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Research Opportunities
(Psychology)
John G. Arena, Ph.D. - Chronic pain and
Psychophysiological Disorders, Augusta Department of Veterans Affairs
Medical Center
Dr. Arena currently has VA Medical Research Merit
Review grant on chronic headache. The project involves three studies.
The first study is designed to investigate the relationship between
anger and HA activity. The second study is designed to determine whether
providing direct feedback to the more tense muscle group (either
forehead or upper trapezius) will afford greater relief to tension HA
sufferers than feedback provided from the less tense muscle group. The
third study is a preliminary inquiry into the feasibility of a
telemedicine delivery system for psychophysiological intervention (e.g.,
relaxation therapy and thermal biofeedback) for chronic vascular HA.
This third study is an analogue study (that is, patients come into Dr.
Arena's lab at the VA and are seen either in standard face-to-face
treatment or treatment through teleconferencing). Preliminary research
on 40 subjects suggests that the telemedicine analogue group is just as
efficacious as the standard face-to-face treatment (both about 70-80%
effective). There are numerous opportunities for residents to tap into
this data base, especially the psychometric one.
There are two pending grants. One is a VA
Rehabilitation Merit Review that involves the applications of
psychophysiological treatment for chronic pain delivered through a
telemedicine delivery system. If funded, there will be two groups: (1)
the experimental group which will receive relaxation therapy and EMG
biofeedback in the home through a standard videophone that uses existing
telephone technology, which will be compared to, (2) a current standard
of care (medical management) control group. Again, there are numerous
opportunities for residents to become involved in this research. The
second pending proposal is a continuation of Dr. Arena's current Medical
Research Merit Review, and involves the applications of a telemedicine
delivery system to chronic benign headache, In the first of two studies,
we will expand and extend our promising telemedicine work with vascular
headache by comparing a control group (standard face-to-face
office-based relaxation and thermal biofeedback treatment) to three
experimental telemedicine groups: (1) home-based low-bandwidth (33,6
Kbps) videophone treatment; (2) remote clinic-site low-bandwidth
videophone treatment; and, (3) remote clinic-site medium-bandwidth (384
Kbps) ISDN-based videoconferencing. Again, opportunities for resident
involvement are available.
In addition to the above, there are numerous
opportunities for basic psychophysiology research and
psychophysiological analogue treatment studies through collaboration
with Augusta State University. Moreover, exhaustive review papers of the
literature which synthesize the research and suggest future research
directions are always available for the resident to conduct. For
example, this year we have had a resident conduct an exhaustive review
of relaxation therapy for chronic low back pain that has been accepted
as a poster which will have the abstract published.
Amy House, Ph.D. - Psychology of Women and
Health Behavior Program of the Department of Psychiatry and Health Behavior,
Medical College of Georgia
1.
Child sexual abuse treatment research: This is a pilot
study examining process variables that account for change in
cognitive-processing therapy for childhood sexual abuse survivors. The first
goal of this study is to examine the effectiveness of this therapy for CSA
survivors in terms of its impact on psychiatric diagnosis and symptom
severity. The second goal of this study is to test two alternative theories
regarding the mechanisms of change in psychotherapy for CSA survivors. One
theory explains the symptoms of PTSD in an information processing model and
posits that changes in cognitive appraisals account for therapeutic change.
Another theory explains PTSD symptoms as a by-product of experiential
avoidance and posits that increases in willingness to experience unpleasant
affect will account for therapeutic change. Data collection for this study
is ongoing. Preliminary examinations of the data in a case-series format are
currently possible.
2.
PTSD and HIV positive women: Many studies have
documented that women with histories of victimization by abuse or assault
have poorer physical health than non-victimized women. However, few studies
have examined all forms of interpersonal violence victimization, and few
have examined factors explaining and influencing the relationship between
victimization and physical health. Some research suggests that posttraumatic
stress disorder (PTSD) may be relevant to the relationship between
victimization and physical health. This study is a proposal to collect data
from HIV positive African American women in an Infectious Disease clinic and
to test the hypothesis that the relationship between interpersonal violence
victimization and HIV-related outcomes is accounted for by the mediating
effect of PTSD. Multiple forms of victimization will be assessed in order to
examine both the cumulative and differential effects of various types of
interpersonal violence victimization on physical health. Data is
currently being collected in this study.
Christian Lemmon, Ph.D. - Eating Disorders
and Health Behavior Program of the Department of Psychiatry and Health
Behavior, Medical College of Georgia
The Eating Disorders Program has a large data base
available from the assessments of about 500 patients who have been
evaluated for eating disorders, including Anorexia Nervosa, Bulimia
Nervosa, Eating Disorder NOS, Binge Eating Disorder, Obesity and an
assortment of other feeding disturbances during the past 11+ years.
These assessments have included the results of several tests specific to
eating disorders (The Bulimia Test, Eating Disorders Inventory, The
Binge Scale, The Restraint Scale, Body Parts Satisfaction Scale, and
Body Shape Questionnaire). Assessments have also included measures of
depression (Beck Depression Inventory) and social avoidance and
distress. In addition to measuring specific eating disordered symptoms,
the EDI also measures other psychological traits presumed to have
relevance in the understanding and treatment of eating disorders. These
include measures of Ineffectiveness, Perfectionism, Interpersonal
Distrust, Interoceptive Awareness, Maturity Fears Asceticism, Impulse
Regulation, and Social Insecurity. Finally, the results from a
self-administered structured interview type questionnaire that is rather
comprehensive and includes information related to patients' demographic
information, academic history, weight history, eating and dieting
habits, sleep patterns, exercise habits, coping styles, personal and
family psychiatric and medical histories, and reasons for seeking
treatment.
This large database could be used to address many
questions that have not been answered with respect to the assessment and
treatment of eating disorders and related feeding disturbances. Some of
the research that is possible from this data set includes, basic
assessment studies, studies investigating the correlations of these
various measures, several different predictive validity studies
(prognosis from initial assessment data, initial differences between
treatment responders vs. treatment drop outs, etc.) and treatment follow
up studies. Of course, this database lends itself to numerous other
research possibilities.
Data is also available (similar to that described
above) from the assessments of at least 60 gastric surgery patients.
Assessment and treatment data is also available
from at least 15 anorexic patients who received psychotherapy and were
prescribed Zyprexa and an antidepressant (usually Paxil), and
experienced weight gains of 10-40+ lbs, with no regression noted after
discontinuation of the Zyprexa. A retrospective report related to this
data is possible. Recent conversations with Eli-Lilly suggest a strong
possibility for some funded research related to this data.
Lara Stepleman, Ph.D. - HIV Psychological
Services and Health Behavior Program, Medical College of Georgia.
One facet of my
research is to examine the utilization, efficacy, and feasibility of
providing mental health services in an integrated manner at medical
clinics for the chronically medically ill who often have great needs for
mental health care and even greater barriers to receiving that care.
Currently our focus is on HIV/AIDS and Multiple Sclerosis in which we
are examining the effectiveness of two types of psychological services
aimed at removing care barriers, reducing distress, and increasing
quality of life. The first service is a patient-centered psychological
consultation program, which we currently have created and are
implementing in both the Infectious Disease and Multiple Sclerosis
clinics at the Medical College of Georgia. Second, as depression
symptoms are the most frequent reason for a consultation and often
significantly impede medical care, we also plan to study the
effectiveness of a short-term depression treatment provided as part of
the patient's HIV or MS medical services. We have already collected data
on our HIV consultation program and submitted a paper for publication
based on the results of this data (Stepleman, Hann, Santos, & House,
2005). My goal is to expand this research to include multi-site and
economic feasibility studies that would be competitive to be funded at
the federal level through NIH and related Institutes.
A second facet
of my research relates to feminist psychological approaches to theory,
therapy, and research, which provide context for the intersection of
gender, race, and socioeconomic status as HIV/AIDS rapidly transforms
into a disease of women, color, and poverty. The psychological, medical,
and social challenges that women living with HIV/AIDS confront each day
are clearly situated within a content domain that has been traditionally
linked with feminism such as body image, sexuality, identity, resource
allocation, and disenfranchisement. As related to this interest, Dr. Amy
House and I are investigating the impact of physical and sexual abuse
and interpersonal violence on African American women's HIV health
outcomes.
Frank Treiber, Ph.D. - Georgia Prevention
Institute and the Medical College of Georiga
The GPI has a variety of NIH funded research
projects evaluating the biobehavioral determinants of preclinical
cardiovascular diseases(CVD) and type 2 diabetes, as well as
nonpharmacologic interventions aimed at halting the early progression of
risk factor development in youth (eg, physical activity , stress
reduction ,smoking prevention programs). The GPI website under the MCG
website research category of institutes and centers has a listing of the
various projects, faculty expertise, etc.
Psychological factors, personality
characteristics, etc play an important role in the development of
physical CVD and type 2 diabetes risk factors. Many of the GPI projects
evaluate the roles of family functioning, anger/hostility, social
support, self esteem, body image, coping styles, etc in the development
of physical risk factors, as well as the interactive effects of
stressful environmental backgrounds and genetic predisposition due to
various genetic polymorphisms upon the development of preclinical
disease states.
One advantage of involvement with the GPI is
availability of large data bases that permit addressing many questions
which have not been answered with respect to the above "psychological
related" factors and the development of CVD or type 2 diabetes.
As a result, our experience has been that
residents, housestaff, faculty, etc who get involved in such research
training efforts usually end up with 1-2 published articles, abstracts,
etc. This has helped not only build up their CV but for some, it has
actually jump started their academic career path.
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