• Families and Addictions: Forgiveness as a Powerful Clinical Tool

      Camino-Gaztambide, Richard F.; Malavé de León, Eunice; Department of Psychiatry and Health Behavior
      Short Description: Addictions are complex behaviors that have a profound impact on the individual, family, and society. Forgiveness can transform negative emotions for oneself or others to achieve or sustain recovery. The purpose of the workshop is to offer the clinical underpinnings that can facilitate the implementation of forgiveness in practice. Abstract: Addictions are complex behaviors that have a profound impact on the individual, family, and at a societal level. Although many see addictions as fundamentally a disease of the brain and clearly brain structures and functions are significantly involved, nevertheless, brain function alone does not address the consequences and profound effects that addictions have on the patient's ecosystem. Family, friends, co-workers, and neighborhood, all are altered with frequent feelings of anger, shame, guilt, and rejection present in all parties. Usually, these feelings are in response to real or perceived transgressions by one or more persons, and it is not uncommon that trauma is present, producing persistent stress which can interfere with recovery. The concept of forgiveness can be a powerful tool to help patients address the injury and trauma that they have done or received by others. Shame, defined as a “flawed self, often accompanied by feelings of worthlessness and powerlessness” is associated with negative feelings and poorer recovery. In contrast, guilt, that focuses more on the behavior not necessarily reflected as the total self, is more amenable to forgiveness. Forgiveness as a disposition to where the use of negative emotions for oneself or others can be transformed to achieve or sustain recovery. The Twelve-step facilitation model can be integrated, especially focusing on steps four through nine, as other models like Narrative, ACT, and CBT are also able to use the concept of forgiveness in effective ways. The purpose of the workshop is to provide basic theoretical and clinical underpinnings, use case presentations, interactive discussions, to provide skills that can facilitate the implementation of forgiveness in clinical practice. “Addiction is more than a disease and involves more than the brain: it is a systemic behavioral disorder.”
    • Gene-Environment Interaction Modulates Schizophrenic Endophenotypes in Heterozygous Reeler Mice

      Howell, Kristy R.; Department of Psychiatry and Health Behavior (2013-07)
      Aim 1: To determine the effect of chronic stress on the VEGF signaling pathway. Aim 2: To determine the effects of prenatal hypoxia on VEGF signaling, behavioral activities, blood flow, and brain volume in heterozygous reeler mice during early adulthood. Aim 3: To evaluate long lasting effects of prenatal hypoxia on VEGF signaling, behavioral activities, blood flow, and brain volume in heterozygous reeler mice. Aim 4: To determine the correlation between serum VEGF levels and brain volumes in schizophrenia subjects.
    • Long-Term Continuous Corticosterone Treatment Decreases VEGF Receptor-2 Expression in Frontal Cortex

      Howell, Kristy R.; Kutiyanawalla, Ammar; Pillai, Anilkumar; Department of Psychiatry and Health Behavior (2011-05-27)
      Objective: Stress and increased glucocorticoid levels are associated with many neuropsychiatric disorders including schizophrenia and depression. Recently, the role of vascular endothelial factor receptor-2 (VEGFR2/Flk1) signaling has been implicated in stress-mediated neuroplasticity. However, the mechanism of regulation of VEGF/Flk1 signaling under long-term continuous glucocorticoid exposure has not been elucidated.
    • Pharmacogenetics of antipsychotic adverse effects: Case studies and a literature review for clinicians.

      Foster, Adriana; Wang, Zixuan; Usman, Manzoor; Stirewalt, Edna; Buckley, Peter F.; Department of Medicine; Department of Pathology; Department of Psychiatry and Health Behavior (2009-03-20)
      There is a growing body of literature supporting the contribution of genetic variability to the mechanisms responsible for the adverse effects of antipsychotic medications particularly movement disorders and weight gain. Despite the current gap between research studies and the practical tools available to the clinician to identify such risks, it is hoped that in the foreseeable future, pharmacogenetics will become a critical aid to guide the development of personalized therapeutic regimes with fewer adverse effects. We provide a summary of two cases that are examples of using cytochrome P450 pharmacogenetics in an attempt to guide treatment in the context of recent literature concerning the role of pharmacogenetics in the manifestation of adverse effects of antipsychotic therapies. These examples and the review of recent literature on pharmacogenetics of antipsychotic adverse effects illustrate the potential for applying the principles of predictive, preventive, and personalized medicine to the therapy of psychotic disorders.
    • Plasma BDNF Levels Vary in Relation to Body Weight in Females

      Pillai, Anilkumar; Bruno, Davide; Sarreal, Antero S.; Hernando, Raymundo T.; Saint-Louis, Leslie A.; Nierenberg, Jay; Ginsberg, Stephen D.; Pomara, Nunzio; Mehta, Pankaj D.; Zetterberg, Henrik; et al. (2012-07-2)
      Brain derived neurotrophic factor (BDNF) has been implicated in the pathophysiology of depression as well as neuropsychiatric and neurodegenerative disorders. Recent studies show a role of BDNF in energy metabolism and body weight regulation. We examined BDNF levels in plasma and cerebrospinal fluid (CSF) samples from age matched elderly depressed and control subjects. Also, the association of BDNF levels with age, gender, body weight, body mass index (BMI), and cognitive performance was evaluated. We did not find any significant differences in plasma and CSF BDNF levels between depressed and control subjects. Plasma BDNF levels were negatively correlated with age (but not with BMI and body weight), when analyses were performed including both depressed and control subjects. A significant reduction in plasma BDNF levels was observed in females as compared to male subjects, and the change in BDNF levels were significantly and positively related to body weight in females. Furthermore, significant increases in Total Recall and Delayed Recall values were found in females as compared to males. In conclusion, the lower BDNF levels observed in females suggest that changes in peripheral BDNF levels are likely secondary to an altered energy balance. However, further studies using larger sample size are warranted.
    • Questionnaire Design and Responsiveness in a Data Capture Tool for Student Sharing of Experiences of Statewide Clerkship Sites

      Zheng, Stephanie; Behrman, David; Agrawal, Parth; Basco, Brian; Ball, Charlotte; Rose, Jennifer; Miller, Samel; Wood, Elena (2017-03)
      Positive clerkship experiences and student performance in the clinical years has been correlated to perceived quality of education and specialty choice amongst medical students [1-3]. The Medical College of Georgia uses a distributed campus model with more than 250 clerkship rotation sites across the state and beyond, making student clerkship choices imperative to their development as physicians. We developed a survey to collect both quantitative and qualitative data from students during their clerkship years and a system to distribute that information to students. The data allowed us to evaluate the effectiveness of various question formats through responsiveness, the length of responses, and time spent on the survey. In addition to this, we looked at the number of responses per clerkship in order to see whether or not our survey was getting information about all of the 3rd year rotations. We aspire to take these findings and utilize them to expand t he program and improve the questionnaire in order to yield more responsiveness from students.