Research

The mission of the Advanced Center for Innovation in Services and Intervention Research (ACISIR) is to improve the quality of life of middle-aged and older adults with psychotic disorders through the development, implementation, and dissemination of evidence-based practice through community partnerships. The Center infrastructure is aimed at fostering research and education that result in pragmatic knowledge, innovative psychosocial instruments and interventions, and cultural competence in delivering services to the underserved. Active partnership with community stakeholders at every stage of research protocol development, evaluation, implementation, and dissemination will be a critical element of our work. The Center will build on and expand its established community partnerships; foster interdisciplinary collaboration; develop, evaluate, and disseminate innovative methods; and cultivate opportunities for new investigators, clinicians, front-line mental health workers, and consumers to improve the care of older persons with psychosis. Our primary community partner is San Diego County’s Adult and Older Adult Mental Health Services (AOAMHS).

Below are a number of studies we are currently recruiting participants for:

 

Age- Related Brain Changes in People with Bipolar Disorder
PI: Lisa Eyler, PhD
Contact Information: Heather Larrabee (858) 552-8585 ext 2774

The purpose of this study is to find out more about how the brain changes with age in bipolar disorder.  More specifically, we want to see if the brain looks and acts differently in people with and without bipolar disorder as they age.  To determine this, we use magnetic resonance imaging or MRI, a technique that uses magnets and radio waves to take pictures of the brain and record the brain’s use of oxygen while performing various memory tasks.

This study is done in three parts.  The first part is a brief phone screening to help us determine whether you would be eligible to participate in the study.  If we think you are eligible, then you will come into our lab at the Veterans Medical Research Foundation where you will decide whether to consent to the study and then have an interview to understand more about your history of mental illness, drug and alcohol use, and use of prescribed medications.  This visit will last approximately 3.5 hours and you will be compensated $60.  If we determine that you are eligible after this visit, you will be contacted to schedule a final visit that will last about 4.5 hours. At this visit, you will complete paper and pencil tests of things like attention, memory and reasoning.  Then, you will be taken to get a small amount of blood drawn and we will walk over to the Keck Imaging Center on the UCSD campus where you will undergo the MRI scan.  You will be paid $100 cash at the end of this day.  Anyone ages 30-79 years old diagnosed with Bipolar I disorder or healthy individuals (with no history of mental illness) are potentially eligible to participate.  If you are interested, please contact Heather Larrabee at (858) 552-8585 ext 2774.

Capacity to Consent to Research on Bipolar Disorder
PI: Barton W. Palmer, PhD

Contact Information: Casey Armstrong (858-535-5795)

The purpose of this study is to better understand how thinking abilities and psychiatric symptoms influence a patient's ability to make informed decisions about participating in a research study. We are also studying how decision making abilities may change over periods of up to 26 weeks. This study is being conducted at the VASDHS, as well as, in clinics and board and cares in the community. We are currently assessing individuals with bipolar disorder and healthy comparison subjects (i.e., no history of psychiatric or neurological illness).

Enhancing Consent for Alzheimer's Research 
PI: Barton W. Palmer, PhD
Contact Information: Casey Loughran (858-535-5795)

The purpose of this study is to learn more about how to effectively provide information about research studies to potential research participants, specifically people with a diagnosis of possible or probable Alzheimer's disease. Participants are asked to complete two study visits, usually on consecutive days. We are currently assessing healthy comparison subjects (i.e., no history of psychiatric or neurological illness) and people with Alzheimer's disease subjects at the VASDHS, in assisted living facilities, and in private residences.

Leadership Development for Evidence-Based Practice Implementation
PI:
 Gregory A. Aarons, PhD
Contact Information: Nikki Shapiro, MA (858-966-7703 x2695)

The goal of this study is to develop and test an organizational intervention to improve mental health program leadership knowledge, skills, and ability to implement evidence-based practices.  A team of experts in evidence-based practice, leadership development, organization development, mental health program management, adult learning, and implementation science will develop the core curriculum and training approach.  Community-based mental health executive directors, program managers, and clinicians will review the materials and training plan for focus, process, acceptability, and viability.  Twelve mental health program managers will then be randomly assigned to either treatment (leadership training) or no treatment (no training) experimental conditions. Analyses will compare leaders in the two conditions on transformational and transactional leadership behaviors, team implementation climate, and staff work attitudes. If successful, the leadership development model will be tested in a larger randomized trial. 

Exposure Therapy for Fear of Falling in Older Adults for Geriatric GAD 
PI: Julie Wetherell, PhD
Contact Information: 619-725-3530

This project will evaluate an in-home, physical therapist-delivered intervention, “Activity, Balance, Learning, and Exposure” (ABLE), that integrates exposure therapy with exercise, education about fall risks, a home safety evaluation, and a medication review for older adults with excessive and disabling fear of falling. If you would like more information about the study, please call Drew Petkus at 619-543-6788.

Healing Emotions After Loss (H.E.A.L.)
PI: Sidney Zisook, MD
Contact Information: Ilanit Young, PhD (858) 552-7598 

Complicated grief is a bereavement reaction in which acute grief is prolonged, causing distress and interfering with functioning. The pain of the loss stays fresh and healing does not occur. The bereaved person feels stuck; time moves forward, but the intense grief remains. Symptoms include a preoccupation with the person who has died, longing and yearning that does not substantially abate with time, and difficulty reestablishing a meaningful life without that person who has died. Complicated grief may affect as many as 1 out of 10 individuals who have lost someone close to them.

If this describes you, and you are between the ages of 18 and 95, you may be eligible to participate in a research project funded by the National Institute of Mental Health (NIMH) and the American Foundation for Suicide Prevention (AFSP). Both veterans and non-veterans are eligible to participate in the study. The objective of this project is to compare the effectiveness of antidepressants alone or in combination with Complicated Grief Treatment (CGT) in individuals who have been bereaved at least 6 months and who meet criteria for complicated grief. If you are interested and think you may be eligible, please contact Ilanit Tal Young, PhD, HEAL-Grief Coordinator, (858) 552-7598 or ityoung@vapop.ucsd.edu.

Validating Assessments of Real-World Outcomes 
PI:: Thomas L. Patterson, Ph.D. 
Contact Information: Barbara Johnson, Study Coordinator, (619)543-6486

This study aims to validate assessments of real-world (RW) functional outcomes in people with schizophrenia. Since the current tool of choice in predicting functional disability in schizophrenia is neuropsychological (NP) testing, proposals to reduce disability have tended to focus on short-term treatment of cognitive impairments. However, such trials are not well suited either to induce or identify improvements in real-world functioning. 
The present proposal has three distinct goals. It aims to determine: (1) the most accurate and practical scale for rating real-world outcomes in schizophrenia; (2) the optimal user of the scale; and (3) the factors that may impair the validity of self-reports of real-world outcomes on the part of schizophrenia patients. 
We adopt a construct-validation approach, using NP testing and functional-capacity measures as indicators of the construct and examining the convergence of various real-world outcome measures with these two indicators. Sophisticated data analysis will be performed to determine the convergences, and retesting will be performed to determine the test-retest stability of the candidate measures. The overall goal is to identify improved strategies for measuring real-world disability in schizophrenia and to inform the coming generation of treatment trials aimed at cognitive and functional enhancement through pharmacology and cognitive remediation in terms of the most suitable outcomes measures.