanisms that underlie the effects of these drugs.  Presently, GABAA inhibitory, and AMPA and NMDA excitatory post-synaptic potentials (IPSPs, EPSPs) or voltage-clamped currents are measured to determine the effects of these drugs.

    Wu, PeterCellular and Molecular Mechanisms Underlying Neuronal Adaptation to Drugs of Abuse

    We design and conduct original research to elucidate the neuronal mechanisms of alcohol and nicotine addiction, which are important mental health issues.  The goal of our research is to determine the molecular targets for the development of efficacious agents for treating the conditions of drugs abuse.

    Our ongoing investigations involve studies of the functional changes in brain neurotransmitter systems that occur during exposure to these drugs of abuse.  We use viable rodent brain slices to study how GABAergic and glutamatergic synaptic neurotransmitter activities are modified by ethanol and/or nicotine during acute and chronic drug treatment.  These electrophysiological studies require monitoring intracellular or whole-cell recordings in individual neurons during ethanol or nicotine application.

    We utilize techniques including evoked responses, paired-pulse stimulation, direct local drug application, and spontaneous neuronal activity to determine presynaptic and postsynaptic mechanisms that underlie the effects of these drugs.  Presently, GABAA inhibitory, and AMPA and NMDA excitatory post-synaptic potentials (IPSPs, EPSPs) or voltage-clamped currents are measured to determine the effects of these drugs.

    Harris, JosetteCognitive Assessment in Spanish for Psychiatric and Neurologically Impaired Adults

    The project aims to develop new tools for assessment of memory in bilingual adults. This project seeks to facilitate the development of appropriate and valid cognitive measures to improve diagnosis and to reduce health disparities for Spanish speaking adults.

    Language minority populations are particularly vulnerable members of our society (NIH, 2001). Research on cognitive impairment and clinical assessment of cognitive abilities in Spanish speaking adults has been constrained by the lack of appropriate methodologies for assessment and by the extremely limited availability of valid published cognitive assessment tests and norms for Hispanic and Spanish speaking individuals residing in the U.S. The paucity of appropriate assessment tools and strategies for Spanish speakers limits the ability of psychiatrists and neurologists to identify, let alone diagnose, memory and other cognitive impairment in the population.

    This project is directed toward the development of a primary Spanish language test of memory with the goal of making it comparable in all respects to a commonly used, well established (English) measure. Students will have the opportunity to interview and screen potential participants and to learn about the methodologies for test development and approaches to memory assessment. A variety of measures of language processing will be employed to analyze performance related to language proficiency. In addition, the role of other novel variables, as well as traditional demographic variables, on performance will be analyzed.

    Reaven, JudyCognitive Behavioral Group Therapy (CBT) for Treatment of Anxiety Symptoms in Children with Autism Spectrum Disorders

    The objective of this project is to determine the efficacy of CBT in anxiety symptom reduction for children with autism spectrum disorders. To further understand what factors contribute to a positive treatment response.

    Anxiety disorders are among the most common psychiatric conditions that present during childhood. Symptoms of anxiety often co-occur with other diagnoses common in childhood, such as disorders of attention, mood, conduct and development. Children with autism spectrum disorders (ASD) are at high risk for developing co-morbid psychiatric conditions, particularly symptoms of anxiety. Previous studies of the effectiveness of treatment for reducing anxiety symptoms in children with ASD have focused primarily on medications. Although there is a vast literature supporting the effectiveness of cognitive-behavioral treatment (CBT) of anxiety symptoms in typically developing children few studies exist on the systematic use of psychosocial interventions for treating anxiety symptoms in children with developmental disabilities or ASD in particular. Modified cognitive behavioral strategies have been demonstrated to be effective in treating the anxiety symptoms of a child with Asperger Syndrome (Reaven & Hepburn, 2003).

    A primary purpose of the current study is to measure the efficacy of a manualized group CBT treatment specifically written for children with ASD and their families. Children and their parents will participate in 14 weeks of group therapy intervention. Pre and post assessment will occur to document progress. Students participating in this project will learn the main components of a CBT protocol for treating anxiety symptoms in the population of high-functioning children with ASD.

    Talmi, AyeletConsultation & Liasion In Mental Health & Behavior (CLIMB): Increasing access to mental health services for underserved and at-risk populations in pediatric primary care

    Project CLIMB integrates mental health services into a pediatric primary care academic training center. Children from low income populations and their families typically have more limited access to appropriate mental health services in part because poor reimbursement by federal and state insurance plans reduce the likelihood that clinicians will accept these plans. At the same time, these children have higher mental health and psychosocial concerns than privately insured children. Pediatric primary care settings provide continuous and comprehensive services that are accessible to the majority of children and their families, and as such, are ideally suited to promote optimal development through the provision of expanded services that address parental concerns, key developmental tasks, psychosocial factors, and mental health issues. Clinical skills needed to identify and address children’s and parents’ developmental and psychosocial issues have not been central in pediatric or family medicine education.

    The current project involves translational research and outcome evaluation of a program that infuses comprehensive mental health services into a primary care setting and aims to improve the capacity of primary care clinicians to identify and treat common mental health concerns in children. The project is particularly well-suited for students who are interested in the integration of physical and psychological issues, pediatrics, psychiatry, primary care and/or outcome research.

    Stafford, BrianConsultation & Liasion In Mental Health & Behavior (CLIMB): Increasing access to mental health services for underserved and at-risk populations in pediatric primary care

    Project CLIMB integrates mental health services into a pediatric primary care academic training center. Children from low income populations and their families typically have more limited access to appropriate mental health services in part because poor reimbursement by federal and state insurance plans reduce the likelihood that clinicians will accept these plans. At the same time, these children have higher mental health and psychosocial concerns than privately insured children. Pediatric primary care settings provide continuous and comprehensive services that are accessible to the majority of children and their families, and as such, are ideally suited to promote optimal development through the provision of expanded services that address parental concerns, key developmental tasks, psychosocial factors, and mental health issues. Clinical skills needed to identify and address children’s and parents’ developmental and psychosocial issues have not been central in pediatric or family medicine education.

    The current project involves translational research and outcome evaluation of a program that infuses comprehensive mental health services into a primary care setting and aims to improve the capacity of primary care clinicians to identify and treat common mental health concerns in children. The project is particularly well-suited for students who are interested in the integration of physical and psychological issues, pediatrics, psychiatry, primary care and/or outcome research.

    Libby, AnneCost-Benefit Literature Review for the Colorado Department of Human Services

    The goal of this project is to update current summary of evidence in the literature on costs and benefits of psychiatric and addiction treatment.

    The State Department of Human Services compiles information to provide to the State Legislature in support of state funding for public mental health and addiction treatment services. Current summaries of evidence in the literature on costs and benefits of psychiatric and addiction treatment are helpful for these purposes. Prior work has compiled this information through 2006; we seek a student to assist in keep this report current and providing the information to the State in a usable format. The student will learn literature searches using PubMed, OVID, and Web of Science; summarize and document empirical study findings; describe summary in executive report format; and possibly present updated materials to the Colorado Department of Mental Health and Alcohol and Drug Abuse Division (ADAD).

    Beals, JanCultural Validity in the Context of Comorbidity

    The objective of this project is to investigate the patterns co-occurrence of psychiatric disorders in 2 American Indian populations and understand how this bears on cultural validity.

    Progress in psychiatric epidemiology has been dramatic. The focus on observable and experienced symptoms in the DSM definitions of mental disorder led to the development of reliable measures for use in population-based surveys. The substantial levels of comorbidity found in such efforts have forced thoughtful reconsideration of this concept. The probable role of sociocultural factors in understanding such comorbidity, however, has remained unexplored, despite evidence of the importance of the sociocultural construction of mental illness in general.

    Involvement in this project would involve the statistical analysis of survey data — both from interviewer-administered protocols of over 3,000 American Indians between the ages of 15 and 54 and re-interviews of 335 participants by clinicians using a semi-structured interview. The most common diagnoses were Major Depressive Episode (MDE), Posttraumatic Stress Disorder (PTSD), and Alcohol Abuse and Dependence (AAD). Rates of MDE in these samples were much lower than we anticipated; however MDE was diagnosed more often in the clinical reappraisal, as was AAD. We will work to understand how methodological and sociocultural factors inform our understandings of diagnostic processes.

    Thomas, MarshallDevelopment of Care Management Strategies for Colorado Access Health Plan Members with Co-morbid Mental and Physical Health Conditions

    Students will help develop and assess care management and clinical intervention programs for Colorado Access Medicaid and/or Medicare members.

    Mental health conditions are common in Medicaid and Medicare populations. The presence of these conditions increases the overall cost of care and is associated with worse physical health outcomes. The goal would be to study the interaction of mental health and physical health conditions within this population.

    Examples of methods to be used include:

    • Identification of particularly important mental and physical health co-morbidities
    • Participate in the development of model clinical interventions for this population.
    • Perform a literature review to identify existing literature about physical and mental health interaction in Medicaid/Medicare populations.
    • Identify evidence based clinical best practices for this population including planned care and chronic care models.
    • Complete data analyses of incidence rates, clinical and financial outcomes physical and mental health co-morbidities.
    • Assess impact of clinical intervention/care management programs.
    Mitchell, ChristinaDevelopment of Problem and Positive Behaviors from Adolescence to Adulthood Among Youth from Two American Indian Tribes

    This project aims to understand normative as well as problematic development among American Indian youth.

    This project involves the statistical analysis of longitudinal survey data from 1,292 youth covering six years with seven data points. The constructs assessed by survey cover a broad list of topics concerning normative development: e.g., ethnic identity, depressive symptoms, competencies, anxiety symptoms, substance use and misuse, social support, and stressful life events, just to name a few. We are focusing on understanding both how some youth develop problems in young adulthood and how others grow into fully functioning young adults.

    Kaufman, CarolDifferential Impact of HIV/AIDS Intervention Among Native Youth

    This project aims to determine the impact of a culturally appropriate HIV/AIDS prevention intervention among middle school students in a Northern Plains tribe.

    Most HIV/AIDS prevention efforts are targeted to urban areas; we know little about what is effective in rural areas, and even less about what might work in American Indian reservation settings. This project, locally known as “Wiconi Teca Waste” (good young life) is in the 4th year of its 5-year funding period. We are still collecting data, but have begun also analyses. Our goal is to see if the culturally-based curriculum is effective, and for which groups of youth it is most and least effective. The project includes extensive community involvement.

    Examples of methods used in this project:

    • Focus groups
    • Surveys—paper-and-pencil
    • Literature review—published standards, applicable guidelines, model programs
    • Background review—program manuals, policies and procedures, curricula
    • Data analysis—behavioral outcomes, longitudinal data analysis, behavioral intervention assessment, development of Best Practices guide for community stakeholders

    Project activities require creativity, curiosity, focus, confidentiality, and objectivity. Organizational skills are required. Writing skills and are helpful, as all components of the project require clear written documentation and effective communication with other project staff members. Background in data analysis or data management is required for participation in the data analysis component.

    Peterson, JohnDistressed Youth's Intentions and Behaviors

    The objective of this project is to evaluate self-harming intentions of psychiatrically hospitalized adolescents.

    Suicide is a leading cause of death among young people and, suicidal and non-suicidal self-injurious behaviors (e.g. "cutting") are common among troubled youth. About 17% to 20% of high school students a year report having seriously considered suicide in the prior 12 months, and 9% indicate that they attempted to end their life. However, not all acts of deliberate self-harm spring from suicidal intentions. An estimated 13% to 18% of youth engage in acute (i.e. non-habitual) self-injurious behavior without having any suicidal intent. Such non-suicidal self-injurious behaviors usually include cutting, scratching, burning or hitting oneself. Although many people who injure themselves without suicidal intent have, at other times, been suicidal, the behaviors contain important differences in the time of crisis. Specifically, adolescents who are suicidal by definition wish to die, and they require help to stay alive. Adolescents who injure themselves without suicidal intent report that they do not wish to die, prompting one researcher to view non-suicidal self-injury as a "morbid form of self-help."

    This study will examine the intentions of self-harming adolescents and evaluate the clinical utility of several suicidal and self-harm rating scales in distinguishing serious suicide intentions from non-suicidal self-injurious behavior.

    Stevens, KarenDrugs Development Using Animal Models of Schizophrenia: Physiology and Pharmacology

    This project will attempt to gain a better understanding of the underlying mechanisms of sensory inhibition deficits

    Sensory inhibition deficits are commonly observed in schizophrenia and are thought to be related to certain cognitive problems and to hallucinations. Similar deficits have been found to occur spontaneously, or can be created via certain manipulations, in rodents. Using rodent models, we are attempting to identify the mechanism(s) underlying the deficit. We are also involved in the development of new drugs to treat the deficit. The primary method employed is electrophysiological recording of auditory evoked potentials, both acutely in anesthetized mice and in chronically implanted, awake and behaving rats. Current projects include investigation of new drugs, permanent correction of the deficit through gestational interventions, and studies of neurotransmitter receptor involvement through alteration of receptor levels via mRNA manipulations.

    Martin, LauraThe Effects of Smoking on Symptoms and Drug Treatment in Schizophrenia

    This project will examine whether or not individuals with schizophrenia who smoke have higher symptom levels and more impaired sensory gating than those individuals with schizophrenia who do not smoke.

    Clozapine is the most efficacious treatment for schizophrenia. This may be due to its ability to increase acetylcholine levels. Acetylcholine is involved with in every day processes such as motivation, pleasure and thinking. Many individuals with schizophrenia smoke tobacco and smoking destroys the ability of the nicotinic acetylcholine receptor to function, a process called desensitization. Smoking may therefore interfere with clozapine's effect. One way to test whether nicotinic receptor desensitization interferes with clozapine's effect is to look at how the brain processes repeated and unimportant sounds. This is called sensory gating and it is dependent on functional nicotinic receptors. If a smoker taking clozapine has a worse sensory gating than a nonsmoker, this is support for the hypothesis that smoking desensitizes nicotinic receptors and makes the illness worse. I will recruit 104 individuals with schizophrenia and examine variables collected from their illness history, assess their sensory gating, and check drug levels to see how they relate to symptom levels. A greater understanding of the effect of chronic smoking on the nicotinic acetylcholine system is necessary to maximize the potential benefit of current and future treatments of schizophrenia involving this system. It may also identify an additional harmful effect of smoking.

    Allen, MichaelEmergency Psychiatry Scholarship Project
    This project offers a great opportunity for students to participate in a research project from its inception. The project objective is to determine what symptoms of psychiatric disorders lead to emergency department presentation and to set standards for evaluation and treatment of these emergency presentations. Students can expect to experience a variety of clinical and performance improvement research experiences, including:
     
    • assessing patients in psychiatric emergencies
    • participating in group supervision of the other mental health professionals in emergency rooms
    • assisting in the collection and analysis of surveillance data regarding the prevalence and common emergency presentations of major psychiatric disorders, including suicidal ideation and behavior, agitation, aggression and addiction

    The project will attempt to set benchmarks for major performance indicators such as time to psychiatric assessment, minimum medical assessment and recidivism. The project is expected to lead to a number of peer reviewed articles.  An apt student may have the opportunity to coauthor reviews, perform peer review for journals and other scientific writing and editorial activities.

    The mentor is a former president of the American Association for Emergency Psychiatry (http://www.emergencypsychiatry.org) and the current vice president of the International Association for Emergency Psychiatry.  He is one of the founding members of a psychiatric emergency research collaboration modeled on EMNet (Emergency Medicine Network, http://www.emnet-usa.org/ ).  Members of this consortium include Johns Hopkins, Massachusetts General Hospital and others.

    Novins, DouglasEpidiemiology of Developmental Psychopathology: Implications for Mental Health Service Delivery

    Dr. Novins, a member of the research team at the National Center for American Indian and Alaska Native Mental Health Research (NCAIANMHR), conducts research critical for improving the mental health of American Indian children and adolescents. These include ongoing and completed studies in the areas of psychiatric epidemiology, developmental psychobiology, and mental health services research. Research opportunities include participation in every stage of the research cycle: 1) articulating and prioritizing research questions; 2) study design; 3) study implementation; 4) data analysis; and 5) information dissemination.

    Psychiatric Epidemiology: The NCAIANMHR has recently completed the first large-scale study of the prevalence of psychiatric disorders, related risk and protective factors, and service utilization among a multi-tribe sample of 3,086 American Indians age 15-54. Analyses will focus on a wide variety of issues, including prevalence of DSM-IV disorders, psychiatric comorbidity, alcohol and drug-related health disparities, other nosological issues such as the relationship between impairment and diagnosis, and the key correlates of psychiatric diagnostic status.

    Developmental Psychopathology: The NCAIANMHR is completing a series of linking longitudinal studies that follow a large sample (approximately 4,800 participants) of American Indian high school students into young adulthood (a total of 7 years of data). To date, analyses have focused on the development of psychiatric symptomatology (e.g., depression, suicidal ideation) and substance use among this sample.

    Mental Health Services Research: NCAIANMHR studies cover a number of areas encompassed by services research. Analysis of data from our epidemiological studies focuses on issues of service utilization, particularly the use of biomedical treatment and traditional healing options. Studies in the area of clinical epidemiology have examined the prevalence of psychiatric disorders and use of mental health services among American Indian juvenile detainees as well as the prevalence of comorbid psychiatric conditions among Indian youth receiving treatment at a residential substance abuse treatment facility and the relationship of comorbidity to treatment process and outcome. In addition, the NCAIANMHR is currently in the process of building its portfolio in two other areas of services research: quality of care and dissemination of research.

    Coors, MarilynThe Ethics of Legal Sanctions for Genetically-influenced Criminal Behavior

    The objective of this project is to explore the ethical issues of genetic-impacts on behavior. Examples of social-ethical-policy projects (student utilizes literature reviews, visits to clinics, attending case conferences, clinical care activities, etc.):

    1. If genetically-influenced brain abnormalities contribute to the patients’ disorders, can patients be held responsible for their behaviors, and what are the appropriate legal sanctions for their criminal behavior? (Drs. Sakai, Coors, Crowley)
    2. If these disorders have a life-long course, is short-term treatment appropriate and ethical? (Drs. Coors, Crowley, Sakai)
    3. Are these risk-prone adolescents able to protect themselves properly when giving consent or assent to participate in research projects? (Drs. Coors, Crowley, Sakai,)
    Feinstein, RobertEvidence-Base Medicine

    This is an ongoing three-year study, which involves the development, and prospective study of effectiveness of a three year EBM curriculum developed for psychiatric residents. We have developed 3 course, a psychiatric Evidence Based Medicine Examination, and 3 survey instruments. Our primary outcomes of interest include the development and use of EBM knowledge and skills and with a special emphasis on what will change physician behavior an encourage use of EBM during psychiatric outpatient visits

    This project will help students learn 6 major EBM skills, which can be applied to psychiatric and all medical patients. It is also an opportunity to learn about curriculum development, educational research, and novel teaching methods. Students on this project can pick an EBM area of interest, review the literature, write an Info Poems, develop novel EBM curriculum, develop new EBM teaching approaches, and write a poster or paper.

    Martinez, RichardThe Experience of Mental Illness and Ethics, Health Services

    In this project students will learn about the legal and forensic issues of insanity and competency by exploring the care and treatment of the mentally ill offender. Students will have the opportunity to interview and collect information on mentally ill offenders from various institutions including several departments of corrections, jails and outpatient community corrections sites. Ultimately, students will complete more than 20 interviews within the study sample. Because of the increasing numbers of mentally ill sentenced and treated within the criminal justice system, understanding the relationship between mental illness and the criminal justice system is the focus of this project.

    This method of research in this project is qualitative, drawing on the practice within anthropology of ethnographic studies. Students will have the opportunity to do preliminary literature research in order to examine the current social and political realities of the relationship between the criminal justice system and mental illness. A paper, as described in the "ethics/humanities" domain, will be required at the end of research.

    Leonard, SherryExpression of Nicotinic Receptors in Postmortem Brain

    The purpose of this project is to determine the expression of three nicotinic receptor subunits in postmortem brain of control and schizophrenic smokers and non-smokers.

    We have shown that schizophrenics have decreased levels of both high- and low- affinity nicotinic receptors in multiple brain regions (Freedman et al 1995; Breese et al 2000) . Recently we have found that the a 7 nicotinic receptor is differentially regulated by smoking in schizophrenic hippocampus (Mexal et al 2005) . The proposed experiment will investigate the expression of nicotinic receptors in a second brain region, cingulated gyrus, which has been implicated in cognitive deficits in the disorder. The student would work with two technicians and a postdoc in the laboratory to measure mRNA levels (QRTPCR), protein levels (western blot), and surface receptors (ligand binding) for three nicotinic receptor subunits, including a 7, a 4 and b 2. The a * receptor constitutes the low-affinity nicotine binding and a 4 b * receptors the high-affinity binding (Leonard Bertrand 2001) . Postmortem cingulated gyrus from 20 controls and 20 schizophrenics will be analyzed. Smoking status is known. These experiments will provide information on expression and regulation of three receptor subunits in the same tissue, an important replication of previous work in the laboratory. The student would how to handle human postmortem tissue and a variety of molecular biological techniques.

    Barnes, MarlaFactors Affecting Prescribing Practices of Physicians at a Public Health Hospital

    This is truly a mentored project in which the student will actively choose his or her own research hypothesis, variables, and methods of collecting and analyzing data with guidance from Dr. Barnes.

    The objective of the research is to determine the relationships, if any, between identified factor or factors (student’s choice) on variations in prescribing practices or response to treatment within certain patient populations. Students will research a factor/variable of his/her choice and its impact on prescribing practices or treatment response and then design a hypothesis and method of collecting and analyzing the data. Data may be collected from electronic records, patient interviews, psychiatrist interviews, or other sources the student has identified.  

    Prescribing practices of psychiatrists vary depending on physician and system factors, such as formulary limitations, managed care directives, level of patient care, etc.  Dr. Barnes will oversee the project and assist with design and writing of the paper but the product will represent the student’s ideas and conclusions. First author, if a paper is generated, will depend on who writes the majority of the material, but ideally will be the student researcher.

    Requirements include independence in generating a research topic, access to web-based journals and search databases (such as Ovid) and comfort level with interviewing patients and/or staff, and an interest in psychopharmacology. Access to medical records and knowledge of how to collect information from the electronic record will also be helpful.  Writing skills and knowledge of research paper design will be required. Knowledge of statistics used in data analysis helpful, but not required, in particular analyses of variance. Practically speaking, a paper or poster presenting the findings would be generated.

    Miklowitz, DavidFamily Focused Treatment in Adolescents with Bipolar Disorder

    Dr. Miklowitz is Professor of Psychology and Psychiatry at the University of Colorado (Boulder and Anschutz Medical Campuses), and for 2006-2007 was a visiting professor in the Department of Psychiatry at Oxford University. He completed his undergraduate work at Brandeis University and his doctoral (1979-1985) and postdoctoral (1985-1988) work at UCLA. His research focuses on family environmental factors and family psychoeducational treatments for adult-onset and childhood-onset bipolar disorder.

    Dr. Miklowitz has received the Joseph Gengerelli Dissertation Award from UCLA (1986), Young Investigator Awards from the International Congress on Schizophrenia Research (1987) and the National Alliance for Research on Schizophrenia and Depression (NARSAD; 1987), a Research Faculty Award from the University of Colorado (1998), and a Distinguished Investigator Award from NARSAD (2001). He is the recent recipient of the 2005 Mogens Schou Award for Research from the International Society for Bipolar Disorders.  He has received funding for his research from the National Institute of Mental Health, the John D. and Catherine T. MacArthur Foundation, and the Robert Sutherland Foundation.

    Dr. Miklowitz has published more than 170 research articles and book chapters on bipolar disorder and schizophrenia, and three books, including The Bipolar Disorder Survival Guide, a bestseller. His articles have appeared in the Archives of General Psychiatry, the American Journal of Psychiatry, the British Journal of Psychiatry, the Journal of Nervous and Mental Disease, Biological Psychiatry, the Journal of Consulting and Clinical Psychology, and the Journal of Abnormal Psychology. His book with Michael Goldstein, Bipolar Disorder: A Family-Focused Treatment Approach (Guilford), won the 1998 Outstanding Research Publication Award from the American Association for Marital and Family Therapy. His latest book, also with Guilford, is titled Bipolar Teens: What You Can Do to Help Your Teen and Family.

    Taussig, HeatherFostering Healthy Futures: A Randomized Controlled Trial of a Preventive Intervention for Maltreated Youth in Foster Care

    This project aims to understand normative as well as problematic development among American Indian youth.

    This project involves the statistical analysis of longitudinal survey data from 1,292 youth covering six years with seven data points. The constructs assessed by survey cover a broad list of topics concerning normative development: e.g., ethnic identity, depressive symptoms, competencies, anxiety symptoms, substance use and misuse, social support, and stressful life events, just to name a few. We are focusing on understanding both how some youth develop problems in young adulthood and how others grow into fully functioning young adults.

    Rojas, DonFunctional Organization of Audition in Schizophrenia

    The objective of this project is to localize and map primary auditory cortex responses in people with schizophrenia and matching control populations.

    The Neuroimaging Lab uses magnetoencephalograpy (MEG), MRI, and fMRI to examine anatomical and functional differences of the auditory cortex in people with Schizophrenia. Alterations in basic auditory perceptions in people with schizophrenia have been noted in many studies. However, little is known regarding the brain mechanisms responsible for these changes, or how such changes relate to the salient clinical features of the disorder. We have previously noted changes in tonotopy and cortical tuning in the secondary auditory cortex of schizophrenia patients. We now are focusing on the primary auditory cortex by comparing its functional organization to the secondary auditory cortex. In addition, we intend to examine whether the experience of auditory hallucinations may influence the auditory cortical organization in schizophrenia.

    Students will assist in the collection and analysis of MEG and MRI data and participate in the administration of neuropsychological evaluations.

    Rojas, DonGamma-Band Dysfunction as a Local Neuronal Connectivity Endophenotype in Autism

    This project aims to evaluate the familiality of a putative new endophenotype, dyscfunctional gamma-band phase locking, in the first degree relatives of people with autism. Magnetoencephalography (MEG) will be the primary measurement strategy. MRI scans will also be required.

    It has been proposed that general abnormalities in structural and functional neuronal connectivity may underlie many of the triad of deficits observed in autism. A limited number of deficits at the neuronal level, widely expressed in multiple neurobehavioral systems could provide substantial explanatory power in autism. For example, abnormal temporal binding and weak central coherence may be related to alterations in brain functional and/or structural connectivity. The long-term goals of this application will be 1) to examine a putative electrophysiological underpinning of such problems, neuronal synchronization ability in gamma band of the EEG and MEG, 2) to evaluate the familiality of evoked and induced gamma power and phase-locking factor in first degree relatives of people with autism, 3) in follow-up studies associate such deficits with GABAergic dysfunction and GABA receptor candidate genes and, 4) evaluate pharmacological interventions that directly target GABA function. Gamma band oscillatory activity has been associated with intrinsic GABAergic activity in animal and computational models of the neocortex and is thought to play an important role in binding and central coherence.

    Hopfer, ChristianThe Genetics of Conduct Disorder and Drug Dependence in Adolescents

    The objective of this project is twofold: 1)to determine what are the genetic contributions to adolescent conduct disorder and drug abuse, and 2) to use neuroimaging to assess what brain regions contribute to the symptoms of conduct disorder and substance abuse.

    We are collecting a large sample of families of youth with drug dependence and conduct disorder for analyses of the familial transmission of these disorders. The primary opportunity for involvement in this project, is involvement in the data collection process. This would primarily involve training in and then conducting recruitment of subjects; providing direct contact with these subjects. There are a number of other projects that are also currently in various phases of development, including the use of neuroimaging to identify brain regions involved in adolescent behavioral disorders and drug dependence. Students could be involved in various projects depending upon interest and commitment. Students will gain insight into the processes involved in research. Opportunities to develop or assist in various publications are also an option.

    Waldo, MerilyneHippocampal Functioning and the Virtual Water Maze Test

    This study is designed to provide pilot data and figures for grant submission purposes.

    In animals, the Morris Water Maze is know to be a sensitive indicator of hippocampal functioning. This relationship has not been established in humans. This project is designed to examine the role of hippocampal functioning in controls and in patients with schizophrenia (who, as a group, are known to have deficits in both the anatomy of and functioning in the hippocampus) and performance on a virtual Morris Water Task (VMWT). The VMWT is a computerized version of the Morris water task for rodents, a test that measures spatial learning and navigation. Control subjects and schizophrenic patients on several atypical antipsychotic medications will receive MRIs while being tested on the water maze test.

    Tregellas, JasonHippocampal Functioning and the Virtual Water Maze Test

    This study is designed to provide pilot data and figures for grant submission purposes.

    In animals, the Morris Water Maze is know to be a sensitive indicator of hippocampal functioning. This relationship has not been established in humans. This project is designed to examine the role of hippocampal functioning in controls and in patients with schizophrenia (who, as a group, are known to have deficits in both the anatomy of and functioning in the hippocampus) and performance on a virtual Morris Water Task (VMWT). The VMWT is a computerized version of the Morris water task for rodents, a test that measures spatial learning and navigation. Control subjects and schizophrenic patients on several atypical antipsychotic medications will receive MRIs while being tested on the water maze test.

    Hunter, SharonInfant Behavior and Psychophysiology

    The objective of this study is to characterize development of certain physiological variables in infants (low and high risk for serious mental illness, i.e., schizophrenia).

    We are collecting data on the development of several psychophysiological variables in infants will little to no genetic risk for schizophrenia, those with a parent with the disease, and infants prenatally exposed to nicotine. Currently, we are collecting evoked potentials to pairs of auditory clicks (p50) and to tones presented at varying intervals (MMN). We are also gathering information on infants’ abilities to detect patterns in the presentation of visual images using eye movements. Most of these studies are conducted with infants from 2 to 6 months of age.

    Tregellas, JasonThe Influence of Nicotinic Receptor Polymorphisms on Brain Structure and Function in Schizophrenia

    This project seeks to determine whether polymorphisms in the apha-7 nicotinic receptor gene are related to brain structure and function in schizophrenia

    This project involves evaluating data from functional magnetic resonance imaging (fMRI) studies of eye movement and auditory gating deficits in schizophrenia in the context of information about polymorphisms in the alpha-7 nicotinic receptor gene. This includes organizing and analyzing both structural and fMRI data from controls and subjects with schizophrenia. The student will become familiar with the design and execution of fMRI experiments and learn how to analyze neuroimaging data. This project is recommended for students who are very computer savvy, as a primary task will be gathering and organizing imaging data from several sources (PC, LINUX), and analyzing the data, which will include identifying neuroanatomical landmarks in MRI images, and running scripts to preprocess and perform statistical analysis on the data. In addition to analyzing data already acquired, students will have the opportunity to run new subjects on our new 3T MR scanner at Anschutz Medical Campus.

    Frankel, KarenLiterature and Chart Review on Psychotropic Medications for Preschoolers with PTSD

    The objective of this project is to learn what is known in the field about treating symptoms of PTSD in young children with medications and examine the use of medications in a daytreatment program for preschoolers.

    Increasing numbers of very young children are experiencing traumatic events today. A small group of children exposed to these events develop the full clinical syndrome of Post-traumatic Stress Disorder. The Kempe Therapeutic Preschool is a day-treatment program specializing in assessing and treating preschoolers with histories of maltreatment and trauma. Children are provided with individual and family therapy, case management and a therapeutic milieu. Each child also receives a psychiatric evaluation and medications are prescribed when warranted. Recently, anecdotal experience at the Preschool has indicated that a subset of children with PTSD treated with Clonidine responded with excessive sedation and irritability. Treating this group of children with Guanfacine has appeared to be more effective with less side effects. However, there is little research to corroborate these observations.

    The student will work with the attending psychologist and child psychiatrist to learn about the use of psychotropic medications to treat symptoms of PTSD in young children. The student will review the literature regarding the treatment of PTSD in children, medications used, any clinical trials. There also may be an opportunity to review charts of children in the Preschool to gather preliminary data related to their medication regimens and responses.

    Ross, RandyLiving with a Child with Severe Mental Illness

    This project will work to describe the impact on children and their families of a childhood psychotic mental illness such as schizophrenia or bipolar disorder.

    While psychotic mental illnesses like schizophrenia and bipolar disorder often develop in adolescence, there are less common cases where symptoms start between 4 and 12 years of age. The impact of a psychotic illness on the child and there family has not been well-described. Examples of incompletely described effects including questions like “What is the impact on the life of the family”, “How does the illness of one child affect goals of other family members,” “What is the financial impact,” and several similar questions.

    Students will have the opportunity to do preliminary literature research in order to examine the current knowledge about these disorders in children. Students on this project would learn to interview children about having the disorder and interview families about the impact of the illness on their family. The method of research in this project is qualitative.

    Hepburn, SusanNational CADDRE Study: Child Development and Autism

    The objective of this study is to join a national network of investigators to study over 2500 young children across the country with autism, with other neurodevelopmental disabilities, and typical controls to learn more about: (1) specificity of the atuism phenotype; (2) associations between autism and severe biological indices, including measures of immune function, hormone levels, gastrointestinal functioning, genetic features, and sociodemographic factors. Study involves testing theories concerning associations with biological and environmental risk factors associated with autism.

    Children with either autism, history of typical development, or another known disability participate in a comprehensive evaluation of symptoms, skills, and abilities. Parents complete several interviews concerning environmental exposures, family history, work history, etc. Data are pooled with 6 other sites across the country in order to obtain adequate power to sufficiently test hypotheses about risk factors. Lab sessions will occur several times per week, will be filmed and include direct assessments of child behavior (standardized and laboratory specific), interviews with parents, checklists or parents and teachers, and full medical review. Biological samples are taken for genetic analysis, a dysmorphology study, and inquires into gastrointestinal functioning.

    Davies, RobertMartial Arts as Early Intervention for Teen Drug Abuse

    The student on this project will develop and do initial testing of innovative new intervention for teen drug users combining cognitive behavioral therapy concepts for substance use with traditional martial arts training.

    Currently beginning a small randomized trial of the intervention which will compare community “treatment as usual” and “karate as usual” with the martial arts intervention. The study is being conducted at the IMA dojo in Louisville, Colorado.  Students’ participation would involve researching and writing (along with PI) a related article (possibly on demographics and recruitment of this poorly studied population) for submission to peer reviewed journal as well as a scientific poster for presentation at a national meeting.

    Waldo, MerilyneMetabolic Risks Associated with Typical and Atypical Antipsychotic Medications

    This project will work to establish the impact of antipsychotic medications on risk of metabolic syndrome in Veterans.

    When initially made available, atypical antipsychotic medications (AA) were embraced with much enthusiasm because of their decreased risk of motor side effects and hopes of greater efficacy compared to standard antipsychotic agents (SA). Indeed clozapine was ultimately found to have greater efficacy in treating psychosis symptoms than both the SAs and other AAs and as such remains the gold standard in this regard. Unfortunately, although AAs offered unique advantages compared to SAs, they have been increasingly implicated in metabolic syndrome (MS), a process involving abnormalities of glucose and lipid metabolism and hypertension. This problem prompted the FDA to issue a warning that AAs are associated with metabolic risk. Although the FDA issued this warning for all drugs of this class, it is not clear that all AAs carry the same metabolic risk. In addition, it is also not clear that AAs produce greater risk than all of the SAs. The purpose of this study is to evaluate metabolic risk factors of patients prescribed AA currently available in the US, aripiprazole, clozapine, olanzapine, quetiapine, risperidone and ziprasidone, and compare these to the SAs haloperidol and fluphenazine.

    Griffith, JayMetabolic Risks Associated with Typical and Atypical Antipsychotic Medications

    This project will work to establish the impact of antipsychotic medications on risk of metabolic syndrome in Veterans.

    When initially made available, atypical antipsychotic medications (AA) were embraced with much enthusiasm because of their decreased risk of motor side effects and hopes of greater efficacy compared to standard antipsychotic agents (SA). Indeed clozapine was ultimately found to have greater efficacy in treating psychosis symptoms than both the SAs and other AAs and as such remains the gold standard in this regard. Unfortunately, although AAs offered unique advantages compared to SAs, they have been increasingly implicated in metabolic syndrome (MS), a process involving abnormalities of glucose and lipid metabolism and hypertension. This problem prompted the FDA to issue a warning that AAs are associated with metabolic risk. Although the FDA issued this warning for all drugs of this class, it is not clear that all AAs carry the same metabolic risk. In addition, it is also not clear that AAs produce greater risk than all of the SAs. The purpose of this study is to evaluate metabolic risk factors of patients prescribed AA currently available in the US, aripiprazole, clozapine, olanzapine, quetiapine, risperidone and ziprasidone, and compare these to the SAs haloperidol and fluphenazine.

    Kaufman, CarolMultilevel Analysis of American Indian Mental Health, Illness, and Service Use

    The goal of the project is to understand the familial, community, and geospatial context of mental health, illness, and service use in 2 American Indian tribes.

    This secondary data analysis project uses multivariate and GIS techniques to assess family, community, and geospatial factors associated with mental health and service use among American Indians.
    Examples of methods used in this project:

    • Surveys—Computer-assisted (data already collected and cleaned)
    • Literature review—published GIS studies of mental health, multilevel analytic applications, American Indian mental health services and programs
    • Data analysis—Multivariate analytic methodologies (especially multilevel ones) applied to psychiatric diagnoses, sub-syndromal disorders, and mental health service use, including biomedical and traditional practices. GIS-generated variables regarding distances to health services will be assessed in econometric-type analyses of medical utilization choice.

    Project activities require creativity, curiosity, focus, confidentiality, and objectivity. Organizational skills are required. Writing skills and are helpful, as all components of the project require clear written documentation and effective communication with other project staff members. Background in data analysis or data management is required for participation in the data analysis component.

    Leiferman, JennMy Baby, My Move: A perinatal Physical Activity Intervention

    This project will attempt to develop a perinatal physical activity intervention to reduce perinatal mood disorders and excessive antenatal weight gain.

    The main objective of this study is to develop an antenatal physical activity intervention to promote engagement in regular leisure physical activity (RLPA). In order to inform the development of the intervention, qualitative studies were conducted to better understand what factors facilitate and prevent pregnant women from engaging in RLPA and to what extent these may differ among pregnant women who currently engage in RLPA versus those who do not. Findings from these qualitative studies coupled with evidence-based practices, will inform the development of the physical activity intervention. In the Summer of 2009, we will pilot test the intervention in pregnant women to provide the necessary information (e.g. effect sizes, adherence and attrition rates) to guide future implementation of a large-scale, randomized controlled physical activity intervention trial in the antenatal period. The hypotheses to be tested in the larger RCT trial include 1) women who engage in the physical activity intervention will report an increase in RLPA, decrease in antenatal weight gain, antenatal depression and perceived stress compared to their control counterparts.

    Jervis, LoriNative Elders and Cognitive Impairment

    This project seeks to explore the cultural phenomenology of cognitive impairment within an American Indian community, and to test the acceptability and validity of a culturally modified dementia evaluation among Native elders.

    This project utilized focus groups with community members to assess and modify measures for cultural relevance; cognitive assessments with 140 Native elders; and ethnographic follow-up interviews with 50 elders. The scholar who works on this project will assist with data analysis and manuscript writing. Possible topics include a cultural examination of performance on cognitive tests; cultural perspectives on cognitive impairment; and notions about elder mistreatment. The exact topic area will be determined according to the interests of the scholar and the needs of the Principal Investigator. The ultimate goal is to co-author a peer-reviewed manuscript based upon these analyses.

    Adams, CathyNeuroanatomy and Nicotonic Receptors in Hippicampus: Relationship to Risk Factors in Schizophrenia
    Dr. Adams’ lab is investigating how hippocampal development is modified by alterations in the density and/or function of the α7 subtype of nicotinic receptor. The α7 receptor is significantly reduced in postmortem brain from individuals with schizophrenia, a disease that is postulated to result from abnormal brain development. The α7 receptor has been implicated in the regulation of several developmental processes. It is possible, therefore, that the schizophrenia-associated paucity of α7 receptors may underlie some aspects of the abnormal brain development thought to occur in this disease. This hypothesis is being tested by examining hippocampal development in strains of mice that differ with regard to their hippocampal α7 receptor density. The lab uses an array of anatomical techniques in these studies, including autoradiography, immunohistochemistry and Golgi staining. Currently, normal hippocampal development is being characterized in several mouse strains. Future studies will examine how gestational exposure to nicotinic agonists alters normal hippocampal development in these mice.
    Laudenslager, MarkNeuroendocrine Function in Medical Illness and Psychiatric Disorders
    Saliva provides a medium for assessing the function of the hypothalamic pituitary adrenal axis that is relatively noninvasive from the patient's/subject's perspective. We are collecting saliva samples from a variety of study groups, including astronauts during flight missions, caregivers of several groups of cancer patients, American Indians with posttraumatic stress disorder, premature infants on a NICU, autistic children, and typical and atypical adolescent populations. These studies offer an opportunity to interact with other investigators as well. From these saliva samples, we can follow diurnal variations in cortisol and dehydroepiandrostone (DHEA). The student will have an opportunity to learn about subject recruitment, survey research, and assessment of diurnal variation in steroid hormones as stress markers. Students will be involved in data entry and analysis to the extent that they are interested in this process. Directed reading will be included allowing the student(s) to appreciate the research problem(s) we are addressing in this laboratory. The students will be required to complete human subjects research training if they have not completed it at this time.
    Freedman, RobertNew Medications for the Treatment of Schizophrenia

    This project aims to develop and test new treatments for persons with schizophrenia.

    The Schizophrenia Research Center is dedicated to using molecular biology and neurobiology, at both the basic and clinical level, to design new treatments for schizophrenia. One such treatment, based on our discovery of a gene that influences inhibitory neuron function in schizophrenia, is currently under investigation. Students can participate in the clinical trial itself, by learning to interview and assess patients both physically and mentally. They can also participate in molecular analyses relevant to the trial, such as learning to genotype participants, or in related imaging studies using the department’s functional magnetic resonance imaging equipment and related physiological monitoring techniques. Students have learned to obtain and analyze brain images and electroencephalographic evoked potentials. Students can also participate in basic electrophysiological studies in animals to model the mechanism of the treatment response.

    Olds, DavidNurse Home Visitation for Primary Prevention
    David Olds directs the Prevention Research Center for Family and Child Health (PRC).  The PRC has three major research foci. The first is the examination of the long-term impact of a program of prenatal and infancy home visiting by nurses on the health and development of low-income, first-time mothers and their families. With funding from the National Institutes of Health, other federal agencies and private philanthropies, longitudinal follow-ups of randomized trials of this program are being conducted in Elmira, New York; Memphis, Tennessee; and Denver, Colorado. The longitudinal follow-ups look at program effects on maternal economic self-sufficiency, substance abuse and children's adaptive functioning, including mental health, criminal behavior and productive life-course as the children reach adolescence and young adulthood. A recently funded follow-up of the Elmira trial is examining the long-term impact of the program on the adult life-course of children whose mothers were enrolled in the study during pregnancy and is examining the moderating impact that genetic polymorphisms may play in moderating the effect of the program on antisocial behavior and depression.

    In recent years, the PRC has begun a process of careful replication of the nurse home visitation program tested in these studies (now called the Nurse-Family Partnership program) in an effort to make the services available to a large portion of low-income pregnant women in the US. The national replication of the program is managed by a nonprofit organization known as the Nurse-Family Partnership (NFP). The NFP national office helps communities develop their capacity to implement the program and provides training and technical assistance to nurses who deliver the services.

    The second major focus of the PRC is now on conducting research aimed at improving the NFP program model with the use of randomized, controlled trials of augmented versions of the NFP model. Randomized trials of these program augmentations, conducted in the system of program sites around the country, include studies of interventions designed to help nurses deal more effectively with maternal depression and to more fully engage participants in the program.

    The third and growing focus of work at the PRC in recent years has been on helping colleagues in other societies develop and test the program in their contexts. Leaders at the Center, for example, are involved in supporting the development and testing of the program in the Netherlands and in Germany. In general, we have taken the position that the program must be adapted, tested and found to be effective before it should be implemented in other countries and contexts.

    During the last year, the Center has incorporated a growing body of research focused on improving assessment-based service-delivery in center- and home-based interventions, such as Early Head Start and Head Start, with the goal of improving literacy, relationship-functioning and school-readiness in children from at-risk families.

    The PRC is also recognized for its periodic reviews of early intervention literature; its support of early intervention programs wishing to improve their effectiveness; its consultation with government and private agencies; and its training of prevention scientists.
    Brenner, LisaOngoing Projects Related to Suicide and/or Traumatic Brain Injury (TBI)
    Dr. Brenner is in the process of completing a study funded by the Colorado Traumatic Brain Injury Trust Fund titled: Traumatic Brain Injury and Post Traumatic Stress Disorder: The Exploration of a Combination Syndrome. She is also involved with a number of different TBI-related research projects both at the Denver VA Medical Center and at Fort Carson. Her areas of research interest include: suicide, TBI, TBI and co-occurring psychiatric disorders, and deployment-related health issues.
    Clyman, RobertPolicy and Foster Care
    Dr. Clyman's research focuses on children in the foster care system.  Two broad areas are under investigation.  The first is developmental risk and prevention in infants placed in foster care, and the second concerns the relations between policy and service system variables and child and family outcomes.  He is beginning a study of developmental risk in a city-wide sample of infants placed into foster and kinship (relative) care, examining parent-infant interaction, infant emotional development, and access to health care and developmental services.  An infant mental health-based early intervention program for these infants is under development.  In a second study, data are being analyzed on differences between 4-6 year olds who are in foster or kinship care.  The study focuses on similar constructs as indicated above. It has a particular emphasis on early onset disruptive behavior problems.  In this laboratory, there are opportunities for post-doctoral fellows to work in developmental psychopathology, preventive intervention, and services research with children in the child welfare system.
    Spicer, PaulPoverty, Stress, and American Indian Child Development: Preventing Obesity in American Indian Infants and Toddlers

    Comprehensive developmental assessment of American Indian infants and toddlers; the development and testing of a perinatal obesity prevention program.

    One slot is available working across two projects that are both focused on the needs of American Indian infants and their parents. The first, “Poverty, Stress, and American Indian Child Development,” is funded by NICHD to explore the developmental trajectories of infants and toddlers from a northern plains tribe, with a specific focus on the impact of poverty on the community, home, and family contexts in which child development occurs. The second, “Preventing Obesity in American Indian Infants and Toddlers” is a pilot project to develop and test materials designed to establish healthy patterns of eating and activity from birth in this same northern plains tribe.

    Browne, JoyPreterm Infant Learning to Organize One's Self

    Dr. Browne's work focuses on neurobehavioral organization of infants, particularly those at high risk for health problems and developmental delay.  Her studies investigate behavioral and physiological organization, and intervention strategies to promote organization in preterm and high risk infants. Investigation of typical newborn intensive care unit practices which impact the physiological and behavioral organization of infants, regulatory processes between infants and their primary caregivers, as well as between multiple birth siblings is ongoing.  Specific studies include the developmental aspects of infant feeding, the impact of handling practices and painful interventions on infant behavioral and physiologic organization, and the impact of cobedding practices on the behavioral organization and outcomes of multiple birth siblings.

    Dr. Browne has also developed and is currently studying an intervention program for infants and their families as they transition from the newborn intensive care to their home and community. Infants born preterm or who are at high risk for developmental delay are identified in the intensive care unit, and followed by community professionals who have been trained in the Family Infant Relationship Support Training program. Studies of the effectiveness of the training, as well as the outcomes of the infants and parents who are followed are the target of ongoing studies.

    Corsi, KarenProject Safe: Street Outreach to Recruit Injection Drug Users into HIV Prevention and Drug Abuse Treatment Research
    The objective of this project is to compare behavioral interventions that help injection drug users (IDUs) reduce their risk of acquiring HIV and HCV; to implement case management interventions to assist crack using minority women in entering drug treatment.

    Project Safe is a research project of the Division of Substance Dependence and has been in existence since 1987, under the direction of Dr. Robert Booth and Dr. Karen Corsi, with funding provided by the National Institute on Drug Abuse and the Substance Abuse Mental Health Services Administration. The goal of Project Safe is to reduce the risk of HIV among injection drug users and crack cocaine smokers. Drug users are at high risk of contracting and spreading HIV through sharing needles and having unprotected sex. A team of outreach interventionists recruit drug users from the streets of Denver and eligible clients receive the following services:

    • Behavioral interventions such as Harm Reduction, Motivational Interviewing and Strengths-Based Case Management, to promote the reduction of HIV risk behaviors and provide support for drug treatment
    • Free testing for HIV, Hepatitis C and Syphilis
    • Structured interviews conducted by research staff.
    • Free HIV prevention materials

    Our ability to provide these services is contingent on a strong research focus in which we systematically test different intervention strategies for their effectiveness in reducing risk behaviors. Over 150 journal articles, book chapters, and presentations (national and international) have been produced through Project Safe.

    Beresford, ThomasPsychological Adaptation to Illness

    The purpose of this project is to sort adaptive mechanisms versus depression and to establish the prognostic value of the adaptive mechanisms. In this process, the student will necessarily gain experience in talking with and listening to patients with what are often frightening illnesses. Students will gain an understanding of the impact of cancer, liver disease, and other conditions on the lives of its sufferers, as well as the remarkable capacity humans possess for adjusting to health crises. Students will participate in gathering, entering and analyzing data, and writing research reports.

    Ego defense mechanisms (coping styles) can vary from outright ignoring illness at one extreme to advancing the knowledge in order to assist others in facing the same illness, at the other. Recognizing and treating less mature or less effective coping styles provides information for clinical decisions. This can offer benefits in maximizing cancer symptom recognition and completion of cancer treatment regimens, while improving clinical recognition of when anti-depressant medications are or are not appropriate. Data sources will include standardized interview questions and cortisol sampling.

    Hepburn, SusanPsychosocial Intervention for Anxiety in Children with Autism

    This study is designed to evaluate the effectiveness of intervention as well as address several questions regarding assessment methodology. Randomized trial (wait list control) of modified cognitive-behavioral, family-focused intervention program for the treatment of anxiety symptoms in children with autism spectrum disorders;

    Children with high-functioning autism and significant anxiety and one or both parents attend a group, family-focused intervention for 14 weeks. Treatment includes psychosocial, cognitive-behavioral strategies, family systems work, and exposure/response prevention protocols. Assessments of child and family functioning are conducted before and after treatment, as well as at 6 months follow-up.

    Feinstein, RobertQuality and Effectiveness of Medical School Didactics and/or Clinical Rotations at the University of Colorado Medical School

    To assess the quality and effectiveness of didactics and/or Clinical Rotations provided during medical school. Emphasis on assessment of psychiatry/ behavioral medicine with in the medical school is suggested as an area of focus. However, any area of medical school curriculum can also be the focus.

    Teaching of core curriculum in Phase I, II, III, & IV vary in their quality and effectiveness, based on the topic, site, teaching methods used, the quality of the speaker, and preparation of the students. Ongoing evaluation with a goal of improving the educational program for medical students is the primary goal. Your program evaluation can focuses on these questions related to any aspects of the Medical School curriculum. Examples of methods used as part of program evaluation include:

    1. Focus groups
    2. Interview/ Surveys with key stakeholders
    3. Surveys—telephonic, paper-and-pencil, web-based
    4. Literature review—published standards, applicable guidelines, model programs
    5. Background review—program manuals, website, policies and procedures, curricula
    6. Data analysis—success or completion rates, competency measures, financial outcomes, comparison to benchmarks

    Program evaluation requires creativity, curiosity, focus, and objectivity. Writing skills are required, as evaluation findings and recommendations are generally summarized in a written report. Other forums for presenting results can include formal oral presentations, presentation to curriculum groups, poster presentation, conference presentation, or peer review publication may also be used.

    Rumbaugh Whitesell, NancySelf-Concept Among American Indian Adolescents: The Impact of Culture on Developmental Trends

    This project aims to understand how cultural context relates to the development of self-concept among American Indian adolescents and young adults

    The development of the self-system has been the focus of a tremendous amount of research for many decades, and the lion’s share of the attention to self development has been directed toward adolescence. However, until recently, the role of cultural context in the construction of self has not been carefully examined, despite growing recognition of the role culture plays in this development. Research on self-concept development among American Indian adolescents and young adults has been particularly scarce.

    Participation in this project would involve the statistical analyses of longitudinal survey data from two linked longitudinal studies of American Indian adolescents and young adults. Analytic techniques to be employed include latent growth curve modeling, growth mixture modeling, and latent transition analyses. Using these techniques, we will explore developmental trajectories of both the level and stability of self-esteem, self-agency, and cultural identity and relate these to structural factors (e.g., gender, tribe), putative causes of differential self-concept development (e.g., exposure to adversity, relationships with parents), and potential outcomes (e.g., internalizing and externalizing problems).
    Wamboldt, MarianneSeroquel for adolescents with bipolar disorder or schizophrenia

    This is a clinical trial examining the efficacy and safety of quetiapine (Seroquel ®) for children and adolescents with either bipolar I disorder (acute mania), or schizophrenia.

    Subjects are recruited from the inpatient psychiatry units, the emergency department, or the outpatient clinics at The Children's Hospital. Each subject requires a standardized psychiatric interview to carefully assess all clinical symptomatology, utilizing the Kiddie-SADS-PL. Subjects also receive standardized ratings of their symptoms on a weekly basis. The bipolar trial lasts three weeks; the schizophrenia trial lasts six weeks. Patients from either trial are eligible for a 26-week, open-label study, where they receive weekly ratings of symptoms and side effects.

    Students will first need to attend the CoMIRB research training course to become familiarized with ethical and practical issues regarding clinical research. They then would be encouraged to learn the interview and rating scales, and to perform these with study personnel. Students will get a good exposure to issues involved with clinical research including recruitment and screening issues, standardized assessments, and management of patients on protocols. They will also get to interview a number of interesting child and adolescent patients and their parents.

    Frank, GuidoSet Shifting in Children and Adolescents with Major Mental Disorders

    Objective: Abnormal set shifting – an aspect of impaired cognitive flexibility – occurs in various major psychiatric disorders. It has been hypothesized to be an endophenotype, or a genetically determined behavioral abnormality, in Major Depressive Disorder (MDD) and anorexia nervosa (AN).

    Methods: In this study we will recruit age and gender matched adolescents (12-17 years of age) with either Major Depressive Disorder (n=15), Anorexia Nervosa (n=15) or healthy controls (n=15). Subjects will complete a careful diagnostic assessment as well as self assessments. Subjects will perform two set shifting tasks (“Houses & Castles Task”, “Gabor Task”).

    Aims and Hypotheses: The aim is to test the behavioral response of the participants to the set shifting task (“Houses & Castles Task”, “Gabor Task”). Subjects have to learn rules how to categorize images by various attributes. The rule that is applied changes during the task application, and we hypothesize that both the MDD and AN groups will have deficits with rule learning, expressed by a longer time to learn the new rule compared to the control subjects.
    The results of this study will be used to support larger grant funding that includes brain imaging in the future.

    Weissberg, MichaelSleep and its Disorders in Children and Adults
    This project will help students learn about sleep and its disorders. Sleep disorders are increasingly recognized as contributing to medical illness (e.g. hypertension) and psychiatric illnesses (e.g. depression). Recognizing and treating sleep disorders can provide long-term benefits. Students on this project can pick an area in sleep of interest, review the literature, collect data and write a poster or review paper.
    Chessick, CherylInpatient Psychiatric Medical Student Projects
    The objective of this project is to understand if patients follow directions at discharge; if they are able to maintain on medications and in treatment as recommended during their inpatient stay.

    Follow up treatment including psychiatric appointments and medications are a challenge for many patients leaving the hospital. Many patients do not choose, or are not able to obtain and maintain in treatment. We would like to know who does follow up and if there are any factors that positively affect their following up after hospitalization. This area has not been explored in much detail from our unit so the medical student would have a lot of room to explore options with the attending.

    Wamboldt, MarianneSymptom Perception in Pediatric Asthma

    Learn how to formulate a research question utilizing an existing database, perform a literature search for relevant background information, and do basic statistical analyses with qualitative and standardized clinical data. Clinical research question must be in the area of symptom perception in pediatric asthma.

    From a multi-site study of symptom perception in adolescents with asthma, three groups of adolescents have been recruited and tested: those with a life threatening asthma attack, those with non-life threatening asthma, and non-ill controls. Literature has suggested that inaccurate symptom perception is a risk factor for life threatening asthma episodes. All subjects are matched for age, gender and ethnicity. Data has already been collected on adolescents’ perceptions of their breathing status during a methacholine challenge test, as well as during a typical asthma attack. Qualitative descriptors of the sensations have been collected, and grouped into key areas. Data on anxiety symptoms, depressive symptoms, and severity of asthma are also available in this sample of approximately 250 subjects. Students can help to formulate questions and hypotheses about this data, do data analysis with supervision, and write up a manuscript for publication.

    Walders, NatalieTODAY: Treatment Options for Type 2 Diabetes in Adolescents and Youth
    Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) is a multi-center clinical research study funded by the National Institutes of Health. It will examine the safety and efficacy of three treatments for type 2 diabetes in the pediatric population, including a lifestyle intervention arm, called the TLP program. TODAY was initiated due to the increase in type 2 diabetes in children and adolescents, which itself is linked to the rise in obesity and sedentary behaviors in American youth. The TODAY team at the Denver site is looking for medical students interested in gaining experience working in a large multi-site study and becoming proficient in delivering a behavioral intervention to promote weight loss through nutrition changes and increases in physical activity. There is an opportunity to become the lead TLP interventionist for summer 2009.
    Ross, RandyViolence in School Aged Children with Schizophrenia

    While psychotic mental illnesses like schizophrenia and bipolar disorder often develop in adolescence, there are less common cases where symptoms start between 4 and 12 years of age. Though bizarre violence has been described in these cases, the frequency of violence in this group is unknown.

    Students will have the opportunity to do preliminary literature research in order to examine the current knowledge about these disorders in children. Students on this project will review charts of over 90 children with the disorder to assess the rates of violence. Direct interviewing of psychotic children and their families is also possible.

    Klinnert, MaryWhat Affects Asthma in Children

    Dr. Klinnert's research focuses on the role of psychological processes in pediatric asthma.  Major research themes have included: 1) psychosocial factors associated with asthma onset and persistence; 2) the relationship between psychosocial functioning, the family’s asthma management system (medical management, exposure to allergens and cigarette smoke) and the persistence and severity of asthma symptoms, and 3) the effectiveness of psychosocial intervention in preventing and/or reducing the severity of early childhood asthma.

    Funded by NIH, the Childhood Asthma Prevention Study (CAPS) was designed to intervene with families of wheezing infants who are from low-income families and are thus at both biological and social risk for persistent asthma.  The goal of the CAPS study was to determine if an intensive intervention using nurse home visitors can reduce asthma prevalence or symptoms in these infants.  Nurse home visitors visited parents for one year to target allergens in the home, environmental tobacco smoke, and quality of maternal caregiving as it relates to asthma prevention and management.  Baseline data showed significant covariation among biological and psychosocial variables that increased infants’ risk for developing asthma. Outcome was assessed at age 4 in terms of asthma status and severity, pulmonary functions, and quality of life and child behavioral adjustment.  Preliminary data indicate the study was successful in reducing asthma among infants with less severe illness at baseline. This may indicate that infants with more severe wheezing illness are not amenable to the type of intervention provided by CAPS.  A follow-up to age 7 was funded and is underway to determine intervention effects on asthma in school-age children. Further investigation of the data will focus on biological and psychosocial determinants of early and school-age asthma in this low income, high risk group, regardless of intervention.

    The Colorado Tobacco Research Program funded a second intervention study with families of children with asthma age 2 to 13 who were exposed to cigarette smoke in the home.  Counselors visited a randomly chosen half of the sample and used behavioral techniques to help families reduce their children’s exposure to cigarette smoke. Exposure was assessed through urinary cotinine as well as parent report of number of cigarettes smoked in the child’s presence.  The children’s asthma was assessed through symptom report as well as pulmonary functions.  The intervention has been completed, and 12-month follow-up will soon be complete, allowing data analysis of the effectiveness of the intervention.

    The role of psychosocial factors and asthma has been central to a longitudinal cohort study that is ongoing in this laboratory.  The Asthma Risk Study (ARS) is a longitudinal prospective study investigating the role of stress in the onset of asthma among genetically predisposed infants.  Assessments of family functioning were made prior to the birth of the index children.  Quality of parenting in the neonatal period was related to asthma onset at age 3 and at age 6.  The children received a comprehensive assessment of asthma and psychosocial functioning at 12 years of age.  Asthma status at age 12 was related not only to lung functions and allergic status, but also to youth report of psychological functioning.  Data analyses are planned to evaluate the longitudinal interplay of biological and psychosocial variables in relation to the expression of asthma.

    Alder, LawrenceAtypical Antipsychotics and P50 Sensory Gating

    This project will attempt to determine the effects of 5HT3 antagonists on sensory gating in schizophrenia.

    Clozapine improves impaired P50 auditory gating to a greater extent than any other antipsychotic. This improvement correlates with clinical improvement. Why clozapine is more effective than other atypicals is not clear, especially since P50 gating is mediated by the alpha-7 nicotinic receptor, not directly acted on by clozapine. Similar atypicals do not effectively improve impaired P50 gating. However, clozapine is a more effective 5HT3 antagonist than either olanzapine or quetiapine. 5HT3 blockade releases acetylcholine, which would stimulate •7 nicotinic receptors responsible for the mediation of P50 gating. This project will test this hypothesis in schizophrenic patients on an acute basis, determining whether adding ondansetron (a specific 5HT3 antagonist) acutely to schizophrenic patients taking olanzapine or quetiapine improves P50 gating. We will be testing schizophrenic patients in a double blind crossover study. Elucidating a potential mechanism by which clozapine alleviates a neurophysiological deficit may help us design better medications in the future.