We aim to determine the accuracy and specificity of Arterial spin labeling (ASL) — a non‐invasive perfusion technique used in MRI to track cerebral blood flow — in measuring vascular and glial‐dependent water transfer to establish whether it is a valuable clinical tool in Alzheimer’s disease. This simple and safe technique, already approved for use in a clinical setting, has potential to circumvent current invasive approaches in human subjects at risk for AD‐related dementias.
Targeted Condition: PTSD
Does the microbiome play a role in adverse outcomes following mTBI and PTSD?
The proposed research will be a preliminary investigation into the potential association between microbiota abundance, hormone levels, peripheral inflammation and current symptoms (psychiatric and cognitive) in Veterans with and without a history of mild traumatic brain injury (mTBI). This work has the potential to form a new line of research that could ultimately provide new treatment options for individuals who have persisting symptoms following mTBI.
Disseminating a user-friendly guide: Advancing the science of intervention adaptation and improving access to evidence-based psychological treatment
Adaptation of evidence-based practices and programs (EBPs) is a necessary component of the implementation process. EBPs must be adapted to function with the constraints of real-world practice settings, providers’ expertise, and patients’ needs. The science of intervention adaptation is hungry for well-defined methods of EBP adaptation to guide decision making. A how-to guide for EBP adaptation titled MODIFI: Making Optimal Decisions for Intervention Flexibility during Implementation, is under development with NIMH funding (F32 MH116623). MODIFI will be disseminated via multiple strategies locally, nationally, and internationally. Dissemination of MODIFI will improve the practice of intervention adaptation by providing practitioners with a how-to guide that is (a) evidence-based, (b) usable, and (c) supported by the expert consensus of implementation practitioners and researchers.
Project SARAH (Sexual Assault, Recovery & Hope)
Project SARAH is a randomized clinical trial providing treatment for PTSD and alcohol use in the first year following sexual assault for individuals who identify as female. The study aims to test 1) the role of fear and reward in recovery following sexual assault; 2) the efficacy of a PTSD vs an alcohol intervention for promoting recovery; and 3) the type and amount of intervention needed to best promote recovery (e.g., whether individuals need both PTSD and alcohol interventions and whether recovery is improved by intervening on PTSD or alcohol use first).
Improving usability
While evidence-based psychosocial interventions (EBPIs) are important, their design is cumbersome, complex, overwhelming, inflexible, and minimizes factors that are crucial for quality delivery of care.
This study will work with six FQHCs across MT that were recently reorganized under Bighorn Valley Health Center’s umbrella to involve their Therapists and Care Managers in the redesign of an intervention to address their unique patient population and to capitalize on their task sharing model.
Project STEP
This project is designed to integrate basic and clinical science to translate mechanisms of recovery from PTSD to testing an intervention in individuals with PTSD and marijuana use. We will recruit 72 individuals with PTSD and varying levels of marijuana use, 36 with current heavy marijuana use and 36 without current marijuana use, to complete a conditional discrimination and extinction task in order to understand the relationship between marijuana and fear learning in individuals with pathological fear. Following this task, participants will receive a brief 6 session imaginal exposure protocol (IE) to explore whether this adapted short form treatment shows increased feasibility (efficacy, reduced drop out) for individuals with co-occurring PTSD and marijuana use. We will also be able to test the link between basic fear and recovery processes by looking at the extinction task as a predictor of treatment response for individuals with and without marijuana use. This research is significant in its potential to identify a predictor of treatment response, to test an underlying mechanism of recovery for PTSD in individuals with PTSD and co-occurring marijuana use, and to test feasibility of a novel intervention for a difficult to treat population.
Study to Promote Innovation in Rural Integrated Telepsychiatry (SPIRIT)
The primary goal of this project is to quantitatively compare the treatment experience, engagement, self-reported clinical outcomes, and recovery-oriented outcomes of patients initially randomized to telepsychiatry collaborative care and telepsychiatry enhanced referral. In addition, for the subset of patients randomized to telepsychiatry enhanced referral who do not engage in treatment and are still symptomatic at 6 months, an additional goal is to quantitatively compare the treatment experience, treatment engagement, self-reported clinical outcomes and recovery-oriented outcomes of patients randomized to continued- telepsychiatry enhanced referral or phone enhanced referral. Additional goals are to gain an in-depth understanding of patients’ and providers’ treatment experiences and to examine treatment heterogeneity among subgroups of patients based on race/ethnicity, age and clinical severity.
Premera rural mental health initiative
The AIMS Center is partnering with Premera to support up to 30 clinics in rural Washington and Alaska to expand access to evidence-based mental health treatment. Selected clinics will receive up to $245,000 over 15 months to defray participation costs.
