American Journal of Psychiatry Audio

Executive Editor Michael Roy speaks with Karen L. Bierman, Ph.D., about her article on reducing adolescent psychopathology in socioeconomically disadvantaged children with a preschool intervention. Dr. Karen Bierman is the Evan Pugh University Professor, Professor of Psychology, Professor of Human Development and Family Studies, and Director of the Child Study Center at Penn State University. Her research looks at the design and evaluation of programs for social and emotional learning within schools and communities. She has also developed and evaluated group interventions for peer-rejected children. How the author became interested in this area of research [1:58] What we know about how exposure to chronic or unpredictable negative circumstances disturbs a developing brain [3:21] Why the intersection of growing up in adverse conditions and the beginning of formal schooling is significant in the life of a child [6:41] Objective of the study [7:54] Outline of the Head Start REDI program [9:26] Description of study participants [11:26] How the authors collected and analyzed data [13:20] How well did the intervention work in terms of reducing conduct problems, emotional symptoms, and peer problems among students? [14:31] Other key findings of the study [17:21] Did any results surprise the authors? [18:45] Study limitations [20:26] How this work fits in to the overall literature on this subject [22:21] Implications this work has for public health policy [24:49] Key points that researchers, clinicians, and other mental health professionals should take away from the article [26:31] Recommendations for further research in this area [27:37] Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Stitcher, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. Watch Deputy Editor Daniel S. Pine, M.D., present highlights from the April 2021 issue. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org

Executive Editor Michael Roy speaks with Ayana Jordan, M.D., Ph.D., and Christina Mangurian, M.D., M.A.S., about their article on psychiatry diversity leadership in academic medicine. Dr. Ayana Jordan is an associate program director of the adult psychiatry training program and an assistant professor of psychiatry at the Yale University School of Medicine. She is a member of the APA Board of Trustees, and she serves on the Early-Career Psychiatrist Advisory Committee for the journal Psychiatric Services. Her research is concentrated on increasing access to care for minoritized populations with substance use problems. Dr. Christina Mangurian is a professor of psychiatry, epidemiology, and biostatistics in the School of Medicine at the University of California, San Francisco (UCSF). She is also vice chair for diversity and health equity at the UCSF Department of Psychiatry and Behavioral Sciences and a former chair of the APA Council on Minority Mental Health and Health Disparities. Her primary research program focuses on promoting mental health equity for patients and the workforce. The authors' background and how they became involved in their work [2:50] How the authors' roles in the workplace and in the community changed over the course of the past few years [7:51] Description of the case vignette presented in the article [14:23] The overall landscape for diversity leaders at psychiatry departments [18:40] Comparisons with other fields of medicine and academia [22:20] Three unique challenges faced by individuals who hold diversity, equity, and inclusion (DEI) roles [24:44] Initial steps that can help leaders in DEI positions [28:42] What people with institutional power can do to make sure that the experiences of BIPOC individuals are not ignored [34:40] Best practices to effectively support DEI leadership efforts in psychiatry [37:18] How scholarly research can adapt to help advance these efforts [42:39] Are the authors optimistic that we can overcome barriers and make real progress in efforts to expand diversity, equity, and inclusion throughout our community and workplaces? [46:11] Photo (from top): Helena Hansen, M.D., Ph.D., Christina Mangurian, M.D., M.A.S., Carolyn I. Rodriguez, M.D., Ph.D., Ayana Jordan, M.D., Ph.D., Ruth S. Shim, M.D., M.P.H., Altha J. Stewart, M.D. (Image courtesy of Dr. Mary Kay Smith.) Full author list of the article: Ayana Jordan, M.D., Ph.D. (Department of Psychiatry, Yale University School of Medicine, New Haven, Conn.) Ruth S. Shim, M.D., M.P.H. (Department of Psychiatry, University of California, Davis) Carolyn I. Rodriguez, M.D., Ph.D. (Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif.) Eraka Bath, M.D. (Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, Los Angeles) Jean-Marie Alves-Bradford, M.D. (Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York) Lisa Eyler, Ph.D. (Department of Psychiatry, University of California, San Diego, and Desert-Pacific Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare Center, San Diego) Nhi-Ha Trinh, M.D. (Department of Psychiatry, Massachusetts General Hospital and Harvard University School of Medicine, Boston) Helena Hansen, M.D., Ph.D. (Departments of Psychiatry and Anthropology, New York University, New York) Christina Mangurian, M.D., M.A.S. (Department of Psychiatry and Behavioral Sciences and Department of Biostatistics and Epidemiology, University of California, San Francisco (UCSF), UCSF Center for Vulnerable Populations at Zuckerberg San Francisco General, and UCSF Philip R. Lee Institute for Health Policy Studies, San Francisco) Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Stitcher, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. Watch Deputy Editor Daniel S. Pine, M.D., present highlights from the March 2021 issue. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org

Executive Editor Michael Roy speaks with Glenn Verner, M.P.H., and Sonja Entringer, Ph.D., about their article on the relationship between maternal psychological resilience during pregnancy and newborn telomere length. Ms. Glenn Verner is a doctoral candidate in medical psychology at Charité University Medicine in Berlin. She is interested in studying the biological mechanisms that underpin maternal and fetal health. Dr. Sonja Entringer is a professor of medical psychology at Charité University Medicine in Berlin. She is also an associate professor in the Health and Disease Research Program at the University of California, Irvine. Her research interests broadly include how developmental programming affects health and disease risk. In particular, she is interested in how stress during pregnancy affects offspring development. How the authors became interested in this area of research [2:10] Overview of the telomere system [4:35] Aims of the study, which examined how positive maternal psychological conditions during pregnancy affect newborn telomere settings [7:40] Characteristics of study participants [10:44] The various data collected during pregnancies [12:26] How resilience and positivity were quantified [13:58] Relationship between newborn telomere length and maternal resilience [15:18] Results that stood out to the authors [16:37] How clinical features or demographic characteristics of the participants affected the study outcome [17:26] Limitations that may have affected the study results [18:43] How this work fits in to the overall literature on this subject [19:51] Implications the work has for the understanding of how maternal health affects infant health and disease risk [20:42] Key points for researchers, clinicians, and other mental health professionals [22:43] Recommendations for further research [23:59] Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Stitcher, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. Watch Deputy Editor Daniel S. Pine, M.D., present highlights from the February 2021 issue. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org

Executive Editor Michael Roy speaks with Luke J. Norman, Ph.D., and Kate D. Fitzgerald, M.D., about their article examining whether brain activity is associated with treatment response to cognitive-behavioral therapy (CBT) in adolescents and adults with obsessive-compulsive disorder (OCD), and whether any associations are treatment specific relative to an active control psychotherapy (stress management therapy; SMT). Dr. Luke Norman was recently a neuroscience postdoctoral fellow at the University of Michigan. He is now affiliated with the National Institutes of Health. His research has looked at treatment for obsessive-compulsive disorder and attention deficit hyperactivity disorder. Dr. Kate Fitzgerald is the Phil F. Jenkins Research Professor of Depression and associate professor in the Department of Psychiatry at the University of Michigan. She is the academic director for child and adolescent psychiatry and co-director of the Pediatric Anxiety Disorders Clinic. She is also an adjunct associate professor in the Department of Psychology. Her work has examined pediatric anxiety and obsessive-compulsive disorders, and currently, she is interested in looking for biomarkers of pediatric anxiety disorders that may represent options for novel, targeted treatments. She also has done work focusing on the use of cognitive-behavioral therapy in schools. How the authors became interested in this area of research [2:42] How prevalent obsessive-compulsive disorder (OCD) is among the general population, and its conventional treatment approaches [5:50] Comparing cognitive-behavioral therapy (CBT) with a control psychotherapy called stress management therapy (SMT) [8:42] Details about two neural networks that have been implicated in OCD (the cingulo-opercular network and the orbito-striato-thalamic network) [12:04] Makeup of study participants, and methods the authors used to analyze the data [14:07] Comparison of symptom change between the group who received CBT relative to the group who received SMT [17:39] Details from functional MRI scans [18:23] Differences by age [20:40] Other notable study results [21:25] Limitations of the study [22:21] Implications that this work has for the understanding and treatment of OCD [23:30] Key points for researchers, clinicians, and other mental health professionals [24:50] Recommendations for further research [26:07] Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Stitcher, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. Watch Deputy Editor Daniel S. Pine, M.D., present highlights from the January 2021 issue. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org

Executive Editor Michael Roy speaks with American Journal of Psychiatry Editor-in-Chief Ned H. Kalin, M.D., and Deputy Editor Carolyn Rodriguez, M.D., Ph.D., about the Journal's response to COVID-19; strategies to combat racism, social injustice, and health care inequities; research highlights from the past year; and what lies ahead in 2021. Dr. Kalin is the Hedberg Professor and Chair of the Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health, where he also serves as the Director of the Health Emotions Research Institute, and Director of the Lane Neuroimaging Laboratory. He is a member of the National Academy of Medicine, is a Distinguished Fellow of the American Psychiatric Association, and serves on the APA Council on Research. His work has aimed to understand the brain mechanisms underlying mental disorders. Dr. Rodriguez is an Associate Professor in the Department of Psychiatry and Behavioral Sciences at Stanford University, where she is Director of the Translational Therapeutics Lab. She also serves as an Associate Dean for Academic Affairs and Associate Chair for Inclusion and Diversity at Stanford University, and she is a member of the APA Council on Research. In 2019, Dr. Rodriguez was selected as a recipient of the Presidential Early Career Award for Scientists and Engineers, which recognizes outstanding scientists and engineers at the outset of their independent research careers. Her research has looked at finding rapid-acting treatments to relieve the suffering of patients with severe mental illness, including obsessive-compulsive disorder. What the Journal has done in response to COVID-19 [3:15] How people can stay resilient during this time [8:04] How have racism and social injustice affected mental health care research and access? [12:04] What can mental health professionals do to address health care inequities? [18:56] Steps the Journal is taking to address racism, social injustice, and health care inequities [22:56] Research highlights of 2020 [25:32] Trends in the field of mental health research [29:38] Topics the editors would like to see more of in the Journal [32:50] Advice for early career researchers [34:49] Looking ahead to 2021 [38:05] Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Stitcher, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. Watch Deputy Editor Daniel S. Pine, M.D., present highlights from the December 2020 issue. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org

Executive Editor Michael Roy speaks with Sara K. Blaine, Ph.D., and Rajita Sinha, Ph.D., about their article on the use of brain imaging in the evaluation of drinking outcomes during early outpatient treatment for alcohol use disorder. Dr. Sara Blaine is an assistant professor in the Department of Psychological Sciences at Auburn University. She recently completed postdoctoral work at Yale University. Her work has looked at how genes and aspects of the brain affect the development of alcoholism under conditions of stress. Dr. Rajita Sinha is the Foundations Fund Professor of Psychiatry at the Yale University School of Medicine, where she also is a professor of neurobiology. She is chief of the psychology section in psychiatry and co-director of education at the Yale Center for Clinical Investigation. In addition, she is a professor in the Child Study Center and founding director of the Yale Stress Center. Her research has looked at the mechanisms of chronic stress, adversity, and coping. She is also interested in developing new ways to counter the effects of stress and addictive behaviors. How the authors became interested in this area of research [2:48] Why the authors studied the neurobiology of individuals who are in the early phase of abstinence from alcohol [4:37] Areas of the brain that are linked to stress and reward circuits that are affected by addiction [6:20] Details about the study design and patient population [8:21] The different measurements used in the study, and how the authors analyzed the data [11:38] Results of the two-part analysis, which observed patients' responses to alcohol, stress, or neutral cues and which evaluated treatment outcomes among patients [17:04] Did any results surprise the authors? [20:56] Study limitations [23:18] How this research adds to the overall body of knowledge about treatment for alcohol use disorder [24:12] Implications the work has for programs that provide treatment for alcohol use disorder [26:12] Main takeaways for researchers, clinicians, and other mental health professionals [27:58] Recommendations for further research [29:42] Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Stitcher, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. Watch Deputy Editor Daniel S. Pine, M.D., present highlights from the November 2020 issue. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org

Executive Editor Michael Roy speaks with Constance Guille, M.D., and Richard F. Summers, M.D., about their article on the prevalence of burnout and depressive symptoms among North American psychiatrists, demographic and practice characteristics associated with risk for these symptoms, and the correlation between burnout and depression. A related commentary on burnout by Dr. Summers also is discussed. Dr. Guille is a professor in the Departments of Psychiatry and Behavioral Sciences and of Obstetrics and Gynecology at the Medical University of South Carolina. She is a member of the American Psychiatric Association (APA) Board of Trustees Workgroup on Psychiatrist Well-Being and Burnout, and she is co-investigator on the Intern Health Study, a large prospective study examining stress and depression among medical trainees. She directs the Women's Reproductive Behavioral Health Division at the Medical University of South Carolina and has published widely on topics including women's health, stress, and depression. Dr. Summers is clinical professor of psychiatry and senior residency advisor at the Perelman School of Medicine at the University of Pennsylvania. He currently is APA treasurer, and he served as chair of the APA Board of Trustees Workgroup on Psychiatrist Well-Being and Burnout. He has published widely on topics including psychodynamic therapy training, the therapeutic alliance, psychodynamic formulation, positive psychology, and psychiatry residency training. He is a distinguished life fellow of APA. Formation of the APA Board of Trustees Workgroup on Psychiatrist Well-Being and Burnout [3:03] The distinction between burnout and depression, and whether there is a general agreement in the field on how these two constructs are related [4:44] What previous research has shown regarding the prevalence of burnout among physicians in other specialties [6:37] How the present study collected data, and what measures were used to quantify burnout and depression [9:04] Demographic characteristics of the study population [11:58] Demographic and work characteristics associated with burnout [13:01] Demographic and work characteristics associated with depression [13:28] Did any results surprise the authors? [13:43] Study limitations [17:57] Placing the present work in context with previous work [19:49] Implications of the study for health care organizations and for workforce policy in general [21:58] Discussion of Dr. Summers' commentary on what burnout is and what it is not [25:53] Recommendations for further work in this area [29:19] Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Play, Stitcher, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. Watch Deputy Editor Daniel S. Pine, M.D., present highlights from the October 2020 issue. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org

Executive Editor Michael Roy speaks with Emily Robertson, M.A., and Paul Frick, Ph.D., about their article on the role that callous-unemotional traits have in the risk for gun carrying and gun use during a crime. Ms. Emily Robertson is a clinical psychology doctoral student in the Developmental Psychopathology Lab at Louisiana State University. This fall, she begins a predoctoral internship at the Mailman Center for Child Development in the Miller School of Medicine at the University of Miami. Dr. Paul Frick leads the Developmental Psychopathology Lab at LSU, where he is the Roy Crumpler Memorial Chair in the Department of Psychology. He holds a joint appointment in the Institute for Learning Sciences and Teacher Education at Australian Catholic University in Brisbane. Why gun violence in the United States has become a significant concern among young people [2:46] What are callous-unemotional traits, and how common are these traits in the general population? [4:10] Why the authors decided to examine the relationship between callous-unemotional traits and gun violence [5:46] How the authors identified the study population, and what covariates or other variables they included [6:35] How the authors determined whether callous-unemotional traits affected a number of variables related to gun violence [10:11] Discussion of the main hypothesis [11:16] How callous-unemotional traits interact with a number of covariates, and other risk factors, to influence the frequency of gun carrying after a first arrest and the status of peer gun carrying and ownership [13:31] Overall conclusions [15:18] Study limitations [16:58] Implications of the work on public policy or on health policy [18:45] Main takeaways for researchers, clinicians, and other mental health professionals [20:18] Recommendations for further research [21:48] Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Play, Stitcher, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. Watch Deputy Editor Daniel S. Pine, M.D., present highlights from the September 2020 issue. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org

Executive Editor Michael Roy speaks with Jennifer Dwyer, M.D., Ph.D., and Awais Aftab, M.D., about the physiology of three major endocrine systems and about the evidence for hormone-based interventions in the treatment of major depressive disorder. Dr. Dwyer is an assistant professor at Yale University, where she is affiliated with the Child Study Center and the Department of Radiology and Biomedical Imaging. Dr. Aftab is a clinical assistant professor in the Department of Psychiatry at Case Western Reserve University. He is also an attending psychiatrist at Northcoast Behavioral HealthCare Hospital. Why are effective treatments for major depressive disorder lacking? [2:22] Why have hormones been implicated in the pathophysiology of major depression? [4:28] Three particular parts of the hormonal system that have been linked to alterations in mood [7:05] The role of the HPA axis in major depression [8:44] The role of the HPT axis in major depression [11:39] The role of the HPG axis in major depression, and differences between men and women [19:42] The efficacy, or drawbacks, of different kinds of hormonal interventions to treat depression [31:15] Overall conclusions as to the utility of hormonal treatments for major depression [39:04] The main messages that researchers, clinicians, and other mental health professionals should take away from the article [40:22] Recommendations for further research in this area [41:32] Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Play, Stitcher, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. Watch Deputy Editor Daniel S. Pine, M.D., present highlights from the August issue. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org

Executive Editor Michael Roy speaks with Stéphane Potvin, Ph.D., and Alexandre Dumais, M.D., Ph.D., about their meta-analysis investigating the association between cannabis use and violence, and, more specifically, the perpetration of any type of physical violence by adolescents and young adults. How prevalent is the use of cannabis among young people? [2:23] What are some of the adverse outcomes that are linked to the use of cannabis, and are these outcomes linked to other difficulties over time? [4:06] Why has the literature been mixed as to whether there is a link between the use of cannabis and violent behavior and aggression? [6:11] How the authors chose their research objective [8:15] Steps of the meta-analysis [9:51] Methods used to analyze the data [11:33] Main findings [14:12] Potential mechanisms that may have a role in the perpetration of violence [16:17] Implications for young people who use cannabis [18:07] Limitations affecting the results [19:19] Does the medical use of marijuana have any bearing on the work? [21:43] Takeaways for mental health professionals and the general public [22:31] Recommendations for further research [23:55] Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Play, Stitcher, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org