Faculty Bibliography

Objectives: The Wellness Self-Management (WSM) is an adaptation and expansion of Illness Management and Recovery (IMR), an internationally recognized best practice. In order to validate the Italian version of WSM our goals included the translation from English to Italian of the WSM workbook and the implementation of an abbreviated WSM program in an Italian day hospital setting. Methods: In a randomized controlled trial 14 patients with a diagnosis of severe mental illness were recruited and randomly assigned to two groups. Seven individuals received an abbreviated version of WSM, while the controls received Treatment as Usual. Groups did not differ for age, education, cognitive functioning and symptomatology. All patients received weekly planned treatment in the day hospital setting. After treatment, group differences on change scores were tested using ANOVA. Results: Compared to controls, at immediate post-intervention, WSM participants reported significant improvement in processing speed, psychopathology, neurocognitive and personal resources and real-life functioning. Conclusions: These results offer promising preliminary evidence that the use of an abbreviated Italian translation of the WSM workbook provides an effective complement to current mental health treatment.

This is a replication, randomized control trial, that investigated the therapeutic effects of a 12-week equine-assisted (EA) intervention on the social and sensory functioning of children with autism. Reliability and stability of parent and teacher reports of children's social and sensory functioning across three assessment times were assessed, in support of the validity of observed outcomes. Furthermore, it was hypothesized that children in the EA group (n = 25) would significantly improve, relative to a wait-list control group (n = 25), in both domains of functioning. Results indicated that reports were reliable, and children in the experimental group improved in overall social and sensory functioning, as well as within specific subdomains, with "unblinded" assessment methods. Relative to the pre-assessment scores, children improved in functioning in specific areas at post-assessment and 8-weeks post-intervention. Therefore, results of the study suggest EA activities may be a beneficial modality for delivering autism-specific treatment strategies.

BACKGROUND: Deficits in N-methyl-d-aspartate-type (NMDAR) function contribute to symptoms and cognitive dysfunction in schizophrenia. The efficacy of NMDAR agonists in the treatment of persistent symptoms of schizophrenia has been variable, potentially reflecting limitations in functional target engagement. We recently demonstrated significant improvement in auditory mismatch negativity (MMN) with once-weekly treatment with d-serine, a naturally occurring NMDAR glycine-site agonist. This study investigates effects of continuous (daily) NMDAR agonists in schizophrenia/schizoaffective disorder. METHODS: Primary analysis was on MMN after double-blind crossover (60mg/kg/d, n=16, 6weeks) treatment with d-serine/placebo. Secondary measures included clinical symptoms, neurocognition, and the effects of open-label (30-120mg/kg/d, n=21) d-serine and bitopertin/placebo (10mg, n=29), a glycine transport inhibitor. RESULTS: Double-blind d-serine treatment led to significant improvement in MMN frequency (p=0.001, d=2.3) generation and clinical symptoms (p=0.023, d=0.80). MMN frequency correlated significantly with change in symptoms (r=-0.63, p=0.002) following co-variation for treatment type. d-Serine treatment led to a significant, large effect size increase vs. placebo in evoked alpha-power in response to standards (p=0.036, d=0.81), appearing to normalize evoked alpha power relative to previous findings with controls. While similar results were seen with open-label d-serine, no significant effects of bitopertin were observed for symptoms or MMN. CONCLUSIONS: These findings represent the first randomized double-blind placebo-controlled study with 60mg/kg d-serine in schizophrenia, and are consistent with meta-analyses showing significant effects of d-serine in schizophrenia. Results overall support suggest that MMN may have negative, as well as positive, predictive value in predicting efficacy of novel compounds. CLINICAL TRIALS REGISTRATION: Clinicaltrials.gov: NCT00322023/NCT00817336 (d-serine); NCT01116830 (bitopertin).

Although the Positive and Negative Syndrome Scale (PANSS) is widely used in clinical research, factor analytic studies of the scale have been inconsistent and questions remain about the underlying factor structure of schizophrenia symptoms. The purpose of this study was to examine whether the factor structure of the PANSS differs in men and women with schizophrenia. Principal components analysis (PCA) with equamax rotation was used to examine the factor structure of the PANSS separately in 124 males and 74 females with schizophrenia related psychoses. In males, a four factor structure was identified: (1) Negative, (2) Cognitive, (3) Positive, and (4) Hostility. In females, a four-factor structure also emerged: (1) Negative, (2) Cognitive, (3) Positive and (4) Depression. The most notable difference between the male and female PCAs was the presence of a depression factor in the females and a hostility factor in males. These results support sex differences in the factor structure of schizophrenia symptoms, which has important implications for clinical research.

OBJECTIVE: To examine the impact of a sleep course on sleep-related behaviors, mood, and anxiety in college students. PARTICIPANTS: Participants were 145 students enrolled in either the sleep course (n = 70) or a psychology course (n = 75); data were collected in September 2014, November 2014, and February 2015. METHODS: Sleep characteristics and symptoms of depression and anxiety were assessed using validated questionnaires and sleep logs. Linear, logistic and proportional odds regression models were used to test course effects. RESULTS: In November, sleep course students reported significant differences in sleep hygiene (SHI; p<0.001), perceived sleep latency (PSQI; p<0.05), and circadian sleep phase (MEQ; p<0.05), compared to controls. In February, the sleep course students maintained most of the aforementioned gains and reported fewer symptoms of depression (CES-D; p = 0.05) and anxiety (BAI; p<0.05). CONCLUSIONS: These positive preliminary results indicate that focused education has potential to improve sleep among college students.