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Todd Ouida Clinical Scholar Awards

The annual Todd Ouida Clinical Scholar Awards are designed to further the research of outstanding young scientists focused on improving outcomes for those suffering from childhood anxiety and depression. The funds provide powerful leverage in helping young investigators achieve successes that will enable them to become eligible for additional funding from public entities (such as the National Institutes of Health) as their careers develop. The award, along with the Todd Ouida Annual Lecture in Childhood Anxiety and Depression, honors the memory of Todd Ouida. Todd, who had triumphed over his own childhood anxiety, was a U-M alumnus and a promising young professional when he lost his life in the September 11, 2001 World Trade Center attacks. The funds were established in 2002.

2017 Emily Bilek
Piloting a “Self-Distancing” Augmentation to Exposure Therapy with Clinically Anxious Youth
2016 Wael Shamseddeen
Electroconvulsive Therapy for Adolescents with Resistant Depression
2015 Jacek Debiec
Attenuating Depressive Ruminations in Patients Receiving ECT through Pre-Treatment Recall of Depressive Thoughts
2014 Elizabeth Koschmann
Dissemination and Implementation of Evidence-Based Practices for the School-Based Support of Students with Depression and Anxiety
2013 Ellen Barrett-Becker
Evaluating and understanding barriers to the treatment of trauma and grief in children and adolescents
2012 Erika Bocknek
Building effective outreach and support for military families with young children following deployment
2011 Polly Gipson 
Pilot feasibility study of community-based preventive interventions for ethnic minority and low-income adolescents at risk for suicide
2010 James Swain
Brain Imaging Studies of the Biological Basis of Families’ Vulnerabilities to Mental Health Problems at Different Developmental Stages
2009 Katherine Rosenblum
The New Beginnings Project: Improving Outcomes for Infants and Children in Foster Care
2008 Julie Kaplow
Children’s Psychological and Physiological Functioning Following the Loss of a Parent
2007 Cynthia Ewell Foster
Community-based depression awareness and suicide prevention interventions for vulnerable youth
2006 Richard Dopp
Levels of Physical Activity in Youth with Depressive Disorders
2005 Maria Muzik
Circle of Security for High-Risk Security
2004 Michelle Kees
The Impact of Maternal Trauma and Post Traumatic Stress Disorder on Children and Parenting
2003 Kate Fitzgerald
Children with Obsessive Compulsive Disorder

Emily Bilek, Ph.D.

Piloting a “Self-Distancing” Augmentation to Exposure Therapy with Clinically Anxious Youth

Anxiety disorders are common and can significantly impair youth. Cognitive Behavioral Therapy (CBT) has been identified as the gold-standard psychotherapy for youth anxiety; however, as many as 40 percent of youth who receive this treatment do not demonstrate optimal treatment response. Research is needed to identify methods for improving or enhancing the good effects of CBT. One area for exploration is exposure. Exposure, or “facing fears” is a CBT component that is critical for improvement. Some children struggle to fully engage with exposures, and this may be related to treatment outcome. “Self-distancing,” or looking at a difficult situation from an outside perspective, is a strategy that can be taught to children to help them persevere through difficult tasks. This study will pilot a brief intervention that combines self-distancing techniques with difficult exposures. This study will examine the feasibility of such an approach, and whether self-distancing assists with perseverance and, ultimately, symptom reduction.

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Wael Shamseddeen, M.D., M.P.H.

Electroconvulsive Therapy for Adolescents with Resistant Depression

According to WHO, depression is first cause of disability-adjusted live years lost (DALYs) among adolescents. Yet, available treatment options are only partially effective. According to the "treatment of adolescent depression study" (TADS), 60-70% of participants showed adequate response by week 12 and around 80% by week 30. According to "treatment of resistant depression study", which investigated second line treatment, 40-50% exhibited adequate response by week 12. However, greater than 70% have residual symptoms & 25% of participants exhibited relapse. Failing two treatments is defined as treatment resistant depression which is associated with increased morbidity and development of chronic depression.

Electroconvulsive therapy (ECT) has been shown to be an effective treatment for resistant depression among adults. However, there is limited data regarding its effectiveness among adolescent with treatment resistant depression. Therefore, this study aims at conducting a chart review of adolescents who have received ECT for depression at University of Michigan in past 20 years.

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Jacek Debiec, M.D., Ph.D.

Attenuating Depressive Ruminations in Patients Receiving ECT through Pre-Treatment Recall of Depressive Thoughts

"Depressive ruminations or persistent negative thoughts are a key feature of a depressive disorder. Depressive disorders are commonly treated with a combination of psychotherapy and medications. Pharmacotherapy-resistant and/or severe depression is routinely treated with electroconvulsive therapy (ECT). One of the major risks of ECT that limits its use is an overall memory impairment, which is correlated with the number of treatments. Recent studies demonstrate that established memories are sensitive to modification upon their recall, a phenomenon referred to as memory reconsolidation. Memory reconsolidation enables updating of existing memories depending on the context of their retrieval. Research shows that a single memory recall or reactivation combined with pharmacological, procedural or behavioral interventions allows modification of emotional, procedural, episodic or declarative memories. Specifically, a recent study demonstrates that a single memory recall followed by the ECT treatment significantly weakens episodic memories. We hypothesize that depressive ruminations undergo reconsolidation processes. We posit that an explicit recollection of depressive ruminations renders them vulnerable to the ECT treatment procedure. We will apply the combined reconsolidation paradigm and the ECT procedure to treat adolescent patients referred to the ECT treatment for their pharmacotherapy-resistant severe depression. This research has the potential to: 1) change the way we understand and treat depressive disorders, and 2) change the way we use ECT by reducing the number of treatments and associated adverse effects. This study will provide pilot data that will allow us to apply for further funding for a more comprehensive investigation".

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Erika Bocknek, Ph.D.
Building effective outreach and support for military families with young children following deployment (2012)

Dr. Bocknek’s research focuses on emotion regulation in toddlerhood, an important early precursor of later mental health problems, in the context of trauma and disruptions in primary relationships, particularly among multi-stressed families. Recently, Dr. Bocknek has become involved in the STRoNG Families project to build effective outreach and support for military families with young children following deployment. The Ouida Award will support her work on this project as she investigates the relationships between the quality of triadic interactions and young children’s regulatory outcomes amidst the disrupted family patterns common to military families. Findings from this work will inform interventions with the many young children and their families impacted by parental military leave, seeking to improve later mental health outcomes for this population via high-quality early intervention.

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Polly Gipson, Ph.D.
Pilot feasibility study of community-based preventive interventions for ethnic minority and low-income adolescents at risk for suicide (2011)

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James Swain, M.D., Ph.D.
Brain imaging studies of the biological basis of families’ vulnerabilities to mental health problems at different developmental stages (2010)

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Katherine Rosenblum, Ph.D.
The New Beginnings Project: Improving Outcomes for Infants and Children in Foster Care (2009)

Dr. Rosenblum’s project focuses on improving outcomes for infants in foster care in Wayne County (MI) by strengthening family connections (with elements of both foster and biological parent support), improving the coordination of developmentally appropriate services, and training professional staff in evidence-based best practices for infants, young children, and their families.  The long-term objective of this project is to improve systems of care for infants and young children in the child welfare system.

Wayne County alone has more than 6,000 in the child welfare system, with children under 3 years of age being the largest group entering care. The population of infants and young children in foster care are at very high risk for behavioral and emotional impairment and psychiatric disorder.  In the context of significant economic strain across the state of Michigan, the wellbeing of infants and young children in Michigan is more precarious than ever.  These factors combine to create a pressing need to identify effective means for improving services and implementing relationship-focused infant mental health interventions to improve infant social-emotional outcomes.

The outcomes being studied include both systems-level changes and child-level changes, including reductions in child anxiety, improvements in relationship security, and enhanced developmental outcomes.  One goal of the project is to establish a specialized juvenile court docket focused on improving systems coordination and ensuring the provision of infant mental health intervention.  In collaboration with colleagues at Wayne State University, Dr. Rosenblum is developing and implementing an evaluation protocol to identify the impact of the court-based intervention on child anxiety and stress, relationship security, and developmental status.  A preliminary description of the process of establishing this specialized “Baby Court” was presented at the American Public Health Association conference in 2010.

The overall goal of this project is to improve outcomes for infants and young children in foster care, and the corresponding research will eventually contribute to understanding of how improved coordination of services and relationship-focused infant mental health interventions can impact children’s social and emotional wellbeing. Given the focus on improving developmental outcomes for very young at-risk children, this project furthers the Depression Center's mission of detecting and treating depression and bipolar disorders earlier and more effectively by facilitating the translation of cutting-edge clinical science. 

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Julie Kaplow, Ph.D., ABPP
Children’s Psychological and Physiological Functioning Following the Loss of a Parent (2008)

Dr. Kaplow’s project aims to gain a better understanding of how children cope following the loss of a parent.  Her work examines potential biological, psychological, and behavioral risk factors associated with children’s long-term maladaptive grief reactions, including depression, posttraumatic stress, and complicated grief.  Preliminary data suggest that children’s avoidant coping strategies are associated with increased complicated grief reactions, whereas warmth of the surviving parent is associated with decreased child anxiety. 

The information gathered from this study has been instrumental in furthering understanding of both normative and maladaptive grief in children and suggesting areas for future research.  For example, participating children have noted that the “hardest part” of the loss process was not the death itself, but the events leading up to the death, such as anticipation of the parent’s death, or having to observe a parent’s invasive treatments, etc.  These particular findings have served as the impetus for another large grant submission aimed at understanding the development of maladaptive stress reactions in children facing maternal cancer.  The findings are also being used as supplemental material to inform the criteria and developmental modifications for a Bereavement-Related Adjustment Disorder in the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-V).  The study will ultimately serve as the foundation for a preventive intervention program aimed at reducing the incidence of maladaptive grief reactions in parentally bereaved children.

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Cynthia Ewell Foster, Ph.D.
Community-based depression awareness and suicide prevention interventions for vulnerable youth (2007)

School-based depression education and stigma reduction interventions for elementary and middle school youth use a public health/universal prevention approach to target barriers (lack of knowledge and stigmatizing attitudes about mental health and its treatment) to service utilization among at-risk youth. As such, these programs have the potential to improve early detection, increase treatment utilization, and ultimately prevent the developmental tragedy of untreated depression in youth.

Depression Awareness and Stigma Reduction in African American Youth (funded by theAetna Foundation). 
This project involved the modification and cultural tailoring of an existing community-based middle school intervention, developed specifically to target stigma in the African American community.  The intervention was implemented and evaluated with over 1000 African American seventh and eighth graders.  The culturally tailored intervention included the following evidence-based components, developed using community and expert input: 1) a personal testimonial of experience with mental illness, 2) information about mental illness (specifically depression and substance abuse) and its effective treatment, 3) refutation of stigmatizing myths about mental illness, and 4) information about accessing mental health resources in the community. 

Preliminary data suggest that the program was successful in increasing student knowledge about mental health and in decreasing stigmatizing attitudes about mental illness. Results also showed increased intentions to seek help from mental health professionals as well as school counselors. The intervention did not produce significant changes in mental health literacy, and there were no significant changes in attitudes about treatment. The Ouida Award, combined with a recently awarded Rachel Upjohn Clinical Scholar Award, will be used in part to conduct the more complex modeling needed to fully examine the data set. 

Mental Health Education and Stigma Reduction for 5th Grade Students (funded by the Flinn Foundation).  
This intervention development project involved extensive work with school and community partners as well as a K-8 teacher consultant to create a program seen as feasible by schools and containing content carefully matched to national and state curriculum guidelines for student instruction.  Community-based participatory research and a review of best practices in mental health and general education guided intervention development.  A series of focus groups with parents, students, and teachers  was used to collect qualitative evaluation data.

According to preliminary qualitative data, student, parent, and teacher satisfaction with the program is good.  Teachers reported being pleased with the overlap between the intervention and the State of Michigan Health and Science curriculum.  Parents reported seeing value in the program and noted no concerns with having it included in their student’s school day. Students reported learning new information about brain function and its relation to mental health, the causes of mental health problems, and the fact that mental illness and mental retardation are distinct. One student wrote, “I learned that you can get help if you get depressed and have a mental illness.”   Students reported particularly enjoying the active learning components of the program, including a brief science experiment, skit, and neuron relay race. The Ouida Clinical Scholar Award, combined with a Rachel Upjohn Clinical Scholar Award, will be used to fund a small evaluation of the program, with a focus on preparing it for national dissemination.

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Richard Dopp, M.D.
Levels of Physical Activity in Youth with Depressive Disorders (2006)

This research involved data collection for a pilot study on the effectiveness of physical activity and exercise in the treatment of depressive illnesses in adolescents.  At the time of the award, although growing literature supported the effectiveness of physical activity and exercise in the treatment of depression in adults, there were no randomized controlled trials in adolescents.  Dopp also received a Rachel Upjohn Clinical Scholars Award to support stage 1 development of a trial of a physical activity intervention for depressed adolescents seeking care through the University of Michigan Depression Center. 

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Maria Muzik, M.D., M.S.
Circle of Security for High-Risk Security (2005)

The Circle of Security (COS) is a relationship-focused parenting group intervention that promotes sensitive caregiving and facilitates child-attachment security in a supportive environment. Circle of Security groups have been conducted with mothers with a history of trauma or who have an insecure-type relationship with their child. Preliminary analyses reveal that a mother’s participation in the COS intervention directly and positively impacts attachment security – all mother-child pairs identified as demonstrating insecure attachment before the group became securely attached after group participation. Such robust preliminary results reinforce the efficacy of the Circle of Security intervention group with particularly high-risk women and their children. In addition, Dr. Muzik and her team found that mothers reported lower behavioral problems in their children on standard behavioral rating scales (CBCL, Achenbach 1991) after the intervention.

Using brain imaging, the study will examine maternal parenting brain circuitry in upcoming COS groups, aiming to expand the understanding of brain function within a parenting and attachment-based context.  Moreover, it will be the first study to examine how treatment gains related to a parenting intervention may be evident in maternal neurocircuitry.

This data is being compiled as preliminary data for an NIMH/NICHD grant submission, and the research group is also writing several internal (CTSA-MICHR) and external NIH grants to continue and expand this line of research.   The COS intervention will not only continue to provide treatment and care for high-risk women, but will ultimately contribute to the understanding of how intervention programs can be tailored to specifically suit the needs of mothers with a history of trauma and posttraumatic stress.  The study’s overarching  goal is to gain a more comprehensive understanding of how a mother’s trauma experience and psychopathology influence her caregiving capabilities and her child’s outcomes, and, perhaps most importantly, how intervention can occur early in these trajectories in order to ameliorate risky outcomes for both mother and child across development. This work has also received Rachel Upjohn Clinical Scholar Award support.

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Michelle Kees, Ph.D.
The Impact of Maternal Trauma and Post Traumatic Stress Disorder on Children and Parenting (2004)

Dr. Kees’ research examined the impact of maternal trauma on children and parenting, looking specifically at the role of interpersonal trauma and Post Traumatic Stress Disorder (PTSD) on women’s parenting and their children’s functioning. In this study, 60 women with a history of interpersonal trauma participated in clinical interviews about their life experiences and completed self-report questionnaires on topics of parenting, depression, substance use, marital relationship, stress, and coping.  One of their children (aged 8-17 years) also completed questionnaires assessing child depression, anxiety, trauma history and symptoms, and parental relationship.  These data will be critical in identifying areas of parenting and child functioning that may be compromised for women who have experienced a trauma or who have PTSD, and in developing appropriate clinical interventions for this population.  Final data analyses are in process, and preliminary results have been presented at the Society for Research in Adolescence biennial conference.  The Clinical Scholars Award has been pivotal in Dr. Kees’ development as a junior researcher, allowing her the opportunity to initiate this study and to expand her research skills through advanced statistical education at the U-M Center for Statistical Consultation and Research (CSCAR). Funds from the award  were leveraged to obtain matched funding from the U-M Institute for Research on Women and Gender (IRWG). 

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Kate Fitzgerald, M.D.
Children with Obsessive Compulsive Disorder (2003)

Dr. Fitzgerald’s research focuses on these questions: does abnormal brain development lead to Obsessive Compulsive Disorder (OCD) in children? By understanding the brain in youth with OCD, can we better develop diagnostic strategies, possibly even predictive strategies for identifying children at risk for the disorder? Could abnormal development of the brain response to potential mistakes contribute to the onset of OCD in children?

Specifically, her Ouida-supported research involved working to develop a “brain probe” of a cognitive function (oculomotor response inhibition) believed to be abnormal in kids with OCD.  Children were asked to perform an eye movement task (avert their gaze from a visual stimulus) while a functional magnetic resonance imaging scanner “took pictures” of the brain.  Previous work demonstrated that children with OCD make more errors than healthy children in performing this task.  Moreover, the task is known to involve a particular brain region, the anterior cingulate, that is “hyperactive” in adults with obsessions and compulsions.  One study has found that the anterior cingulate is enlarged in children with OCD, suggesting that it is affected early in disease course, but no research had yet examined functional abnormalities of this region in pediatric OCD.  Using the oculomotor brain probe, the research team hoped to determine if this hyperactivity also occurs in children with OCD and whether it could be linked to the specific deficit of response inhibition.

The long range goal was to identify a task that could be used to reliably “probe” the anterior cingulate in children with OCD to help determine if abnormality in this region is a cause of the illness, versus a long-term effect.  This information might then be used to develop better diagnostic strategies (possibly even predictive) as well as better treatments.

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