I am Professor and Associate Director for Evidence-Based Psychosocial Interventions at the AIMS Center, and Director of the National Network of PST Clinicians, Trainers & Researchers. In these roles, I develop and lead implementation and training programs in a variety of behavioral health interventions.
I am a geriatric psychiatrist and health services researcher. My research focuses on ways of improving mental health and well-being among older adults, especially those with dementia and their caregivers.
My research interests cover two main areas:
1) development and use of novel radioligands for positron emission tomography (PET) in CNS disorders
2) cannabinoid pharmacology, and cannabis use disorder and comorbid neuropsychiatric disorders
My VA Career Development Award (VA equivalent of an NIH K-award) focuses on the translational development of imaging neuroinflammation with PET following repetitive blast mild traumatic brain injury (mTBI). In collaboration with David Cook’s lab, imaging neuroinflammation in a mouse model of repetitive mTBI provides an opportunity to compare imaging outcomes directly with histopathology in brain tissue, which is not possible in humans. In collaboration with Elaine Peskind, imaging neuroinflammation in Veterans with mTBI and persistent post-concussive symptoms provides neuroanatomical specificity to ongoing neuroinflammation, which to date has been informed using cerebrospinal fluid and serum biomarkers. To accomplish this, my laboratory evaluates and develops established and novel PET radioligands for biomarkers of neuroinflammation. Additionally, I am interested in developing novel radioligands for druggable targets for which there are no current, suitable radioligands available. I have several ongoing collaborations with other investigators at UW and VA in which I provide support with PET imaging.
As a clinician and researcher, I am interested in how patients use cannabis for perceived therapeutic effect, and the risks and adverse outcomes resulting from substantial or chronic cannabis use. These clinical patterns can now be placed into context with a better understanding of the endocannabinoid system (ECS), which provide opportunity for more selective and safer therapeutic drug development. Due in part to the recentness of discovery of the ECS, one of my goals is to educate clinical providers on the preclinical and evidenced based research conducted to date on cannabis use and the ECS so they are better informed when discussing cannabis use with patients, and better prepared for understanding mechanisms of anticipated ECS-based medications currently under development. A second goal is to conduct research on cannabis use disorder and comorbid conditions, and identification of therapies that might better address a patient’s desired outcome from cannabis use, thereby reducing the likelihood of its associated risks.
Dr. Sylvers serves as the Director of Psychology Training at the Veterans Affairs Puget Sound Health Care System, American Lake Division. His primary research interests include personality and its relation to treatment outcomes, treatment outcomes related to trauma and anxiety related disorders, and the etiology and treatment of aggressive behavior. Dr. Sylvers also serves as a consultant for the Department of Veterans Affairs Acceptance and Commitment Therapy for Depression training initiative.
My work focuses on education and training in the areas of suicide prevention and suicide care. Particular interests include supporting clinicians who have experienced the loss of a patient to suicide and building knowledge among health care professionals about cultural aspects of firearm ownership and use.
My clinical service and research focuses on the interaction of mental and physical illness, especially in patients with chronic pain. Much of my research in recent decades has focused on the risks of treating chronic pain with opioids. I have developed educational programs and outcome tracking tools to assist with opioid treatment of chronic pain. I have published a book about patient empowerment in chronic disease care, The Patient as Agent of Health and Health Care (Oxford, 2017). I have another book written with Jane Ballantyne forthcoming, The Right to Pain Relief and other deep roots of the opioid epidemic (Oxford, 2022).
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.
Over the last 25 years, my work has focused on relationships between stress and health in several risk groups (spouse caregivers of persons with Alzheimer’s disease, medical students, psychiatric/medical outpatients/inpatients, air traffic controllers, and camp counselors). We have developed and/or revised measures of medical student stress, caregiver burden, patient anger/dyscontrol, process coping, appraisal, neuropsychological function and physician awareness of patient problems. These measures have been used by university researchers, insurance companies, pharmaceutical companies in clinical trials, prisons, nursing homes/long term care, rehabilitation facilities, and public health organizations. These psychosocial and behavioral measures have been shown to predict and be predicted by physiological and cognitive measures. We have also focused on moderators of such relationships, such as gender, personality, and co-morbidities. We have used primarily multicohort long-term studies that allow for interactions between exposures to stressors, hard-wired vulnerabilities, and more temporal resources. We attempted to identify mechanisms that can be potentially altered to have long-term public health significance in persons under chronic stress. I have also attempted to isolate groups that are at high risk for negative outcomes. In a perfect world, interventions should be used to help all persons who have deleterious responses to stress, but society cannot afford this. For this reason, the identification of high risk groups is imperative for maximizing the effect of interventions.
My research program’s long range goal is to better understand the mechanisms by which chronic stress translates into physical, mental, or cognitive health problems. We are examining caregivers of spouses with AD and demographically-similar spouse non-caregivers across time and assessing the degree to which elevated depression, stress hormones, inflammation, and insulin resistance in caregivers predict cognitive decline in caregivers relative to non-caregivers. We are also attempting to replicate our earlier work that showed that chronic stress and chronic disease moderate each other’s physiological risks. For example, physiological dysregulation that is specific to a disease (e.g., metabolic syndrome with CHD, blood pressure reactivity with hypertension, and immune function with cancer history, HbA1c with diabetes) is exacerbated in caregivers with a chronic disease relative to non-caregivers with a chronic disease, but no such differences occur in caregivers versus non-caregivers without a chronic disease. Finally, we are examining a large cohort of older adults sampled from various U.S. communities in order to assess the influence of life stressors on long term cognitive function and potential mediators of such changes.
