Faculty Bibliography

Psychotic disorders are not uncommon in late life. These disorders often have varied etiologies, different clinical presentations, and are associated with significant morbidity and mortality among the older adult population. Psychotic disorders in late life develop due to the complex interaction between various biological, psychological, social, and environmental factors. Given the significant morbidity and mortality associated with psychotic disorders in late life, a comprehensive work-up should be conducted when they are encountered. The assessment should not only identify the potential etiologies for the psychotic disorders, but also recognize factors that predicts possible outcomes for these disorders. Treatment approaches for psychotic disorders in late life should include a combination of nonpharmacological management strategies with the judicious use of psychotropic medications. When antipsychotic medications are necessary, they should be used cautiously with the goal of optimizing outcomes with regular monitoring of their efficacy and adverse effects.

It has long been theorized that humans develop higher mental functions, such as executive functions (EFs), within the context of interpersonal interactions and social relationships. Various components of social interactions, such as interpersonal communication, perspective taking, and conforming/adhering to social rules, may create important (and perhaps even necessary) opportunities for the acquisition and continued practice of EF skills. Furthermore, positive and stable relationships facilitate the development and maintenance of EFs across the lifespan. However, experimental studies investigating the extent to which social experiences contribute causally to the development of EFs are lacking. Here, we present experimental evidence that social experiences and the acquisition of social skills influence the development of EFs. Specifically, using a rat model, we demonstrate that following exposure to early-life adversity, a socialization intervention causally improves working memory in peri-adolescence. Our findings combined with the broader literature promote the importance of cultivating social skills in support of EF development and maintenance across the lifespan. Additionally, cross-species research will provide insight into causal mechanisms by which social experiences influence cognitive development and contribute to the development of biologically sensitive interventions.

Background: The burden of mental, neurological, and substance (MNS) disorders is greater in low- and middle-income countries (LMICs). The rapid growth of digital health (i.e., eHealth) approaches offer new solutions for transforming pediatric mental health services and have the potential to address multiple resource and system barriers. However, little work has been done in applying eHealth to promote young children's mental health in LMICs. It is also not clear how eHealth has been and might be applied to translating existing evidence-based practices/strategies (EBPs) to enable broader access to child mental health interventions and services. Methods: A scoping review was conducted to summarize current eHealth applications and evidence in child mental health. The review focuses on 1) providing an overview of existing eHealth applications, research methods, and effectiveness evidence in child mental health promotion (focused on children of 0-12 years of age) across diverse service contexts; and 2) drawing lessons learned from the existing research about eHealth design strategies and usability data in order to inform future eHealth design in LMICs. Results: Thirty-two (32) articles fitting our inclusion criteria were reviewed. The child mental health eHealth studies were grouped into three areas: i) eHealth interventions targeting families that promote child and family wellbeing; ii) eHealth for improving school mental health services (e.g., promote school staff's knowledge and management skills); and iii) eHealth for improving behavioral health care in the pediatric care system (e.g., promote use of integrated patient-portal and electronic decision support systems). Most eHealth studies have reported positive impacts. Although most pediatric eHealth studies were conducted in high-income countries, many eHealth design strategies can be adapted and modified to fit LMIC contexts. Most user-engagement strategies identified from high-income countries are also relevant for populations in LMICs. Conclusions: This review synthesizes patterns of eHealth use across a spectrum of individual/family and system level of eHealth interventions that can be applied to promote child mental health and strengthen mental health service systems. This review also summarizes critical lessons to guide future eHealth design and delivery models in LMICs. However, more research in testing combinations of eHealth strategies in LMICs is needed.

BACKGROUND:Substance use and unprotected sex are prevalent among adolescents. The link between substance use and unprotected sex is well-established. Research has also highlighted how adolescents' attitudes and risk perceptions regarding unprotected sex, including concerns about pregnancy ("Getting pregnant would force me to grow up too fast"), are associated with unprotected sex and unplanned pregnancy. However, less research has examined the potential relationship between pregnancy concerns and substance use among adolescents. OBJECTIVES/OBJECTIVE:The study prospectively examined (1) differences in pregnancy concerns across patterns of substance use and (2) whether pregnancy concerns mediate the relationship between substance use and later unprotected sex among a sample of middle and high school students. METHOD/METHODS:98 adolescents [M(SD) age = 14.28(1.68), 59.4% female, 59.4% black/African American] completed self-report measures of marijuana and alcohol use, pregnancy concerns, and unprotected sex across three time points over 6 months (T1-T3). RESULTS:Substance users (alcohol/marijuana) reported fewer pregnancy concerns compared to non-substance users (t = 2.99, p = .04). Pregnancy concerns at T2 mediated the relationship between T1 lifetime substance use and later unprotected sex (T3) (indirect effect: b = 0.10, CI[.01-.41]; direct effect: b = 0.15, p = .32), controlling for gender, age, and race. More frequent substance use (T1) was related to fewer pregnancy concerns at T2 (b = -0.10, p = .04); fewer pregnancy concerns were related to increased likelihood of later unprotected sex (b = -1.02, p = .02). CONCLUSIONS:Findings offer new insight into associations between substance use and unprotected sex and suggest that substance use and sexual health interventions should target pregnancy concerns.

This study examined the effect of an interference task on the consolidation of duration in long-term memory. In a temporal generalization task, the participants performed a learning phase with a reference duration that either was, or was not, followed 30 min later by a 15-min interference task. They were then given a memory test, 24 h later. Using different participant groups, several reference durations were examined, from several hundred milliseconds (600 ms) to several seconds (2.5, 4, and 8 s). The results showed that the scalar timing property (i.e., precision proportional to judged duration) was preserved despite the interference task given during the memory consolidation process. However, the interference task increased the variability of time judgment and tended to produce a lengthening effect in all reference duration conditions. The modeling of individual data with parameters derived from scalar expectancy theory suggests that disrupting the memory consolidation of learned reference durations introduces noise in their representation in memory, with time being specifically distorted toward a lengthened duration.

Unwanted sexual incidents on university campuses pose significant public health and safety risks for students. This study explored survivors' perspectives on secondary prevention of campus sexual assault and effective strategies for intervention programs for unwanted sexual incidents in university settings. Twenty-seven student survivors of unwanted sexual experiences participated in semi-structured in-depth interviews. Data were analyzed using thematic analysis and a constructionist perspective. The findings were contextualized using the ecological model. Barriers to reporting included concerns about one's story not being believed, personal minimization of the incident, belief that no action will be taken after reporting, confidentiality concerns, and other perceived costs of reporting. Survivors provided valuable insight on potentially effective prevention and intervention strategies to address the problem of unwanted sexual incidents on university campuses. These findings may be useful for prevention and intervention policies and programs in university settings and for providers who assist survivors of unwanted sexual experiences.