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David J. Miklowitz - One of the best experts on this subject based on the ideXlab platform.
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Treatment Development and feasibility study of family-focused Treatment for adolescents with bipolar disorder and comorbid substance use disorders.
Journal of psychiatric practice, 2014Co-Authors: Benjamin I. Goldstein, Tina R. Goldstein, Katelyn Collinger, David A. Axelson, Oscar G. Bukstein, Boris Birmaher, David J. MiklowitzAbstract:Findings from adults with bipolar disorder (BD) indicate that the presence of comorbid substance use disorders (SUD; abuse or dependence of drugs and/or alcohol) is associated with delayed recovery from mood episodes, more rapid relapse into recurrent mood episodes, increased symptoms, functional impairment,1 suicidality,2 polarity “switching” into mania,3 forensic difficulties4, and decreased medication adherence5 and quality of life.6 BD with onset during youth (before the person is 18 years of age) may confer an elevated risk of SUD even in comparison to adult-onset BD.7,8 BD among adolescents follows an even more symptomatic course compared to adult BD,9 and it is associated with significant functional impairment and high rates of psychiatric hospitalization and suicide attempts.10,11 Similar to adults, adolescents with BD are also at increased risk of SUD compared with the general population and even with adolescents with other psychiatric illnesses.10 By the end of adolescence, 30%–50% of youth with BD will have experienced a lifetime SUD, approximately triple the rate among youth without BD.12,13 Correlates of SUD among adolescents with BD include conduct disorder, suicide attempts, legal problems, pregnancy, and academic failure.14–16 During prospective follow-up, adolescents with BD and comorbid SUD have earlier recurrences and greater medication non-adherence compared with adolescents without comorbid SUD.17 To date, to our knowledge, only one published study has examined pharmacological Treatment of adolescents with comorbid BD and SUD,18 and no study has expressly examined the effectiveness of a psychosocial intervention in this group. Studies of manualized family therapies for youth with SUD generally exclude subjects with BD or enroll a small number of these subjects, and these interventions do not incorporate BD-specific Treatment strategies.19,20 This exclusion is important to reconsider because of mounting evidence that family therapy improves SUD among adolescents. In fact, recent practice parameters for youth with SUD gave the highest recommendation for family therapy (or at least significant family/parental involvement) as part of the minimal standard of Treatment. Family therapy was the only psychosocial Treatment to receive this level of recommendation.21 Family-focused Treatment (FFT), as an adjunct to pharmacotherapy, is effective in reducing symptoms of mania and particularly depression, preventing mood episode recurrence, and improving medication adherence among adolescents and adults with BD.22–24 However, adolescents with active SUD have been excluded from previous FFT studies, and FFT does not as yet integrate specific Treatment for SUD. There is a growing recognition of the importance of integrated psychosocial interventions targeting mood disorders and SUD,25 and recent findings from adults suggest that integrated Treatment of BD and SUD affords advantages compared with standard drug counseling.26 Therefore, we conducted a Treatment Development and pilot study in order to modify FFT for adolescents (FFT-A) to specifically target the Treatment challenges posed by adolescents with comorbid BD and SUD. We first present a brief overview of the FFT-A Treatment manual for BD. We describe specific considerations in treating adolescents with BD and SUD and explain how these considerations have been incorporated into a modified FFT-SUD manual for this population. Next, we present descriptive findings regarding therapy attendance and changes in mood and substance use among the adolescents enrolled in this pilot Treatment Development study. We anticipated that integrating an SUD perspective into FFT-A would retain the intervention’s benefits in terms of mood stability, and would also be associated with reductions in substance use.
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early psychosocial intervention for youth at risk for bipolar i or ii disorder a one year Treatment Development trial
Bipolar Disorders, 2011Co-Authors: Kiki D Chang, Dawn O Taylor, Christopher D Schneck, L M Dickinson, Meghan Howe, Elizabeth L George, Manpreet K Singh, David J. Miklowitz, Judy GarberAbstract:Objectives Previous studies have identified behavioral phenotypes that predispose genetically vulnerable youth to a later onset of bipolar I or II disorder, but few studies have examined whether early psychosocial intervention can reduce risk of syndromal conversion. In a one-year open trial, we tested a version of family-focused Treatment adapted for youth at high risk for bipolar disorder (FFT-HR).
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Life stress and the course of early-onset bipolar disorder.
Journal of Affective Disorders, 2007Co-Authors: David J. Miklowitz, Adrine Biuckians, Kimberley L MullenAbstract:Background Studies of adult bipolar patients and adolescents with major depression indicate that life stress and mood symptoms are temporally and causally related to one another. This study examined whether levels of life stress predict levels of mood symptoms among bipolar adolescents participating in a Treatment Development study of family-focused psychoeducation and pharmacotherapy.
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Integrated family and individual therapy for bipolar disorder: results of a Treatment Development study.
The Journal of clinical psychiatry, 2003Co-Authors: David J. Miklowitz, Elizabeth L George, Jeffrey A. Richards, Ellen Frank, Richard L. Suddath, Kristin B. Powell, Jennifer A. SacherAbstract:BACKGROUND Several studies have established the efficacy of psychosocial interventions as adjuncts to pharmacotherapy in the symptom maintenance of bipolar disorder. This study concerned a new psychosocial approach - integrated family and individual therapy (IFIT) - that synthesizes family psychoeducational sessions with individual sessions of interpersonal and social rhythm therapy. METHOD Shortly after an acute illness episode, 30 bipolar patients (DSM-IV criteria) were assigned to open Treatment with IFIT (up to 50 weekly sessions of family and individual therapy) and mood-stabilizing medications in the context of a Treatment Development study. Their outcomes over 1 year were compared with the outcomes of 70 patients from a previous trial who received standard community care, consisting of 2 family educational sessions, mood-stabilizing medications, and crisis management (CM). Patients in both samples were evaluated as to symptomatic functioning at entry into the project and then every 3 months for 1 year. RESULTS Patients in IFIT had longer survival intervals (time without relapsing) than patients in CM. They also showed greater reductions in depressive symptoms over 1 year of Treatment relative to their baseline levels. The results could not be explained by group differences in baseline symptoms or pharmacologic Treatment regimens. CONCLUSION Combining family and individual therapy with medication may protect episodic bipolar patients from early relapse and ongoing depressive symptoms. Further examination of this integrative model within randomized controlled trials is warranted.
Daniel C. Javitt - One of the best experts on this subject based on the ideXlab platform.
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A roadmap for Development of neuro-oscillations as translational biomarkers for Treatment Development in neuropsychopharmacology
Neuropsychopharmacology, 2020Co-Authors: Daniel C. Javitt, Steven J. Siegel, Kevin M. Spencer, Daniel H. Mathalon, L. Elliot Hong, Antigona Martinez, Cindy L. Ehlers, Atheir I. Abbas, Tobias Teichert, Peter LakatosAbstract:New Treatment Development for psychiatric disorders depends critically upon the Development of physiological measures that can accurately translate between preclinical animal models and clinical human studies. Such measures can be used both as stratification biomarkers to define pathophysiologically homogeneous patient populations and as target engagement biomarkers to verify similarity of effects across preclinical and clinical intervention. Traditional “time-domain” event-related potentials (ERP) have been used translationally to date but are limited by the significant differences in timing and distribution across rodent, monkey and human studies. By contrast, neuro-oscillatory responses, analyzed within the “time-frequency” domain, are relatively preserved across species permitting more precise translational comparisons. Moreover, neuro-oscillatory responses are increasingly being mapped to local circuit mechanisms and may be useful for investigating effects of both pharmacological and neuromodulatory interventions on excitatory/inhibitory balance. The present paper provides a roadmap for Development of neuro-oscillatory responses as translational biomarkers in neuropsychiatric Treatment Development.
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Neurophysiological models for new Treatment Development in schizophrenia: early sensory approaches.
Annals of the New York Academy of Sciences, 2015Co-Authors: Daniel C. JavittAbstract:Abstract Schizophrenia is a major mental disorder associated with core neurocognitive impairments. The ability to recreate these deficits in animal models is limited, hampering ongoing translational drug Development efforts. This paper reviews the use of electroencephalography (EEG)-based neurophysiological measures, such as event-related potentials (ERPs) or event-related spectral perturbations (ERSPs), as novel translational biomarkers for both etiological and Treatment Development research in neuropsychiatry. In schizophrenia, cognitive impairments manifest as deficits not only in high-level processes, such as working memory or executive processing, but also as deficits in neurophysiological responses to simple auditory and visual stimuli. Moreover, neurophysiological responses can be assessed even in untrained animals and are therefore particularly amenable to translational, cross-species investigation. To date, several sensory-level ERP measures, including auditory mismatch negativity and N1, and visual P1 and steady-state responses, have been validated in both human clinical investigations and animal models. Deficits have been tied to impaired neurotransmission at N-methyl-d-aspartate-type glutamate receptors (NMDARs). Time-frequency analysis of ERSP permits further extension of these findings from physiological to circuit/cellular levels of analysis.
Adam M. Leventhal - One of the best experts on this subject based on the ideXlab platform.
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Positive psychotherapy for smoking cessation: Treatment Development, feasibility, and preliminary results
The journal of positive psychology, 2013Co-Authors: Christopher W. Kahler, Nichea S. Spillane, Anne M. Day, Elise M. Clerkin, Acacia C. Parks, Adam M. Leventhal, Richard A. BrownAbstract:Low positive and high negative affect (NA) predict low rates of smoking abstinence among smokers making a quit attempt. Positive psychotherapy can both increase positive affect (PA) and decrease NA and, therefore, may be a useful adjunct to behavioral smoking counseling. The purpose of the present study was to assess the feasibility and acceptability of a positive psychotherapy for smoking cessation (PPT-S) intervention that integrates standard smoking cessation counseling with nicotine patch and a package of positive psychology interventions. We delivered PPT-S to 19 smokers who were low in PA at baseline. Rates of session attendance and satisfaction with Treatment were high, and most participants reported using and benefiting from the positive psychology interventions. Almost one-third of the participants (31.6%) sustained smoking abstinence for six months after their quit date. Future studies to assess the relative efficacy of PPT-S compared to standard smoking cessation Treatment are warranted.
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Abstinence-related expectancies predict smoking withdrawal effects: implications for possible causal mechanisms
Psychopharmacology, 2013Co-Authors: Peter S. Hendricks, Adam M. LeventhalAbstract:Rationale Despite the decades-long emphasis on withdrawal in leading models of addiction, the causal mechanisms driving smoking withdrawal effects are not well known. This gap in the knowledge base has stalled theory and Treatment Development for smoking dependence.
Richard A. Brown - One of the best experts on this subject based on the ideXlab platform.
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Positive psychotherapy for smoking cessation: Treatment Development, feasibility, and preliminary results
The journal of positive psychology, 2013Co-Authors: Christopher W. Kahler, Nichea S. Spillane, Anne M. Day, Elise M. Clerkin, Acacia C. Parks, Adam M. Leventhal, Richard A. BrownAbstract:Low positive and high negative affect (NA) predict low rates of smoking abstinence among smokers making a quit attempt. Positive psychotherapy can both increase positive affect (PA) and decrease NA and, therefore, may be a useful adjunct to behavioral smoking counseling. The purpose of the present study was to assess the feasibility and acceptability of a positive psychotherapy for smoking cessation (PPT-S) intervention that integrates standard smoking cessation counseling with nicotine patch and a package of positive psychology interventions. We delivered PPT-S to 19 smokers who were low in PA at baseline. Rates of session attendance and satisfaction with Treatment were high, and most participants reported using and benefiting from the positive psychology interventions. Almost one-third of the participants (31.6%) sustained smoking abstinence for six months after their quit date. Future studies to assess the relative efficacy of PPT-S compared to standard smoking cessation Treatment are warranted.
Kimberley L Mullen - One of the best experts on this subject based on the ideXlab platform.
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Life stress and the course of early-onset bipolar disorder.
Journal of Affective Disorders, 2007Co-Authors: David J. Miklowitz, Adrine Biuckians, Kimberley L MullenAbstract:Background Studies of adult bipolar patients and adolescents with major depression indicate that life stress and mood symptoms are temporally and causally related to one another. This study examined whether levels of life stress predict levels of mood symptoms among bipolar adolescents participating in a Treatment Development study of family-focused psychoeducation and pharmacotherapy.
