KL2 Faculty Scholar Awards Support Rising Psychiatric Researchers
David Grodberg, MD, Assistant Professor of Psychiatry, and Emily Stern, MD, Assistant Professor of Psychiatry and Neuroscience, have received KL2 Faculty Scholar Awards from the Mount Sinai School of Medicine Conduits, also known as the Institutes for Translational Sciences. The awards were created to promote and support outstanding junior faculty involved in patient-oriented, clinical, and translational research. As part of the program, the scholars will be able to allot at least 75% of their time for research career development.
“KL2 Faculty Scholar Awards were created to facilitate the translation of basic scientific discoveries into clinical practice,” says Alan J. Moskowitz, MD, Director of the KL2 Scholars Program and Professor and Vice-Chair of Health Evidence & Policy. “The research being conducted by Dr. Grodberg shows tremendous promise for transforming our ability to diagnose autism spectrum disorders (ASD) in community settings, while Dr. Stern’s investigations will help us understand the pathophysiology of obsessive-compulsive disorder and, ultimately, develop better targeted treatments.”
Developing the Autism Mental Status Exam
The diagnosis of ASD in underserved and under-resourced populations is often unreliable. In most community-based clinical settings, physicians diagnose autism based on their exam. Standardized autism assessments like the Autism Diagnostic Observation Schedule, which are time-consuming, costly, and require specialized training to complete, are rarely used. Consequently, there is a significant delay in the diagnosis of ASD.
There is an urgent need for a brief observational tool that is validated against the gold standard for ASD diagnostic assessment. As a result, Dr. Grodberg has developed the Autism Mental Status Exam (AMSE), a timely assessment tool that structures the way physicians observe and record social, communicative, and behavioral functioning in people with ASD.
Dr. Grodberg’s goal is to develop a standardized web-based reliability training protocol for administering the exam and to validate the AMSE among multiple sites across the United States. Preliminary studies have shown that the AMSE has excellent inter-rater reliability and classification accuracy when compared to the more in-depth Autism Diagnostic Observation Schedule.
“The AMSE we have developed has the potential to represent the next forefront in community-based ASD diagnoses,” says Dr. Grodberg.
Understanding OCD and Imagined Possibilities of Harm
Obsessive-compulsive disorder (OCD) is a chronic disorder characterized by negative intrusive thoughts, feelings, or images, and repetitive behaviors. One theory is that OCD involves an excessive preoccupation with imagined possibilities of harm combined with a difficulty distinguishing between imagined and real events.
Dr. Stern’s research will test this theory experimentally with the goal of identifying novel targets in the brain that will improve treatments for patients. Research using functional magnetic resonance imaging (fMRI) has linked internally focused mental processes, including event imagination, to the activation of a large-scale brain system called the default mode network (DMN).
In previous studies, the ability to disengage attention from an internal focus has been linked with a decrease in DMN activity. As a result, DMN activation will be measured while participants perform an internally focused imagination task that is followed by a target detection task requiring externally focused attention. Dr. Stern will analyze the subject’s behavior, neural co-activation, and connectivity during both activities.
“We predict that OCD patients will be unable to disengage from imagining negative events during the target detection task, exhibiting behavioral inflexibility that is characteristic of the disorder,” says Dr. Stern. “Better understanding of the neurocircuitry associated with this inability to disengage from obsessive thoughts will help us develop new treatments.”