Bradley Hospital

About: Bradley Hospital is a healthcare organization based out in East Providence, Rhode Island, United States. It is known for research contribution in the topics: Mental health & Bipolar disorder. The organization has 261 authors who have published 265 publications receiving 10477 citations.

Self-Efficacy As a Target for Neuroscience Research on Moderators of Treatment Outcomes in Pediatric Anxiety

Abstract: Objective: Despite the advances in the field of neuroscience, many questions remain regarding the mechanisms of anxiety, as well as moderators of treatment outcome. Long-term adverse outcomes for a...

Inpatient Behavioral and Cognitive Therapy for Substance Abuse in Adolescents

Abstract: Substance abuse, or chemical dependency, continues to be a major public health problem, with substance use or abuse among adolescents occupying increasing national attention and concern. In the United States, overall drug use in young people is the highest among the industrialized nations, despite recent statistics indicating a continued trend of gradual decline (Johnston, Bachman, & O’Malley, 1988). In this highly quoted annual (1987) survey of high school seniors, over half (57%) of the seniors reported having tried an illicit drug and 92% reported some experience with alcohol. The seniors indicated a daily use of 4.8%, 3.3%, and 0.3% of alcohol, marijuana, and cocaine, respectively (Johnston et al., 1988). Adolescents who use alcohol or other drugs have an increased vulnerability to accidents, injuries, and a variety of dangerous behaviors. Alcohol-related motor vehicle accidents are the leading cause of death among American youth between the ages of 15 and 24, and increased alcohol levels are found in victims of suicide and homicide (American Academy of Pediatrics, 1987). Clearly, with increasing recognition of this serious problem, society in the United States now directs more resources toward the treatment of chemically dependent adolescents. In this chapter, we hope to describe the entity of adolescent chemical dependency and to discuss assessment methods and appropriate behavioral treatment modalities as applied to hospitalized adolescents with alcohol and/or drug use problems.

Neurocognitive heterogeneity across the spectrum of psychopathology: need for improved approaches to deficit detection and intervention.

Abstract: Neurocognition is one of the strongest predictors of clinical and functional outcomes across the spectrum of psychopathology, yet there remains a dearth of unified neurocognitive nosology and available neurocognition-targeted interventions. Neurocognitive deficits manifest in a transdiagnostic manner, with no psychiatric disorder uniquely affiliated with one specific deficit. In fact, recent research has identified that essentially all investigated disorders are comprised of 3-4 neurocognitive profiles. This within-disorder neurocognitive heterogeneity has hampered the development of novel, neurocognition-targeted interventions, as only a portion of patients with any given disorder possess neurocognitive deficits that would warrant neurocognitive intervention. The development of criteria and terminology to characterize these neurocognitive deficit syndromes would provide clinicians with the opportunity to more systematically identify and treat their patients and provide researchers the opportunity to develop neurocognition-targeted interventions for patients. This perspective will summarize recent work and discuss possible approaches for neurocognition-focused diagnosis and treatment in psychiatry.

Family Stress Moderates Emotional and Behavioral Symptoms in a Child Partial Hospital Setting

Abstract: Partial hospitalization programs are an increasingly utilized, multidisciplinary treatment for children with social, emotional, and behavioral needs. Although previous work suggests these programs improve children’s mental health functioning, outcomes research has been limited. This study examines moderators of emotional and behavioral outcomes in children with serious mental illness, with particular focus on demographic (age, race, insurance type, and gender) and family (stressors and supports) factors. The study includes 287 children ages 7–13. Children completed standardized questionnaires at admission and discharge including the Behavior Assessment System for Children-2 the Child Depression Inventory 2, and the Screen for Child Anxiety Related Disorders while caregivers completed the Strengths and Difficulties Questionnaire. Results indicate improvements in children’s anxiety, depressive symptoms, psychological adjustment, and emotional symptoms. Furthermore, children with private insurance reported significant decreases in depressive (p < 0.001) and emotional symptoms (p< 0.001) compared to children with state funded insurance. Females reported sharper decreases in depressive symptoms (p< 0.001) compared to males (p= 0.019). Finally, children in families with no stressors in the past month demonstrated sharper declines in depressive symptoms (p< 0.001) compared to children in families with one or more stressors in the past month (p= 0.001). Family support did not moderate these outcomes. This study suggests partial hospitalization programs may be effective in improving emotional and behavioral problems. This study suggests family stressors are important to consider and emphasize in treatment.

Across-subjects multiple baseline trial of exposure-based cognitive-behavioral therapy for severe irritability: a study protocol

Abstract: Introduction Irritability is defined as a tendency towards anger in response to frustration. Clinically, impairing irritability is a significant public health problem. There is a need for mechanism-based psychotherapies targeting severe irritability as it manifests in the context of disruptive mood dysregulation disorder (DMDD). This study protocol describes a randomised multiple baseline design testing the preliminary efficacy of a new treatment, exposure-based cognitive-behavioral therapy for severe irritability in youth, which also integrates components of parent management training. We will investigate associations of this intervention with primary clinical measures, as well as ecological momentary assessment measures. Methods and analysis Forty youth will be enrolled. Participants, aged 8–17 years, must present at least one of two core symptoms of DMDD: abnormal mood or increased reactivity to negative emotional stimuli, with severe impairment in one domain (home, school, peers) and moderate in another, or moderate impairment in at least two domains. Each participant is randomised to a 2-week, 4-week or 6-week baseline observation period, followed by 12 active treatment sessions. Clinical ratings are conducted at baseline, biweekly (clinician), weekly (parent/child) throughout treatment, post-treatment, and 3-month and 6-month follow-up (clinician). Clinician ratings on the Affective Reactivity Index and Clinical Global Impressions-Improvement scale for DMDD are our primary outcome measures. Secondary outcome measures include parent and child reports of irritability. Post hoc additional symptom measures include clinician, parent and self-ratings of depression, anxiety and overall functional impairment. Prospective, digitally based event sampling of symptoms is acquired for a week pre-treatment, mid-treatment and post-treatment. Based on our pathophysiological model of irritability implicating frustrative non-reward, aberrant threat processing and instrumental learning, we probe these three brain-based targets using functional MRI paradigms to assess target engagement. Ethics and dissemination The research project and all related materials were submitted and approved by the appropriate Institutional Review Board (IRB) of the National Institute of Mental Health (NIMH). Trial registration numbers NCT02531893 and NCT00025935.