Child and Adolescent Psychiatry Fellowship Training Program

Research

Child Behavior Disorders
Halperin J, Newcorn JH

For the past 12 years our program has cultivated an incremental program of study with children with ADHD and other disruptive behavior disorders. Our research has examined: 1) the nature of presenting pathology and classification of these children, including the objective measurement of inattention, impulsivity and hyperactivity symptoms, discriminant validity with regard to other psychiatric conditions, and the differential impact of psychiatric comorbidity; and 2) the neurochemical basis of aggression and learning disabilities in ADHD children. Currently this work focuses on follow-up of children with ADHD and/or aggression into adolescence, comparing neuropsychological disturbances in those whose symptoms persist to those whose symptoms remit, risk for substance use, and impact of comorbidity.

This research program in disruptive behavior disorders represents a unique interdisciplinary and inter-institutional effort. Dr. Jeffrey Halperin, whose principal appointment is in the Neuropsychology Graduate Program at Queens College (CUNY) heads this research team and holds a faculty appointment in this Division. Dr. Newcorn is a co-investigator in this research with Dr. Halperin. This project has been supported by grants from NIMH, Queens College, and the William T. Grant Foundation.

Neuropsychology and Treatment of ADHD Subtypes
Solanto M, Newcorn JH

This set of interconnecting studies is designed to investigate differences in the etiology, neuropsychological functioning, neurophysiology, and the treatment response of children with the inattentive subtype of ADHD. An NIMH-funded study examines pharmacologic responses as a function of subtype. The neural basis of ADHD subtypes is also examined using fMRI.

Psychopharmacologic Trials in Children and Adolescents
Newcorn JH, Aronowitz J, Ivanov I

The Division of Child and Adolescent Psychiatry conducts several clinical pharmacologic trials in a variety of child and adolescent disorders including ADHD, conduct disorder, and mood and anxiety disorders. Trainees have the opportunity to participate in treating study patients under faculty supervision. There is a weekly meeting which reviews all aspects of protocol development and design, issues regarding IRB approval and study implementation, and ethical issues. All participants in the program attend this meeting.

ADHD Research Network
Newcorn JH, Halperin J, Solanto M, Schulz K, Fan J

Dr. Newcorn is the PI of an interdisciplinary research network to investigate the role of dopamine in ADHD, bringing together the scientific expertise of leading investigators from Brookhaven National Laboratory, Sackler Institute of Weill-Cornell Medical Center, Oregon Health Sciences University and the University of California at Irvine. The Network supports collaborative planning and pilot studies to test neurobiological mechanisms in preclinical and clinical populations.

Dopamine Function in Adults with ADHD
Newcorn JH, Solanto M, Schulz K

Dr. Newcorn is a co-investigator and Mount Sinai PI of this study to investigate the role of the dopamine system (dopamine transporter; D2 receptors) in ADHD using PET radioligand methodology. The study aims to determine the extent to which psychostimulant treatment for one year will alter the functioning of the dopamine. This grant is done in collaboration with Brookhaven National Laboratory (PI: G-J Wang).

fMRI Studies of ADHD
Schulz K, Fan J, Newcorn JH, Halperin J, Solanto M, Tang C

Several studies are ongoing to examine brain activation in individuals with ADHD in response to a cognitive task challenge. All represent a collaboration between various members of the Division of Child and Adolescent Psychiatry and fMRI researchers in the Departments of Psychiatry and Radiology (Fan, Tang). One study (Halperin, Schulz et al.) examines brain activation in adolescents formerly diagnosed with ADHD, who retain the disorder to varying degrees. A second (Solanto, Newcorn, Schulz) examines differences in brain activation in ADHD patients with combined and predominantly inattentive subtype. A third(Newcorn, Schulz et al.) examines differences in activation following treatment with atomoxetine; and measures differential activation patterns to atomoxetine and stimulants.

Child and Adolescent Trauma Recovery Program
Chemtob C

Dr. Chemtob is the Principle Investigator of an NIMH funded Research Infrastructure Support Grant that is supporting the development of an academic-community service partnership aimed at developing field based trials of child trauma assessment and treatment. The collaborating institution is the Jewish Board of Family and Children's Services (JBFCS). The co-investigator is Dr. Robert Abramovitz of JBFCS. In addition, Dr. Chemtob is conducting a large scale screening and intervention program with children below the age of 5 and their families who were directly exposed to 9/11 downtown Manhattan. He is also developing a registry and conducting research on the current psychological recovery status of children bereaved as a result of 9/11. Dr. Chemtob is involved in school-based screening and intervention programs in New York City and Israel. He actively collaborates with Israeli and French colleagues on trauma related research. Dr. Chemtob has just received funding to establish a new program to address catastrophic life events in young children. He consults internationally on terrorism and its impact on children and families.

Child and Adolescent Trauma Treatment and Services Consortium (CATS)
Abramowitz R, Newcorn JH, Chemtob C

The CATS program at Mount Sinai is a collaborative effort with the Jewish Board of Family and Children's Services (Abramowitz) and is a part of a seven-site project coordinated by the New York State Office of Mental Health and supported by grant funding from FEMA and SAMHSA. The goal of the consortium is to deliver and evaluate mental health treatment to children and adolescents affected by the incidents of September 11, 2001. Clinically, CATS uses Cognitive Behavioral Therapy (CBT) and includes psychoeducation, coping skills training, relaxation training, learning how to recognize, understand, and control difficult feelings, and learning how thoughts affect emotions and behavior. The evaluation component of the CATS program will provide data about trauma focused CBT in order to promote the delivery of high quality treatments to youth affected by traumatic events.

The Seaver Autism Center for Research and Treatment
Buxbaum J

The Center, funded by a major grant from the Seaver Foundation since 1993, is dedicated to unraveling the biological causes of autism and related disorders, and developing effective treatments for autism. The Seaver Center's interdisciplinary approach to the study of autism includes Genetic studies, Brain Imaging studies, and Biological, Neuropsychiatric and Psychosocial, and Psychopharmacological Treatment Studies. The Seaver Autism Center offers an integrated series of unique programs ranging from clinical care to neurobiology to genetic studies. Our commitment to understanding autism ranges from studies of the whole family and continues through the very molecules that make up genes.

PTSD and Nonadherence in Children Who had a Liver Transplant
Shemesh E

This project investigates medical disease-related PTSD. It hypothesizes that some patients stop taking their medications to avoid reminders of stressful experiences related to their illness. The project includes an adherence protocol (investigating adherence to medications in children with liver illnesses) and psychiatric evaluations that are done in the pediatric liver / liver transplant clinics at The Mount Sinai Hospital. The evaluations include measures of posttraumatic stress, depression, anxiety, and other psychopathology in patients and their parents. The project will identify predictors for nonadherence in order to target them for intervention.

Collaborative HIV Prevention and Adolescent Mental Health Project (CHAMP)
McKay, M

Dr. McKay directs a program of NIMH-funded research focused on identifying the mental health needs of urban youth and their families and testing innovative ways to address those needs. For example, Dr. McKay is the Principal Investigator of CHAMP (Collaborative HIV Prevention and Adolescent Mental Health Project) Family Program study, a test of a community-collaborative, family-focused HIV prevention program for youth living in high HIV infection rate communities in New York, Chicago, South Africa and Trinidad. In addition, Drs. McKay and Marcus are investigating an approach to mobilizing urban parents to deliver an evidence-based prevention program in New York City schools and community centers, "Community Partnerships to Prevent Urban Youth Health Risks." Finally, Dr. McKay is collaborating with the New York State Office of Mental Health to develop methods to engage youth and their families in needed mental health services and the New York City Department of Health and Mental Hygiene to increase parent participation in Early Intervention services for youth children with developmental disabilities.

Delineating Differences Between Inattentive and Combined Type ADHD Children Using the CPT and Event-Related Potentials
Solanto, M

This project is designed to study the kinds of difficulties in attention, planning, and self-control that children with different types of Attention Deficit/Hyperactivity Disorder may experience. Comparisons between Inattentive Type, Combined Type, and psychiatric controls will be made based on the Connors Continuous Performance Test and electrical potentials in the brain evoked by a simple, computer-based task.

Physiologic Responses to Violent/Non-Violent Films in Children with a History of Aggression and Trauma
Ivanov I

The purpose of this study is to examine changes in physiologic responses (heart rate and salivary cortisol) in children watching violent and non-violent films. The hypothesis is that children with a history of aggression and trauma will demonstrate increased activity in physiologic response to violent visual stimuli and those with aggression of a non-traumatic etiology will not show significant changes in activity from baseline levels. Heart rate and salivary cortisol levels during exposure to violent stimuli can then potentially be used as biochemical markers for trauma-related aggression and may also serve as a screening tool to aid in diagnosis.

The Relationship Between Obsessive-Compulsive Behaviors and Whole Blood Serotonin in Autism: Searching for Evidence of Autism Endophenotypes
Kolevzon, A

This study examines the relationship between whole blood serotonin level and obsessive-compulsive behavior in multiplex families with at least one autistic proband. We expect to reproduce previous findings that demonstrate serotonin levels to be familial and significantly higher in some individuals with autism. This work will also incorporate qualitative (ADI-R, Y-BOCS) and quantitative (whole blood serotonin) measures to identify a specific pattern of symptoms in order to describe a more homogeneous phenotype which can be used for genetic analysis in the future. In addition to providing further evidence for familial symptom domains in autism, this study may identify specific symptom patterns associated with serotonin level, supporting the use of serotonergic medications in subgroups of youth with autism and emphasizing the need for clinical trials in the future.