American Journal of Psychiatry Audio

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

Executive Editor Michael Roy speaks with Katherine MacDuffie, Ph.D., and Annette Estes, Ph.D., about their longitudinal neuroimaging study examining associations between sleep difficulties and developmental trajectories among infants who go on to develop autism spectrum disorder. Why is sleep so important during early life? [2:16] How can sleep affect a child's behavioral and mental development, as well as overall functioning? [3:34] Why the authors conducted this research [4:47] Areas of the brain that were of particular interest [6:35] Methods used in the research [8:34] Main findings of the research [10:54] How results aligned with previous research [12:22] Potential neurobiological mechanisms underlying the results [13:57] Limitations of the work [15:26] Conclusions that researchers, clinicians, and other mental health professionals can take away from the work [17:12] Recommendations for further research in this area [18:21] 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

Executive Editor Michael Roy speaks with Collin Reiff, M.D., and William McDonald, M.D., about their evidence-based summary of the literature on the clinical application of psychedelic drugs in psychiatric disorders. How hallucinogens were first used, and some of the key individuals involved in the development of these drugs for medical use [2:23] What led to the worry about use of these compounds in the 1960s, and what actions did U.S. policymakers take at the time? [5:35] How have opinions changed from the 1960s to the present? [7:01] How the authors conducted their research [8:23] How the authors determined which drugs to examine [9:38] What findings stood out to the authors? [10:28] Relationships between the psychological effects and the neurobiology of psychedelic compounds [12:59] How ketamine came to be used in clinical care, and what studies have shown about its safety and effectiveness [14:18] An outline of psycholytic therapy and psychedelic therapy [17:16] What is the potential for these kinds of drugs to be misused? [19:24] Conclusions that researchers, clinicians, and other mental health professionals should take away [21:15] Recommendations for further research in this area [22:20] 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 Image: detail from a 1978 painting by Flournoy Holmes, "Fire Being" (acrylic, 36 in x 42 in). Image provided courtesy of the artist. For this and other works, visit flournoyholmes.com.

Executive Editor Michael Roy speaks with Sarah A. Sullivan, Ph.D., and Stanley Zammit, Ph.D., about their research on the incidence, course, and outcome of psychotic experiences from childhood through early adulthood in the general population, and the prediction of psychotic disorder. How common are psychotic experiences in the general population, and what burdens do they place on public health systems? [2:19] What kinds of services are available to identify and treat individuals who have psychotic experiences? [3:48] Study methods [5:33] What kind of psychotic experiences were reported? [7:41] Age as a significant factor [8:57] Prediction of psychotic disorder by age 24 [10:33] Implications for practicing clinicians and other mental health professionals [11:58] Limitations of the study [12:41] What other studies should explore regarding first-episode psychosis [13:52] 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. Also visit the online edition of this month’s Journal to watch a video of Deputy Editor Daniel S. Pine, M.D., present highlights from the issue. Follow the Journal on Twitter. E-mail us at ajp@psych.org

Executive Editor Michael Roy speaks with Damiaan Denys, M.D., Ph.D., and Ilse Graat, M.D., about their research on the tolerability and effectiveness of deep brain stimulation (DBS) for patients with refractory obsessive-compulsive disorder (OCD). What characterizes OCD, and how widespread is it? [2:35] What treatment with DBS involves [4:07] Outline of study methods [6:25] Why the part of the brain studied is relevant for DBS, and description of the scales used to measure how well the treatment worked [7:54] Main findings with regard to response of OCD symptoms in patients who received DBS [10:51] Discussion of adverse events [12:40] Implications of the work for researchers, clinicians, and other mental health professionals [14:54] What further studies should explore with regard to treatment with DBS [15:43] 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. Also visit the online edition of this month’s Journal to watch a video of Deputy Editor Daniel S. Pine, M.D., present highlights from the issue. Follow the Journal on Twitter. E-mail us at ajp@psych.org