Faculty Bibliography

The goal of this paper is to synthesize available data to help guide policy and programmatic initiatives for families with substance abuse problems who are involved with the child welfare system, and identify gaps in the research base preventing further refinement of practices in this area. To date, Family Treatment Drug Court and newly developed home-based substance abuse treatment interventions appear the most effective at improving substance abuse treatment initiation and completion in child welfare populations. Research is needed to compare the efficacy of these two approaches, and examine cost and child well-being indicators in addition to substance abuse treatment and child welfare outcomes

Introduction: An important goal of ongoing Alzheimer's disease (AD) research is to identify markers that allow one to predict risk for the development of this type of dementia in cognitively intact elderly. Known cognitive changes associated with AD, possibly reflecting hippocampal pathology, include a worse recall of primacy items and better immediate recall of items learned at the end of a list compared to the middle (recency effect). Aims: The aim of our study was to examine whether learning and recall of primacy and recency words predicted future decline in intact elderly subjects. Methods: Individuals with MMSE of 28 or over at baseline were included in the study. Of these, 211 had at least two successive cognitive evaluations; mean age at baseline was 69.5 (SD=8.0). We regressed MMSE decline on baseline Auditory-Verbal Learning Test (AVLT) memory measures, focusing especially on learning and recall of primacy and recency words, and controlling for baseline age, time since baseline and other variables. Results: Worse learning/delayed recall of primacy words on AVLT trials consistently predicted greater subsequent cognitive decline. Additionally, this effect was stronger among older subjects than among younger ones. APOE e4, a well established genetic risk factor for late-onset AD, was not a significant predictor of MMSE decline in this sample. Conclusions: Decreased learning and poorer recall of primacy words in the AVLT is a predictor of decline in healthy elderly individuals, and future studies should examine if decreased learning and recall can predict conversion to AD

The functional significance of the brain's white matter was not fully appreciated until new imaging methods were developed to visualize fiber pathways and connections in the living brain. Rapid advances in diffusion tensor imaging (DTI) have led to substantial insights into human brain development and disease processes and have thrust white matter into the focus of researchers and clinicians alike. The full clinical potential of this relatively new technique remains to be determined, but early indicators suggest that DTI will be a significant new technology in mapping mechanisms of human health and disease. Here we review brain changes that have been studied with DTI over the human lifespan and findings in a variety of neuropsychiatric disorders. We also suggest future areas where DTI is likely to have significant impact.

Posttraumatic stress disorder (PTSD) is a common and disabling anxiety disorder that may occur in the aftermath of exposure to potentially traumatic life events. PTSD is moderately heritable, but few specific molecular variants accounting for this heritability have been identified. Genes regulating the hypothalamic-pituitary-adrenal (HPA) axis, such as corticotrophin-releasing hormone type 1 receptor gene (CRHR1), have been implicated in traumatic-stress related phenotypes but have yet to be studied in relation to PTSD. The present study sought to examine the relation between 9 single nucleotide polymorphisms (SNPs) in the CRHR1 gene and posttraumatic stress symptoms in a prospective study of pediatric injury patients (n=103) who were first assessed in the acute aftermath of their injury at the hospital. Results indicated that multiple SNPs were associated with acute symptoms at a univariate level, and after correction for multiple testing, rs12944712 was significantly related to acute PTSD symptoms. Longitudinal latent growth curve analyses suggest that rs12944712 is also related to both acute symptom level and trajectory of symptoms over time. The present study adds support for the role of CRHR1 in the stress response following potentially traumatic event exposure in youth. It should be noted that the sample size in this study was small, and therefore statistical power was low; following, results from this study should be considered preliminary. Although results are not definitive, the findings from this study warrant future replication studies on how variation in this gene relates to response to traumatic event exposure in youth