Health & Medicine
Our sciences are contributing in many ways to health and medicine, including investigating a potential treatment for the symptoms of fetal alcohol syndrome; working on gene therapy treatments for central nervous system disorders, including stroke; recognizing the link between satisfying martial relationships for good health; and developing cost effective treatments for autism.
Brain Injury Treatments
Promising human research trials using the hormone progesterone in severely brain-injured patients showed an almost 60% reduction in mortality compared to standard care, and several larger clinical studies are now underway. These discoveries have developed from behavioral neuroendocrinology research showing that female rats recover more readily from brain injury than do males. 1-5
Fetal Alcohol Syndrome Treatments
Developmental psychobiologists are investigating the essential nutrient choline as a potential treatment for symptoms of fetal alcohol syndrome. Research on rats has shown that extra choline given during, or even after, alcohol exposure can significantly reduce some alcohol-related deficits, particularly memory deficits. These basic science findings have led to two current clinical trials examining whether choline supplementation can improve cognitive functioning in humans with or at risk for fetal alcohol spectrum disorders. 6,7
Behavior analysts were first to characterize the reinforcing effects of drugs, revolutionizing the scientific investigation and treatment of addictive disorders. Based on this knowledge, successful interventions to treat stimulant, opiate, nicotine, and alcohol addiction have been designed to facilitate major lifestyle changes that strengthen behavior that is incompatible with addictive behavior. Contingency management approaches explicitly arrange incentives for maintaining abstinence. 8,9
Central Nervous System Disorder Treatments
Behavioral neuroscientists are currently working on gene therapy treatments for central nervous system disorders, including stroke, based on accumulated evidence that stress-related hormones can accelerate brain cell death. Researchers also are using information about the impact of stress on the brain to develop strategies for reducing stress. 10
Slowing Brain Degeneration
Increased understanding of the influence of sex hormones on the brain may lead to new treatments for neurodegenerative and psychiatric disorders in both men and women. Behavioral neuroendoscientists study how sex-related hormones affect brain cell changes and hormonal involvement in brain disorders such as depression and Alzheimer's disease. Research with rodents has demonstrated that some forms of the sex hormone estrogen have positive effects on learning and slow brain degeneration. 11,12
In a NIH-funded study of heart rate variability in biofeedback therapy for asthma, biofeedback researchers found that all participants receiving the treatment avoided an asthma exacerbation over a 3-4 month period, took less asthma medication, and exhibited fewer symptoms compared to those who didn’t receive the treatment. Asthma affects approximately 10% of the population and accounts for approximately 5000 deaths annually in the U.S., 1.2 million emergency department visits, and 445,000 hospital days. The economic burden is estimated to be $5.1 billion. 13
Reduced Disability/Improved Outcome
NIMH-funded research has demonstrated that in people with schizophrenia, cognitive remediation treatment improves cognitive functioning and, when added to other evidence-based treatments for schizophrenia, resulted in increased amount of time worked (approximately 25%) and better social skills acquisition (approximately 30% improvement). Cognitive impairment is a strong predictor of poorer functioning, and commonly used medications do little to treat this deficit. Cognitive rehabilitation is a cost-effective method to reduce disability and improve treatment outcomes. 14-18
Maximizing Function in Schizophrenia
Schizophrenia researchers studying negative symptoms (disturbances in motivation and emotion) and social cognition (mental processes related to interacting with others) have identified factors that predict continued poor community functioning in people with schizophrenia and are developing psychosocial and pharmacological treatments to maximize functioning. Schizophrenia is among the top six leading causes of disability in the world. Despite effective treatments for psychotic symptoms, the majority of people with schizophrenia experience major social, educational, and occupational difficulties. 19,20
Prevention & Treatment of Mental Illnesses
By understanding how hormones affect the brain during adolescence, progress can be made toward improving prevention and treatment of disorders that arise during this critical period. Behavioral neuroendocrinologists study how sex-related hormones affect adolescent brain development in humans and animals, specifically examining changes in social behaviors and social cognition associated with mental illnesses that often emerge in adolescence and disproportionately affect women (eating disorders and depression) or men (schizophrenia). 21-23
Improved Outcomes After Brain Tumor
Neuropsychological research has led to the development of neuropsychological interventions like cognitive remediation that can reduce educational costs among children who survive brain tumors. Approximately 66% of children with brain tumors survive longer than 5 years after diagnosis, making amelioration of residual disease and treatment effects critical to ongoing behavioral, cognitive, and educational functioning. 24
Better Treatments for ADHD
Accurate diagnosis and use of evidence-based treatment increases the probability of positive outcomes for the approximately 5 million American children with ADHD. ADHD is common, but because it is often associated with other disorders, it can be difficult to diagnose and complex to treat. Neuropsychologists have developed assessments to identify both co-occurring conditions and specific deficits, resulting in more comprehensive treatment, targeted interventions, and thus improvements in multiple aspects of quality of life and potential cost savings. 25
Cost Effective Treatments for Autism
Cost savings due to Early and Intensive Behavioral Interventions (EIBI) for children with Autism Spectrum Disorders have been estimated at $1.5 million to $2.5 million per child across ages 3-55 years and over $208K per child for 18 years of education. Developed through Behavior Analysis research, EIBI is a widely accepted, evidence-based treatment that helps children with autism spectrum disorders attain intellectual, academic, communication, social, and daily living skills, often within the normal range. 26-30
Concussion Evaluation & Recovery
Identifying boxers who are still symptomatic following concussion improves safety by preventing premature return to activity. Returning to boxing prior to full neuropsychological/neurological recovery increases the risk of cumulative concussions and long-term brain damage and associated costs. Neuropsychological tests are the most sensitive method for detecting neurological dysfunction in active amateur boxers. 31,32
Optimize Medical Treatment & Expenditures
Identifying people with schizophrenia who do well without ongoing pharmaceutical treatment may diminish the presence of potentially life shortening medication side effects and optimize medical expenditures. Schizophrenia affects millions and results in billions of dollars in medical expenses, particularly the cost of long-term antipsychotics that are currently the standard of care. In a 20-year longitudinal study, brain scientists found that a subgroup of patients not continuously treated with antipsychotics functioned well compared to continuously medicated patients. 33,34
Psychologists have discovered ways to improve health and well-being and decrease health care utilization through inexpensive and easily administered strategic writing exercises. Expressive writing about painful or stressful experiences helps people focus and make sense of their circumstances and has even been associated with significant health changes including decreased number of doctor visits and stronger antibody responses to viruses and vaccines. 35,36
Effective Parenting Interventions
Increased understanding of the environmental and biological bases of parenting provides direction for developing interventions to improve the quality of human parent-child relationships. Animal research in behavioral neuroscience has demonstrated that young animals separated from their mothers grow up to be more impulsive and active, and less socially appropriate and attentive to their own young; but that these deficits can be eliminated through additional stroking during the separation period. 37
Improving Marriage & Health
Hostility during marital conflict has been associated with poorer health, including coronary artery calcification, poorer immune functioning, slower wound healing, and greater inflammation. Recognizing the link between satisfying marital relationships for good health, social psychologists have demonstrated that couples given brief assignments directing them to write about their conflicts from a neutral perspective maintained their level of marital quality over time, compared to couples not given the writing exercise who showed a drop in marital quality. 38-42
- Stein DG. Brain damage, sex hormones and recovery: A new role for progesterone and estrogen? Trends in Neurosciences. Jul 2001;24(7):386-391.
- Stein DG. Progesterone exerts neuroprotective effects after brain injury. Brain Research Reviews. Mar 2008;57(2):386-397.
- Stein DG. Is progesterone a worthy candidate as a novel therapy for traumatic brain injury? Dialogues in Clinical Neuroscience. 2011;13(3):352.
- Wright DW, Kellermann AL, Hertzberg VS, et al. Protect: A randomized clinical trial of progesterone for acute traumatic brain injury. Annals of Emergency Medicine. Apr 2007;49(4):391-402, 402 e391-392.
- The brain research lab of emory university. 2012; http://brainresearchlab.weebly.com/.
- Thomas JD, Idrus NM, Monk BR, Dominguez HD. Prenatal choline supplementation mitigates behavioral alterations associated with prenatal alcohol exposure in rats. Birth Defects Research. Oct 2010;88(10):827-837.
- Thomas JD, La Fiette MH, Quinn VR, Riley EP. Neonatal choline supplementation ameliorates the effects of prenatal alcohol exposure on a discrimination learning task in rats. Neurotoxicology and Teratology. Sep-Oct 2000;22(5):703-711.
- Higgins ST, Silverman K, Heil SH. Contingency management in substance abuse treatment. The Guilford Press; 2007.
- Silverman K, Robles E, Mudric T, Bigelow GE, Stitzer ML. A randomized trial of long-term reinforcement of cocaine abstinence in methadone-maintained patients who inject drugs. Journal of Consulting and Clinical Psychology. Oct 2004;72(5):839.
- Saplosky RM. Glucocorticoids, neuroendangerment and neurotoxicity. In: Fink G, ed. The encyclopedia of stress. Vol 2: Academic Press; 2000:238-243.
- Barha CK, Galea LAM. Influence of different estrogens on neuroplasticity and cognition in the hippocampus. Biochimica et Biophysica Acta (BBA)-General Subjects. 2010;1800(10):1056-1067.
- Workman JL, Barha CK, Galea LA. Endocrine substrates of cognitive and affective changes during pregnancy and postpartum. Behavioral Neuroscience. 2012;126(1):54.
- Lehrer PM, Vaschillo E, Vaschillo B, et al. Biofeedback treatment for asthma. Chest. Aug 2004;126(2):352-361.
- Bowie CR, McGurk SR, Mausbach B, Patterson TL, Harvey PD. Combined cognitive remediation and functional skills training for schizophrenia: Effects on cognition, functional competence, and real-world behavior. American Journal of Psychiatry. May 11 2012;169(7):710-718.
- Eack SM, Hogarty GE, Cho RY, et al. Neuroprotective effects of cognitive enhancement therapy against gray matter loss in early schizophrenia: Results from a 2-year randomized controlled trial. Archives of General Psychiatry. Jul 2010;67(7):674-682.
- McGurk S, Mueser K, Feldman K, Wolfe R, Pascaris A. Cognitive training for supported employment: 2-3 year outcomes of a randomized controlled trial. American Journal of Psychiatry. Mar 2007;164(3):437-441.
- Silverstein SM, Spaulding WD, Menditto AA, et al. Attention shaping: A reward-based learning method to enhance skills training outcomes in schizophrenia. Schizophrenia Bulletin. Jan 2009;35(1):222-232.
- McGurk S, Twamley E, Sitzer D, McHugo G, Mueser K. A meta-analysis of cognitive remediation in schizophrenia. American Journal of Psychiatry. Dec 2007;164(12):1791-1802.
- Horan WP, Green MF, DeGroot M, et al. Social cognition in schizophrenia, part 2: 12-month stability and prediction of functional outcome in first-episode patients. Schizophrenia Bulletin. Jun 2012;38(4):865-872.
- Horan WP, Kern RS, Tripp C, et al. Efficacy and specificity of social cognitive skills training for outpatients with psychotic disorders. Journal of Psychiatric Research Aug 2011;45(8):1113-1122.
- Schulz KM, Molenda-Figueira HA, Sisk CL. Back to the future: The organizational–activational hypothesis adapted to puberty and adolescence. Hormones and Behavior. May 2009;55(5):597-604.
- Sisk CL, Foster DL. The neural basis of puberty and adolescence. Nature neuroscience. Oct 2004;7(10):1040-1047.
- Sisk CL, Zehr JL. Pubertal hormones organize the adolescent brain and behavior. Frontiers in Neuroendocrinology. Oct-Dec 2005;26(3):163-174.
- Turner CD, Rey-Casserly C, Liptak CC, Chordas C. Late effects of therapy for pediatric brain tumor survivors. Journal of Child Neurology. Nov 2009;24(11):1455-1463.
- Pritchard AE, Nigro CA, Jacobson LA, Mahone EM. The role of neuropsychological assessment in the functional outcomes of children with adhd. Neuropsychology Review. Mar 2012;22(1):1-15.
- Chasson GS, Harris GE, Neely WJ. Cost comparison of early intensive behavioral intervention and special education for children with autism. Journal of Child and Family Studies. 2007;16(3):401-413.
- Eldevik S, Hastings RP, Hughes JC, Jahr E, Eikeseth S, Cross S. Using participant data to extend the evidence base for intensive behavioral intervention for children with autism. American Journal on Intellectual and Developmental Disabilities. 2010;115(5):381-405.
- Jacobson JW, Mulick JA, Green G. Cost–benefit estimates for early intensive behavioral intervention for young children with autism—general model and single state case. Behavioral Interventions. 1998;13(4):201-226.
- Lovaas OI. Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology. Feb 1987;55(1):3-9.
- Lovaas OI, Schreibman L, Koegel RL. A behavior modification approach to the treatment of autistic children. Journal of Autism and Developmental Disorders. Mar 1974;4(2):111-129.
- Ross RJ, Cole M, Thompson JS, Kim KH. Boxers--computed tomography, eeg, and neurological evaluation. JAMA. Jan 14 1983;249(2):211-213.
- Heilbronner RL, Bush SS, Ravdin LD, et al. Neuropsychological consequences of boxing and recommendations to improve safety: A national academy of neuropsychology education paper†. Archives of Clinical Neuropsychology. 2009;24(1):11-19.
- Harrow M, Jobe T, Faull R. Do all schizophrenia patients need antipsychotic treatment continuously throughout their lifetime? A 20-year longitudinal study. Psychological Medicine. 2012;1:11.
- Harrow M, Jobe TH. Factors involved in outcome and recovery in schizophrenia patients not on antipsychotic medications: A 15-year multifollow-up study. The Journal of Nervous and Mental Disease. 2007;195(5):406-414.
- Pennebaker JW, Chung CK. Expressive writing and its links to mental and physical health. In: Friedman HS, ed. Oxford handbook of health psychology. New York, NY: Oxford University Press; In press.
- Harris AHS. Does expressive writing reduce health care utilization? A meta-analysis of randomized trials. Journal of Consulting and Clinical Psychology. 2006;74(2):243.
- Barrett J, Fleming AS. Annual research review: All mothers are not created equal: Neural and psychobiological perspectives on mothering and the importance of individual differences. Journal of Child Psychology and Psychiatry. 2011;52(4):368-397.
- Kiecolt-Glaser JK, Loving TJ, Stowell JR, et al. Hostile marital interactions, proinflammatory cytokine production, and wound healing. Archives of General Psychiatry. Dec 2005;62(12):1377.
- Kiecolt-Glaser JK, Malarkey WB, Chee M, et al. Negative behavior during marital conflict is associated with immunological down-regulation. Psychosomatic Medicine. 1993;55(5):395-409.
- Smith TW, Uchino BN, Florsheim P, et al. Affiliation and control during marital disagreement, history of divorce, and asymptomatic coronary artery calcification in older couples. Psychosomatic Medicine. May 2011;73(4):350-357.
- Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: A meta-analytic review. PLoS Medicine. Jul 2010;7(7):e1000316.
- Finkel E, Slotter E, Luchies L, Walton G, Gros J. A brief intervention to promote conflict reappraisal preserves marital quality over time. Psychological Science. In Press.