Faculty Bibliography

BACKGROUND: Much has been theorized about the emotional properties of the hemispheres. Our review of the dominant hypotheses put forth by Schore, Joseph, Davidson, and Harmon-Jones on hemispheric emotional valences (HEV) shows that none are supported by robust data. Instead, we propose that individual's hemispheres are organized to have differing HEVs that can be lateralized in either direction. METHODS: Probe auditory evoked potentials (AEP) recorded during a neutral and an upsetting memory were used to assess HEV in 28 (20 F) right-handed subjects who were either victims of childhood maltreatment (N = 12) or healthy controls. In a sub-population, we determined HEV by emotional response to lateral visual field stimulation (LVFS), in which vision is limited to one, then the other hemifield. We compare a number of morphometric and functional brain measures between individuals who have right-negative versus left-negative HEV. RESULTS: Using AEPs to determine HEV, we found 62% of controls and 67% of maltreated subjects had right negative HEV. There was a strong interaction between HEV-laterality and gender, which together accounted for 60% of individual variability in total grey matter volume (GMV). HEV-laterality was associated with differences in hippocampal volume, amygdala/hippocampal ratios, and measures of verbal, visual and global memory. HEV-laterality was associated also with different constellations of symptoms comparing maltreated subjects to controls. Emotional response to LVFS provided a convenient and complementary measure of HEV-laterality that correlated significantly with the HEVs determined by AEPs. CONCLUSION: Our findings suggest that HEV-laterality, like handedness or gender, is an important individual difference with significant implications for brain and behavioral research, and for guiding lateralized treatments such as rTMS

BACKGROUND: Although abnormalities in reward processing have been proposed to underlie attention-deficit/hyperactivity disorder (ADHD), this link has not been tested explicitly with neural probes. METHODS: This hypothesis was tested by using fMRI to compare neural activity within the striatum in individuals with ADHD and healthy controls during a reward-anticipation task that has been shown previously to produce reliable increases in ventral striatum activity in healthy adults and healthy adolescents. Eleven adolescents with ADHD (5 off medication and 6 medication-naive) and 11 healthy controls (ages 12-17 y) were included. Groups were matched for age, gender, and intelligence quotient. RESULTS: We found reduced ventral striatal activation in adolescents with ADHD during reward anticipation, relative to healthy controls. Moreover, ventral striatal activation was negatively correlated with parent-rated hyperactive/impulsive symptoms across the entire sample. CONCLUSIONS: These findings provide neural evidence that symptoms of ADHD, and impulsivity or hyperactivity in particular, may involve diminished reward anticipation, in addition to commonly observed executive dysfunction

INTRODUCTION: A growing number of studies have found evidence that anxiety and depressive disorders are associated with atypical amygdala hyperactivation, which decreases with effective treatment. Interest has emerged in this phenomenon as a possible biological marker for individuals who are likely to benefit from tailored treatment approaches. OBJECTIVE: The present study was designed to examine relationships between pretreatment amygdala activity and treatment response in a sample of anxious children and adolescents. MATERIALS AND METHODS: Participants, who were diagnosed predominantly with generalized anxiety disorder (GAD), underwent functional magnetic resonance imaging (fMRI) scanning before treatment with fluoxetine or cognitive behavioral therapy (CBT). RESULTS: Results indicated significant negative associations between degree of left amygdala activation and measures of posttreatment symptom improvement in the group, as a whole. DISCUSSION: Taken together with research on associations between adult amygdala activation and treatment response, these findings suggest that patients whose pretreatment amygdala activity is the strongest may be particularly likely to respond well to such widely used treatments as selective serotonin reuptake inhibitor (SSRI) medications and CBT.

The present experiment employed the peak-interval (PI) procedure to study the effect of an intruded cue on timing behavior. Rats were trained on a 30-s PI procedure with a tone cue. Subsequently, a 6-s flashing light was paired off-baseline with foot shock (Experiment 1) or presented alone (Experiment 2). Then, in test trials, the light cue was presented 9s prior to (before) or 3s after (during) the onset of the timing cue, or the light was omitted (probe). Results showed rightward shifts in peak time occurring on both before and during trials in both experiments. Peak shifts on during trials exceeded the reset prediction in Experiment 1. When PI functions for before and probe trials were normalized in peak rate and peak time, they superimposed better than when functions were adjusted additively along the time axis, suggesting that the light cue may engender a decrease in functional clock rate. The findings suggested that the intruded cue produced both intracue and postcue interference with timing that was enhanced by fear conditioning.

OBJECTIVE: We sought to identify characteristics of pediatricians that were associated with identification or management (referral and/or treatment) of mothers with depression. METHODS: A cross-sectional survey was mailed to a random sample of 1600 of the 50,818 US nonretired members of the American Academy of Pediatrics. Overall, 832 responded, with 745 responses from nontrainee members. The 662 fellow nontrainee members who engaged in direct patient care and completed information on identifying, referring, and treating maternal depression were included in the analyses. RESULTS: A total of 511 of 662 respondents reported identifying maternal depression; of those who reported identifying maternal depression, 421 indicated they referred and 29 that they treated maternal depression in their practices. Pediatricians who are older, work in practices that provide child mental health services, see primarily (> or = 75%) white patients, use > or = 1 method to address maternal depression, agree that pediatricians should be responsible for identifying maternal depression, think that maternal depression has an extreme effect on children's mental health, and are attitudinally more inclined to identify or manage maternal depression had significantly higher odds of reporting identification of maternal depression. Positive correlates of identification and management of maternal depression included practicing in the Midwest, using > or = 1 method to address maternal depression, working in a practice that provides child mental health services, thinking that caregiving problems attributable to maternal health have an extreme effect on children's physical health, having attitudes that are more inclined to identify and to manage maternal depression, and usually inquiring about symptoms routinely to identify maternal depression. CONCLUSIONS: Pediatricians' practice characteristics and attitudes are associated with their identification and management of mothers with depression.

OBJECTIVE: Despite major recent research advances, large gaps exist between accepted mental health knowledge and clinicians' real-world practices. Although hundreds of studies have successfully utilized basic behavioral science theories to understand, predict, and change patients' health behaviors, the extent to which these theories-most notably the theory of reasoned action (TRA) and its extension, the theory of planned behavior (TPB)-have been applied to understand and change clinician behavior is unclear. This article reviews the application of theory-driven approaches to understanding and changing clinician behaviors. METHODS: MEDLINE and PsycINFO databases were searched, along with bibliographies, textbooks on health behavior or public health, and references from experts, to find article titles that describe theory-driven approaches (TRA or TPB) to understanding and modifying health professionals' behavior. RESULTS: A total of 19 articles that detailed 20 studies described the use of TRA or TPB and clinicians' behavior. Eight articles describe the use of TRA or TPB with physicians, four relate to nurses, three relate to pharmacists, and two relate to health workers. Only two articles applied TRA or TPB to mental health clinicians. The body of work shows that different constructs of TRA or TPB predict intentions and behavior among different groups of clinicians and for different behaviors and guidelines. CONCLUSIONS: The number of studies on this topic is extremely limited, but they offer a rationale and a direction for future research as well as a theoretical basis for increasing the specificity and efficiency of clinician-targeted interventions.

OBJECTIVE: The combined contribution of neonatal, perinatal, and maternal health, demographic, environmental, and family psychosocial factors to early onset asthma and wheezing in a healthy birth cohort was examined. METHODS: Participants included 1,158 ethnically and socioeconomically diverse parents of 2- and 3-year olds who completed mailed questionnaires. RESULTS: Asthma and wheezing prevalence was 8.4 and 8.1%, respectively. Asthma during pregnancy, smoking in the home, and being male increased risk for asthma diagnosis and wheezing whereas social support minimized risk for both. Shorter gestational age, exposure to violence, and maternal anxiety increased risk for wheezing. The negative impact of smoking in the home was greatest for children with shorter gestational ages and mothers with asthma during pregnancy. CONCLUSION: Findings confirm and extend previous work documenting demographic risks and highlight smoking, violent events, and social support in early onset asthma and wheezing. Findings illustrate the need for ecologically based interventions to treat asthma and wheezing in young children.

Maintaining balance is a central problem for new walkers. To examine how infants cope with the additional balance control problems induced by load carriage, 14-month-olds were loaded with 15% of their body weight in shoulder-packs. Both symmetrical and asymmetrical loads disrupted alternating gait patterns and caused less mature footfall patterns. Walking was most severely compromised by back loads. Infants with less walking experience, lower levels of walking proficiency, and chubbier body proportions were more adversely affected. In addition, infants displayed a unique postural response to asymmetrical loads. In contrast to older children and adults, infants leaned with loads rather than in the opposite direction to the loads. Findings are discussed in terms of development from accommodation to compensatory strategies.

The effect of a course of electroconvulsive therapy (ECT) on blood pressure control in hypertensive patients has not been studied. We retrospectively examined pre- and post-ECT blood pressures in hypertensive and nonhypertensive patients. In neither group was there a statistically significant change in blood pressure with a course of ECT. We conclude that a course of ECT does not worsen blood pressure in hypertensive patients beyond the peritreatment period.

Throughout adulthood, new neurons are continuously added to the dentate gyrus, a hippocampal subregion that is important in spatial learning. Whether these adult-generated granule cells become functionally integrated into memory networks is not known. We used immunohistochemical approaches to visualize the recruitment of new neurons into circuits supporting water maze memory in intact mice. We show that as new granule cells mature, they are increasingly likely to be incorporated into circuits supporting spatial memory. By the time the cells are 4 or more weeks of age, they are more likely than existing granule cells to be recruited into circuits supporting spatial memory. This preferential recruitment supports the idea that new neurons make a unique contribution to memory processing in the dentate gyrus.