Friends & Family
Judith Cohen, MD
Medical Director, Center for Traumatic Stress in Children & Adolescents
Allegheny General Hospital
Professor of Psychiatry
Drexel University College of Medicine
Dr. Cohen discusses how children experience PTSD and effective treatments.Listen
OCD burdened a bright young woman for more than 10 years. Read all about her recovery and her advice to others who are suffering in Working Toward Compassion and Moderation.
Richard A. Bryant, PhD
Director, Traumatic Stress Clinic
Scientia Professor of Psychology, University of New South Wales
Dr. Bryant talks about the intersection of traumatic brain injury (TBI) and PTSD, including treatment and how therapy needs to be adapted for TBI survivors.Listen
My son Dan was in college, and by the time I arrived at his dorm, he had not eaten in more than a week. He was spending hours at a time sitting in one particular chair, hunched over with his head in his hands, doing absolutely nothing. He could not enter most of the buildings on campus and could only do minimal amounts of work at specific times. To top it all off, he was self-injuring. My son was in the throes of severe OCD.
This study examines whether an antibiotic, d-cycloserine (DCS), boosts the effectiveness of cognitive behavior therapy (CBT) for social anxiety. CBT has been shown to be effective for the treatment of social anxiety in children and adults, but even after treatment, approximately 40% may remain diagnosable. All participants will receive 12 weekly CBT sessions. In addition to receiving the CBT, participants will be randomly assigned (similar to a coin toss) to receive either DCS or a placebo (sugar pill). The pill will be taken 1-2 hours prior to each of the 12 CBT sessions.
- Subjects between 8 yrs of age (preadolescents) and under 55 yrs of age.
- Subjects medically healthy.
- Able to give informed consent.
- Not on psychotropic meds for a minimum of 6 weeks for fluoxetine; a minimum of 1 week for PRN benzodiazepines and beta blockers, and a minimum of 3 weeks for all other psychotropic meds.
- Subjects diagnosed with DSM IV symptoms of social phobia, generalized or specific type.
- Current major depressive disorder.
- Lifetime diagnosis of psychotic disorder, bipolar disorder, eating disorder, mental retardation, substance or alcohol dependence (other than nicotine); active suicidal ideation.
- Current or lifetime history of a neurological disorder (other than tic disorders, febrile seizures of infancy), seizure disorder.
- Any unstable medical condition.
- Use of any psychoactive substance in the past 30 days.
This study uses functional magnetic resonance imaging (fMRI) to learn how the brain functions in adolescents receiving fluoxetine (Prozac) or cognitive behavioral therapy (CBT) for anxiety or depression in children/adolescents. All participants will receive interviews to assess how they are doing in general, including his or her general mood, degree of nervousness and behavior. Each participant and one of his or her parents will be interviewed separately and together.
Age: 8 to 17
Consent: Can give consent/assent. (Parents will provide consent; minors will provide assent.)
IQ: All subjects will have IQ greater than 70 (Assessment relies on WASI)
SUBJECTS WITH AN ANXIETY DISORDER
Diagnosis: Current Diagnosis of Social Phobia, Separation Anxiety, or Generalized Anxiety Disorder (Based on K-SADS)
Symptom Severity: Score greater than 9 on PARS (This score was used to enroll subjects in previous trial demonstrating efficacy of an SSRI in pediatric anxiety.)
Clinical Impairment: CGAS less than 60
SUBJECTS WITH A MOOD DISORDER
Diagnosis: Current Diagnosis of Major Depression (Based on K-SADS (juveniles) or SCID (adults))
Clinical Impairment: CGAS less than 60 (juveniles) GAS less than 70 (adults)
Symptom Severity: CDRS Score greater than 39 (juveniles) (This score was used to enroll subjects in previous trials demonstrating efficacy of an SSRI in pediatric depression.)
Consent: Can give consent/assent.
IQ: All subjects will have IQ greater than 70. Assessment relies on WASI.
Any serious medical condition or condition that interferes with fMRI scanning, and for patients electing medication, any condition that increases risk of SSRI treatment. All patients will have complete physical examination. Healthy volunteer participants will be medication-free and have no current serious medical conditions, based on a review of their medical history.
Current use of any psychoactive substance; current suicidal ideation; current diagnosis of attention deficit hyperactivity disorder (ADHD) of sufficient severity to require pharmacotherapy. These factors could complicate treatment with an SSRI. No subject on medication will be accepted into the trial. Subjects will not be taken off of medications to enter the trial.
Current diagnoses: Tourette's, OCD, posttraumatic distress disorder, conduct disorder. These factors may be effected by SSRI treatment, influencing ability to detect effects on anxiety/depression
Past or current history of mania, psychosis, or pervasive developmental disorder. These factors may be effected by SSRI treatment, influencing ability to detect effects on anxiety/depression
Recent use of an SSRI: All subjects must have been free of any SSRI use for at least one month (fluoxetine six months) and must not have been treated with an SSRI for their current depressive episode. This is designed to exclude subjects who have failed a trial of an SSRI for their current episode of major depression.
HEALTHY ADULT SUBJECTS
Any current psychiatric diagnosis. Assessment relies on SCID.
SUBJECTS WITH AN ANXIETY DISORDER
Current Major Depressive Disorder
Children and teens with bipolar disorder experience unusual and extreme mood changes, which can affect energy and behavior. These changes are different from normal childhood and adolescent ups and downs. At times, those with bipolar disorder feel very happy and are much more active than usual. But other times, they feel extremely sad and are much less active.
Melinda Stanley, PhD
Professor and Head, Division of Psychology
The McIngvale Family Chair in Obsessive Compulsive Disorder Research
Menninger Department of Psychiatry and Behavorial Sciences
Mental Health Services Researcher, Houston Center for Quality of Care and Utilization Studies
Michael E. DeBakey Veterans Affairs Medical Center
Affiliate Investigator, South Central Mental Illness Research,
Education, and Clinical Center
Ron Rapee, PhD
Professor, Department of Psychology
Director, Centre for Emotional Health