Phan presented research from the Mood and Anxiety Disorders Research Program that morning on treatments, strategies, and interventions for dysregulation of nodes in the amygdala-frontal brain network that underlies human emotion and motivation. As part of the UICDR leadership, he has been actively looking to collaborate with two other neuroscience laboratories involved in UICDR—the Chicago Laboratory of Emotion and Physiology and the Cognitive Neuroscience Center—which could create new understanding of the relationship between depression and anxiety disorders.
In collaboration with Dr. Stewart Shankman, who runs the Chicago Laboratory of Emotion and Physiology through the psychology department and Dr. Scott Langenecker, Director of the Cognitive Neuroscience Center, Phan is interested in where their areas of investigation overlap.
“Evidence seems to show that general anxiety, dysthymia, major depression, social anxiety, panic disorders have more in common with one another—they are more similar—than they are different.” Phan elaborates. “By looking at the shared biology of these disorders we can not only gain a better understanding of them, but also, practically speaking, a better understanding of how we can intervene on them.”
The Chicago Laboratory of Emotion and Physiology (dubbed the “Uncertainty Lab”) uses a multi-method approach to understand the nature of depression and explore the relationship between mood and anxiety disorders combining clinical and epidemiological approaches with neuroscience and psychophysiological methods. The Mood and Anxiety Disorders Research Program integrates affective, cognitive, and social neuroscience perspectives primarily using magnetic resonance imaging (fMRI, DTI, sMRI) and electroencephalography (EEG) of event-related potentials (ERP) looks at brain circuit function as they relate to emotion, affect regulation, motivation and decision-making. While, the Cognitive Neuroscience Center, has expertise in translational neuroscience drawing on the disciplines of physics, engineering, computer science, statistics, psychology, neuroanatomy, pathology, endocrinology to understand the neurobiology of depression and more effectively treat mood disorders.
If this collaboration gains traction and secures grant funding, they could begin not only to compare data, but also strategically share research subjects between each of the three labs. Currently, all three labs inadvertently compete with one another for research subjects, but creating a common core where the same patient can participate in research for all three labs. This would wide variety of data collected from a diverse array of neuroimaging tools—fMRI, EEG—considered through different lenses—neuropsychiatry, clinical psychology, neuropsychology—possibly yielding new insights into anxiety and depression.
“We can look for consistency across all these diseases. Is there a common construct to depression, worry, panic? Can we do something about these patterns? By combining our multiple skillsets and approaches to consider these questions, we can get results that we may not be able to reach independently.” Phan elaborates.
By encouraging collaborations among these diverse methods—not just neuroimaging, but also blood, saliva, deep phenotyping, genomic/ genetic studies, genetic signals—and pooling collected data UICDR hopes for a more nuanced perspective of depression, anxiety, and mood disorders.
Catalyzing a culture of collaborators
“The goal of the retreat was really to catalyze collaborations. In principle it achieved that just by getting these groups together. The challenge will be how we build on that initial group from here,” Phan states.
Optimistically, he sees possibilities beyond an annual retreat. “The future of neuroscience is that we should all be in the same group. We should be able to fuse neuroimaging, neuropathology, clinical approaches, and so on to focus on issues together.”
The Neuroscience Retreat and the collaborative spirit of the UICDR are the first steps to shifting the culture from siloed researchers single mindedly focusing on a solution to a community of problem solvers approaching multiple strategies to making change.
On the Table discussion on "Building a Mental Health Resilience Plan for Chicago"
How can we have an impact on mental health citywide? How can individual treatment methods be translated into policy? What does mental health look like through a public health lens?
These were the questions raised during an On the Table discussion hosted by UICDR titled “Creating a Mental Health Resilience Plan for Chicago,” part of the series of conversations held on May 10 in conjunction with the Chicago Community Trust and the Kennedy Forum.
On the Table is an annual forum designed to elevate civic conversation, foster new relationships and create a unifying experience across the region. Thousands of Chicago-area residents gather in small groups to share a meal and discuss the challenges and opportunities the city is confronting. Over 55,000 people all over Chicago joined in this year’s discussions, with 270 of these conversations focused on mental health thanks to the Kennedy Forum’s participation. This is the second year that UICDR has been involved.
UICDR convened speakers from urban planning, public health, psychology, psychiatry, and early childhood education for this timely discussion. Only a couple weeks earlier, on May 2, Chicago announced its first Chief Resilience Officer, Aaron Koch.
The Rockefeller Foundation launched a 100 Resilient Cities initiative as part of a global plan to help cities become more resilient. Recognizing that “crisis is the new normal,” the Foundation rolled out a plan worldwide to address social and structural issues alike, issues of inequality, health, and the environment. The citywide resilience plan identifies what makes each city vulnerable and what can be done to strengthen it. In Chicago, an aging infrastructure, crime and violence prevention, and flooding were highlighted as priority areas of focus.
This On the Table discussion centered on recognizing the role mental health plays in these conversations. Mental health is implicit to human resilience. Resilience is the ability to bounce back or recover from an event. It is an important trait for the individual, as well as for the city of Chicago. And, mental health is part of the physical, social, and economic challenges of the 21st century. This conversation was an opportunity to make mental health an explicit part of the conversation.
These areas may be more closely connected than they first appear. As Dr. Charlie Hoch, Professor in the Department of Urban Planning & Policy put it: “The vocabulary of resilience in reference to urban planning and housing is very different to that of mental health, but there are strong linkages to be made.” Hoch studies spatial planning focusing on issues of homelessness and affordable/supportive housing.
“What I understand the city of Chicago wants to do is that they want to find ways to address both everyday stresses and extraordinary events: floods, tornados, or terrorist events,” explains Dr. Stevan Weine, an expert on extremism and disaster response with UICDR, who spoke at the event and has worked with Los Angeles, CA on developing their city-wide resilience plan.
Weine notes: “People, clinicians, sometimes have a misunderstanding of what the role of psychiatry and mental health is in a disaster or resilience. They think that it is just applying their clinical skills directly to treating patients. From a public health point of view how do you get out a certain amount of information or strategies that we can teach people through the media, through schools, through primary care to kind of get people some level of assistance that they can use on their own. A lot of our job becomes not directly treating people, but more education. So, education through the media or education through leaders in other institutions, like in schools, like in primary care clinics, like in faith-based institutions.”
Putting this framework into practice on the resilience end of the spectrum is Dr. Marc Atkins, Director of the Institute for Juvenile Research, who has spent the past two decades developing models for children’s mental health that leverage natural settings.
“We can’t just think of mental health as something that happens in clinics or hospitals. Mental health happens everywhere. By introducing opportunities for positive intervention into places where children already feel comfortable—home, schools, playgrounds, even on public broadcasting—we can have more success creating strategies that work.” Atkins argues.
He and his team currently operate a school-based program with 16 Chicago Public School serving more than 900 children and families, an afterschool recreation program with several park districts, a home visitation program for first time moms, and a partnership with the local public broadcasting station that infuses mental health content into short television spots. These touch points, which draw on a public health framework, provide an opportunity to foster resilience in the institutions where children are already involved.
Much of the literature for this work has been conducted internationally, where a lack of mental health professionals and resources is outpaced by need, but demands in the United States are quickly catching up. An estimated 14.8 million U.S. adults are affected by depression costing approximately $80 million annually due to lost productivity and health care with a shortage of mental health professionals.
“We need to increase the mental health workforce by training up,” says Dr. Pauline Maki, Director of the Women’s Mental Health Research, where she focuses on cognition and sex differences.
For Atkins, increasing the mental health workforce involves training paraprofessionals to provide support via home visits, in the classroom, or through the park district. From training teachers to use classroom-based interventions for disruptive students to deescalating aggressive behavior on the playground before it becomes violent, Atkins’ team has refined a public health approach that uses resources inherent in natural community settings to achieve mental health aims alongside social, emotional, recreational and educational goals.
Maki in turn trained OBGYN providers—physicians, nurses, midwives, attendees, residents—on using the PhQ9, a validated tool for screening depression among pregnant and postpartum women from low-income Chicago neighborhoods. Many of the women in the project were not receiving routine medical care prior to their pregnancy, let alone mental health care, but their routine check-ups provided a window of opportunity for the research team to address those barriers. In a six-week trial involving 25 women, the project decreased symptoms of depression, and was a marked success. Participants were better able to manage their mood and stress, and take on the responsibilities of motherhood.
Innovative strategies for leveraging the natural settings, institutions, and systems where people live, work, learn, and play, while expanding the mental health workforce to include paraprofessionals, teachers, coaches, and medical staff is the future of mental health. These interventions represent ways to meet the growing mental health needs of Chicago in an efficient, effective way.
Dr. Jenna Duffecy Nominated for Social Innovation Award
For the past 14 years, the Chicago Innovation Awards has recognized inventors, entrepreneurs, startups, and established companies alike in an effort to make Chicago a hub of innovation. Created by the Chicago Sun-Times and Kuczmarski & Associates in 2002, the Chicago Innovation Awards recognizes 10 Chicago area businesses, nonprofits, and government organizations that develop the year’s most innovative new products and services.
This year, UI CDR is honored to have clinician and researcher Dr. Jenna Duffecy nominated for a Social Innovation Award. Duffecy is the Director of CBT Research and Services at UIC and a clinician in the Anxiety and Mood Disorders Clinic. She recently created Sunnyside for Moms, an app that helps treat depression in pregnant low-income minority women. Launched in conjunction with a Women’s Mental Health Research Program, part of a larger UICDR initiative, Sunnyside for Moms screens pregnant and postpartum women from low-income Chicago neighborhoods for depression.
Duffecy attributes the success of her approach to the clinician/ scientist model. Early in her career as a researcher developing mental health interventions through emerging technologies, she maintained a private practice, so that she could have firsthand experience employing techniques that work. Today, as the director of CBT services in the mood disorder clinic, she continues this individualized therapeutic approach as a way of informing her research.
In a six-week trial including 25 women, Sunnyside decreased symptoms of depression, and was a marked success. Participants were better able to manage their mood and stress, and take on the responsibilities of motherhood. Sunnyside for Mom’s created protocols to follow up on screens for depression, so that appropriate interventions can be created that account for the social, cultural, and physical barriers to receiving care.
This includes the CBT app, developing a protocol where CBT can be delivered over the phone, and a group therapy tailored to the needs of UIC obstetric patients.
Winners for the Chicago Innovation Awards are named on September 7, 2016 at an event at the Harris Theater.
UICDR to Develop a Discussion Guide for Middle Schoolers Confronting Social Pressures of Digital Media
Andrea A. Lewis, author of the new book Love Yourself(ie), Life Lessons for Building Kid Charisma™, partnered with UICDR to develop a discussion guide which helps instill self-confidence and foster resilience for middle schoolers confronting the social pressures of digital media.
Lewis, a parent herself, wrote the book after seeing the impact of social media firsthand on her daughters. Many preteens check social media 100 times a day because they are concerned about fitting in. The book follows the fictional story of Harper, who learns to use self-acceptance to filter social media and manage peer pressure and competition. With a focus on teaching what we think of ourselves matters most and ‘how’ to use self-acceptance to keep others from influencing bad feelings and behaviors, Love Yourself(ie) is a highly relatable story kids see themselves in, with a practical perspective and advice they can use to understand what they’re feeling and become more confident and true to themselves – on social media and in life.
“There’s very little guidance for parents that’s relevant to a child’s experience,” noted Dr. Julie Carbray, clinical professor of psychiatry and nursing at UIC, who developed a series of social media tips for preteens, ages 9 to 13, and their parents to prevent social media use from deflating their self-worth. “Parents need to be able to talk to kids in ways that are relevant to the kids.” Carbray stated in a recent interview on the topic: http://bit.ly/29nVqpS
"Socially and emotionally, middle school can leave preteens questioning who they are and how to act – at an age when character development is being shaped. Social media is further testing the strength of that character. By building resilience through self-esteem in preteen years more kids will have the character strength they need to feel good about themselves and manage conflict – on social media and in life. While it is important to provide proper guidance to help preteens build resilience, many parents are unfamiliar with the topic and unsure how to approach the conversation with their child.
Navigating friendships, belonging, self-image and bullying has long been part of growing up, social media makes the experience public – and it is leaving preteens feeling left out and insecure. Parents and children can use the following tips, inspired by the book and current psychological literature, to help guide them through this new terrain.
The tips are part of a larger strategy that aims at releasing the discussion guide to accompany the book for middle school classrooms in time for back-to-school in September. Dr. Jenna Duffecy, UI CDR Researcher, Director of CBT Research and Services and a clinician in the Anxiety and Mood Disorders Clinic, will also be helping with the development of the discussion guide. Lewis has generously offered to donate $1 for each book sold as a part of the launch.