Research Interests
Bipolar disorder is a chronic condition characterized by recurrent episodes of mania and depression. It is one of the leading causes of disability worldwide. In the United States, approximately 2.8% of the adult population suffers from the disorder (NIH, 2022). It is now well known that the course of bipolar disorder is wrought with faster reoccurrences of episodes, dysfunction, disability, frontal cognitive abnormalities, cognitive impairment, and treatment refractoriness if episodes are left untreated (Post, 2021). While many researchers believe in the "wait and see" model for diagnosing bipolar disorder (Malhi et al., 2020), studies such as the Systematic Enhancement Program for Bipolar Disorder (STEP-BD) have shown that out of a cohort of 983 participants, 27.7% had an onset <12 and 36.6% had an onset between the ages of 13-18 (Leverich et al., 2007).
Schizophrenia affects 24 million people worldwide, or 1 in 300 people (World Health Organization, 2022). The disorder causes three groups of symptoms that affect the individual’s mental state and ability to function. Positive symptoms include hallucinations and delusions, negative symptoms include insufficiencies in social experience, and cognitive symptoms include issues with learning and attention (StÄ™pnicki et al., 2018). Due to the nature of the symptoms, schizophrenia is one of the top twenty-five leading causes of disability in the world (World Health Organization, 2022).
To date, my research has focused on early-onset mood and psychotic disorders, with a particular focus on bipolar disorder and schizophrenia. Many individuals with bipolar disorder experience an onset of the condition during childhood or adolescence. Yet, Pediatric Bipolar Disorder (PBD) remains a controversial diagnosis due to concerns about stigmatization and early exposure to medication side effects. Addressing an individual’s condition early can help mitigate negative outcomes, supporting early development of effective coping skills, and more autonomous symptom management for a better long-term prognosis.
I am interested in the role that Family-Focused Therapy plays in the treatment of those diagnosed with early-onset bipolar disorder. Family-Focused Therapy (FFT) is an evidence-based treatment modality that has shown to produce intrinsic changes in the portion of the brain known as the ventrolateral prefrontal cortex, which causes emotion dysregulation in patients with bipolar disorder. FFT is one of the only family-oriented psychotherapeutic treatment modalities that has been demonstrated to support healthy changes to manic and depressive episodes for individuals with bipolar disorder. But many clinicians do not practice this treatment modality; possibly due to its complexity in implementation. FFT equips the individual and their closest family members with psychoeducation, problem-solving tools, and enhanced communication skills so they can better understand, accept, and manage the symptoms of bipolar disorder.
My current research targets two specific aspects of FFT:
First, I want to make FFT less complicated to practice. I would like to draw more attention to the value of FFT so that other clinicians consider this treatment modality when working with their clients. The cost of failing to diagnose and treat early-onset conditions is far too high. I hope to support clinicians and other researchers in ethically and confidently providing the support that individuals and families need to preempt negative outcomes in adulthood.
Second, I am actively working to expand research on the most effective applications of FFT in early-onset psychosis. I believe it can have the same influence on those who experience psychosis in their early years of life as it does with bipolar disorder. My current work seeks to develop our understanding of the basis of paranoid ideation for the purpose of adapting FFT to psychotic disorders.
I am inspired by the individuals seeking strength beyond their diagnosis. The science is on their side: When individuals receive proper tools to manage their symptoms their prognosis improves. For these reasons, I am optimistic about the future for those with early-onset mood and psychotic disorders.
-Leverich, G.S., Post, R.M., Keck, P.E., Altshuler, L.L., Frye, M.A., Kupka, R.W., Nolen, W.A., Suppes, T., McElroy, S.L., Grunze, H., Denicoff, K., Moravec, M.K.M., & Luckenbaugh, D. (2007). The Poor Prognosis of Childhood-Onset Bipolar Disorder. The Journal of Pediatrics, 150(5), 485-490. https://doi.org/https://doi.org/10.1016/j.jpeds.2006.10.070
-Malhi, G.S., Bell, E., Hamilton, A., & Morris, G. (2020). Paediatric Bipolar Disorder: prepubertal or premature? Australian & New Zealand Journal of Psychiatry, 54(5), 547-550. https://doi.org/10.1177/0004867420920365
-NIH. (2022). Bipolar Disorder. National Institute of Health. Retrieved January 18, 2022 from https://www.nimh.nih.gov/health/statistics/bipolar-disorder
-Post, R.M. (2021). The Kindling/Sensitization Model and Early Life Stress. Curr Top Behav Neurosci, 48, 255-275. https://doi.org/10.1007/7854_2020_172
-Stępnicki, P., Kondej, M., & Kaczor, A.A. (2018). Current Concepts and Treatments of Schizophrenia. Molecules (Basel, Switzerland), 23(8), 2087. https://doi.org/10.3390/molecules23082087
-World Health Organization. (2022). Schizophrenia. World Health Organization. Retrieved March 8, 2022 from www.who.intl/mental_health/management/schizophrenia/en/