Faculty Bibliography

While static functional connectivity (sFC) of resting state fMRI (rfMRI) measures the average functional connectivity (FC) over the entire rfMRI scan, dynamic FC (dFC) captures the temporal variations of FC at shorter time windows. Although numerous studies have implemented dFC analyses, only a few studies have investigated the reliability of dFC and this limits the biological interpretation of dFC. Here, we used a large cohort (N = 820) of subjects and four rfMRI scans from the Human Connectome Project to systematically explore the relationship between sFC, dFC and their test-retest reliabilities through intra-class correlation (ICC). dFC ICC was explored through the sliding window approach with three dFC statistics (standard deviation, ALFF, and excursion). Excursion demonstrated the highest dFC ICC and the highest age prediction accuracy. dFC ICC was generally higher at window sizes less than 40 s sFC and dFC were negatively correlated. Compared to sFC, dFC was less reliable. While sFC and sFC ICC were positively correlated, dFC and dFC ICC were negatively correlated, indicating that FC that was more dynamic was less reliable. Intra-network FCs in the frontal-parietal, default mode, sensorimotor and visual networks demonstrated high sFC and low dFC. Moreover, ICCs of both sFC and dFC in these regions were higher. The above results were consistent across two brain atlases and independent component analysis-based networks, multiple window sizes and all three dFC statistics. In summary, dFC is less reliable than sFC and additional experiments are required to better understand the neurophysiological relevance of dFC.

Youth with autism spectrum disorder (ASD) are psychiatrically hospitalized at high rates. Though specialized psychiatric units are effective, few specialized units exist. The ASD Care Pathway (ASD-CP) was developed as a scalable approach to improving care in general psychiatric units through staff training and a package of autism-specific intervention strategies. An evaluation of the effectiveness of the ASD-CP in a public hospital child psychiatric service compared 18 months (n = 17) versus 18 months (n = 20) post implementation. Average length of hospital stay decreased 40% (22.4-13.4 days) and use of crisis interventions decreased 77% (holds/restraints; 0.65/day to 0.15/day), though each result only approached statistical significance (p = 0.07; 0.057). This study provides preliminary evidence for improved outcomes after implementation of an ASD-CP.

OBJECTIVE:This study examined associations between 3 distinct parent factors (parent personal distress, parenting stress, and spina bifida (SB)-specific parenting stress) and youth and parent proxy reports of youth health-related quality of life (HRQOL) over time. METHOD:Participants were recruited as part of a longitudinal study, and data were collected at 3 time points, spaced 2 years apart. Parents and youth completed questionnaires, and youth completed neuropsychological assessment tasks to determine youth intelligence quotient during home visits. RESULTS:Analyses revealed that higher levels of maternal SB-specific parenting stress were related to lower levels of youth-reported HRQOL at time 1. Other parent factors were not associated with youth report of HRQOL at the earlier time points, although higher levels of maternal SB-specific parenting stress and paternal parenting stress were associated with lower levels of youth HRQOL at time 3. For mothers and fathers, increased parent personal distress, parenting stress, and SB-specific parenting stress were associated with decreased proxy report of youth HRQOL. Of these three parent factors, SB-specific parenting stress was consistently the most strongly associated with parent proxy-report of youth HRQOL. CONCLUSION:Parenting stress and distress are important targets for interventions, and these interventions may improve youth outcomes, especially as youth age. Future research is needed to identify other factors influencing youth HRQOL over time.

In psychological experiments, behavioral speed varies across trials, and this variation is often associated with corresponding fluctuations in cortical activity. Little is known about such cortical variations in semantic priming tasks where target words are matched with preceding sensory object cues. Here, two visually presented target words ("pear" and "lilac") were repeatedly cued by corresponding odors or pictures, and the participants were to indicate matching or nonmatching combinations. Data were split in behaviorally "fast" versus "slow" trials. We hypothesized that slow trials would be associated with higher prestimulus alpha activity and reduced ERP amplitudes, and that response-time differences between odor-cued and picture-cued trials would be especially large in slow behavioral trials. Results confirmed that slow trials showed increased alpha-band activity prior to word target onset, as well as amplitude decreases in the sensory P1 and semantic N400 components. However, no interactions between cue-modality and processing speed were observed. Instead, odor-cue integration responses were uniquely delayed on incongruent trials, a novel behavioral effect that was not observed in EEG measures. The results show that semantic integration speed is reflected in cortical activity before and during stimulus processing. Behavioral interactions with cue modality did not correspond to observed cortical activity changes, perhaps because olfactory circuits are not readily observed in scalp-recorded EEG. We conclude that combining behavioral speed variability and cortical EEG measures is useful in understanding the fluctuating nature of cognitive processing sequences. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

OBJECTIVE:This study aimed to improve our understanding of how to best assist marginalized youth during their transition to adulthood, and how to provide them services that help them achieve independence within existing public systems of care. METHOD/METHODS:Using purposive sampling methods, 17 direct service providers and supervisors of a large behavioral health organization participated in individual interviews and focus groups. RESULTS:A team of analysts identified eight primary themes: (a) the primacy of consistent and caring relationships with adults; (b) working with youth and family concurrently; (c) the complicated dance of autonomy and independence; (d) engagement of alumni and peers in service delivery; (e) transition navigator: an active not passive approach to becoming an adult; (f) youth as the drivers of treatment and recovery; (g) provider training and resources to address the unique needs of transition-age youth; and (h) broadening the definition of treatment. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE/CONCLUSIONS:Our findings have important implications for practice, including (a) adapting clinical practice to meet the unique needs of transition-age youth and young adults; (b) engaging and expanding positive support systems; and (c) shifting the mindset of transition-age youth and young adults, their caregivers, and providers from a perspective of "aging out" of the mental health system to a perspective of "continuing on" in the management of their mental health through treatment and rehabilitation as needed as young adults. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Recent efforts to reform and improve the juvenile justice system have overlooked one critically important issue-the widespread failure to routinely screen for intellectual and developmental disabilities (I/DD) in young offenders. Pursuant to the Americans with Disabilities Act and Individuals with Disabilities Education Act, offenders with I/DD must receive appropriate accommodations. Yet across the country, adolescents and adults with I/DD must engage with the juvenile justice system without appropriate supports and often with their disabilities unknown to corrections staff, lawyers, judges, and other personnel.

BACKGROUND:Preexposure prophylaxis (PrEP) reduces risk of human immunodeficiency virus infection for many gay and bisexual men (GBM); however, bacterial sexually transmitted infections associated with decreasing condom use among users is of concern. Center for Disease Control and Prevention's guidelines for PrEP use recommend bacterial sexually transmitted infection screening every 6 months. We sought to investigate comprehensive PrEP care, defined as: (1) discussion of sexual behavior, (2) blood sample, (3) urine sample, (4) rectal sample (rectal swab), and (5) throat sample (throat swab), provided at the user's last PrEP appointment. METHODS:The PrEP-using GBM in New York City (n = 104) were asked about their last PrEP care visit. We examined associations of demographics (age, race/ethnicity, and education), recent number of condomless anal sex events, time on PrEP, and health care provider type on receiving comprehensive care at last visit using fully adjusted binary logistic regression. RESULTS:At their last visit, nearly all men (94%) gave blood for testing, 88% provided a urine sample, and 77% discussed sexual behavior with their provider. However, only 51% reported having a rectal swab, and 48% an oral swab. Only 32% of men received comprehensive PrEP care at their last PrEP visit. Odds of receiving comprehensive care were significantly higher among younger men, men with a bachelor's degree or more education, and those who reported more condomless anal sex. CONCLUSIONS:Less than one third of GBM received comprehensive human immunodeficiency virus/sexually transmitted infection counseling and testing at their last visit. These findings indicate further efforts are needed to prepare health care providers for prescribing and managing patients on PrEP.

Faces are often used in psychological and neuroimaging research to assess perceptual and emotional processes. Most available stimulus sets, however, represent minimal diversity in both race and ethnicity, which may confound understanding of these processes in diverse/racially heterogeneous samples. Having a diverse stimulus set of faces and emotional expressions could mitigate these biases and may also be useful in research that specifically examines the effects of race and ethnicity on perceptual, emotional and social processes. The racially diverse affective expression (RADIATE) face stimulus set is designed to provide an open-access set of 1,721 facial expressions of Black, White, Hispanic and Asian adult models. Moreover, the diversity of this stimulus set reflects census data showing a change in demographics in the United States from a white majority to a nonwhite majority by 2020. Psychometric results are provided describing the initial validity and reliability of the stimuli based on judgments of the emotional expressions.

Hoarding disorder is characterized by difficulty parting with possessions and by clutter that impairs the functionality of living spaces. Cognitive behavioral therapy conducted by a therapist (individual or in a group) for hoarding symptoms has shown promise. For those who cannot afford or access the services of a therapist, one alternative is an evidence-based, highly structured, short-term, skills-based group using CBT principles but led by non-professional facilitators (the Buried in Treasures [BIT] Workshop). BIT has achieved improvement rates similar to those of psychologist-led CBT. Regardless of modality, however, clinically relevant symptoms remain after treatment, and new approaches to augment existing treatments are needed. Based on two recent studies - one reporting that personalized care and accountability made treatments more acceptable to individuals with hoarding disorder and another reporting that greater number of home sessions were associated with better clinical outcomes, we tested the feasibility and effectiveness of adding personalized, in-home uncluttering sessions to the final weeks of BIT. Participants (n = 5) had 15 sessions of BIT and up to 20 hours of in-home uncluttering. Reductions in hoarding symptoms, clutter, and impairment of daily activities were observed. Treatment response rate was comparable to rates in other BIT studies, with continued improvement in clutter level after in-home uncluttering sessions. This small study suggests that adding in-home uncluttering sessions to BIT is feasible and effective.