My primary clinical interest and expertise is in the evaluation and treatment of women with mental health issues during pregnancy and postpartum, as well as women’s mental health throughout the life cycle, including premenstrual and menopause-related psychiatric symptoms. In addition, I am interested and experienced in evaluation and treatment of anxiety disorders and depression.
I am a Clinical Psychologist working in the Addiction Treatment Center, VA Puget Sound Healthcare System, Seattle Division since 2000. I work primarily on the Opiate Use Disorder treatment team (ATC Team 1) with both male and female Veterans on pharmacological maintenance therapy (methadone, buprenorphine, or naloxone). I am on faculty for the Seattle VA Psychology Training Program, Seattle VA CESATE Multidisciplinary Fellowship Program, and UW Psychiatry Residency Program as a clinical supervisor for psychotherapy.
My primary interests are in diagnostic evaluation, psychiatric methods, psychosomatic medicine, fatigue syndromes, pain disorders, abnormal illness behaviors, and human temperament and personality. I have conducted research jointly with colleagues at the University of Washington and the University of Washington Twin Registry on chronic widespread pain, depression and related phenomena.
I am a Child and Adolescent Psychiatrist who has served for over 20 years as the attending psychiatrist on the middle-schooler unit at Child Study and Treatment Center. I also serve, 25% time , as “College Mentor” in the UW School of Medicine Introduction to Clinical Medicine Curriculum where I mentor six students in each UW SoM class through their four year curriculum. I serve as preceptor/supervisor for one CAP fellow during their rotation at CSTC. I also run the elective clerkship for fourth year medical students (approximately 10 students/year) during 2 and 4 week rotations at CSTC.
| I am a Seattle native who has spent my entire academic career at the University of Washington School of Medicine. I joined the faculty of the UW Department of Psychiatry and Behavioral Sciences in 1977 and was based at the Seattle VA Puget Sound Health Care System. I joined the Seattle-American Lake Geriatric Research, Education and Clinical Center (GRECC) in 1977 as a clinical investigator and later served as GRECC Director from 1987-1998. In 1998, I was appointed Chair of the Department of Psychiatry and Behavioral Sciences and held this position until February, 2014. I am certified by the American Board of Psychiatry and Neurology with Added Qualifications in Geriatric Psychiatry and am listed in America’s Top Doctors and Best Doctors in America. I am recipient of the 2005 American Academy of Child & Adolescent Psychiatry, Robert Cancro Academic Leadership Award: Best Chair. I have conducted extensive research on the treatment of depression in patients with heart disease and stroke and has published more than 140 scientific publications. I am active in community efforts to improve the quality of care for the seriously mentally ill and with my faculty colleagues am implementing regionally, nationally, and internationally innovative and highly effective models of care that integrate mental health care into primary care settings. I am working with medical schools and the health ministries in Vietnam and Cambodia to strengthen psychiatric education, expand the mental health workforce, and develop delivery systems for psychiatric care in those countries. |
My lab’s focus is reward processing, how it differs under behavior phenotypes that are more vulnerable or resilient to mental illness and how it is changed by psychiatric pathology. Our primary focus is dopamine transmission and the circuits in which is participates.
We developed tools that allow us to track dopamine with sub-second resolution in animals over the course of months (Clark et al, Nat Methods, 2010). This approach allows us to study trajectories of precise neurochemical encoding of behaviors over the course of the development of symptomology and subsequent treatment in animal models of disease. We also have adapted this technology for intraoperative recording in humans (Kishida et al, PLoS One, 2011).
Our research highlights include contributions in the area of dopamine’s role in learning (Flagel et al, Nature, 2012), decision making (Gan et al, Nat Neurosci, 2010) and goal navigation (Howe et al, Nature, 2013). We have gleaned information on how stress impacts appetitive motivation (Wanat et al, Nat Neurosci, 2013), how adolescent alcohol use produces enhanced risk taking later in life (Clark et al, PLoS One, 2012), and identified biological mechanisms for the motivational shift in stress-induced depressive disorders (Lemos et al, Nature, 2012) and the switch to excessive drug intake in substance abuse (Willuhn et al, Nat Neurosci, 2014).
These approaches have attracted a large number of collaborations, including National Academy members Akil, Palmiter, Graybiel and Kandel.
Helping individuals in the time of their personal crisis, whether emotional, psychological or behavioral, is what feeds my passion for psychiatry.
