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How would you explain your research to a lay-person?
At any one point in time we usually have several lines of research going on. So if someone were to ask me about my research on risk for schizophrenia, I would explain that that particular research project is focused on adolescents who have behavioral disorders that are known to be linked with risk for the development of later schizophrenia.
In that research we're interested in identifying biological indicators that predict which of those adolescents at risk are most likely to go on to develop a major mental disorder. Among the things we look at are stress hormones and other kinds of biochemical indicators, and also indicators of exposure to pre-natal complications.
What about your research on the link between stress and schizophrenia?
One area of interest is what neural mechanisms might be involved in the exacerbation of psychiatric symptoms following stress exposure.
Related to that is a project we have going on this summer. It's intended to examine the relationship between stress hormone release and the individual's development of conditioned fear responses. In that study, we're attempting to determine whether people who show heightened stress sensitivity are also more likely to show physical signs of arousal or fear to threatening stimuli. That research is related in part to our general interest in the way stress and stress hormones might influence the expression of fears, anxiety, and other psychiatric symptoms.
Our research on the precursors of schizophrenia focused on a variety of domains. We've examined motor development and cognitive factors, characteristics of emotional expression, and also more general behavioral phenomena. The results of that research were consistent with other studies which indicate that children at risk for schizophrenia show deviations from normal development as early as infancy. For example, in infancy, they show delays and abnormalities in motor development, and also differences compared to their siblings in temperament. So, the infants who later developed schizophrenia showed more signs of negative affectivity or negative emotion.
What about your research on the differences between men and women in terms of schizophrenia?
The differences between men and women in the clinical characteristics of schizophrenia are somewhat subtle, though consistent. Women tend to develop schizophrenia later in the life-course than men. And when they do show schizophrenia, their prognosis, on average, seems to be somewhat better than men. One of the primary theories on that is that estrogen has effects on neurotransmitters that result in a reduction in dopamine activity, and that in turn results in a reduction of the severity of schizophrenia in women. Dopamine happens to be the primary neurotransmitter system that's been implicated in schizophrenia.
So any other factor or any other hormone that might produce a change in dopamine neurotransmission could potentially alter the severity or course of schizophrenia.
What's your philosophy of teaching?
I haven't had the opportunity to do as much teaching in the past few years as I would like, because of research grants and commitments. But when I do teach, my main objective is to stimulate thinking and to encourage students to try to put together pieces of scientific evidence in a way that offers new insights.
What other projects are you currently working on?
Most of the teaching I do now is with graduate students- so I have graduate students who work in my lab, and also undergraduate honors students. So my teaching focuses more on individual interactions and supervision of students, as opposed to classroom teaching. Although I do that occasionally.
Other research projects we've been working on concern various facets of schizophrenia, other forms of psychopathology, and risk for them. For example, in one study we recently completed, we worked with data from the National Institute of Mental Health, where we examined data from sets of identical twins where one twin has schizophrenia and the other does not. In that research we're trying to determine what, if any, differences exist between the two members of the identical twin pairs, in hormonal or neurotransmitter characteristics that might explain why one has schizophrenia and one does not. Clearly, given that they're identical twins, one would conclude that it couldn't just be genetics, since they both have the same genotype. So in order to understand the ideology in those particular individuals, we have to look at other factors that might have influenced one twin but not the other.
So for example pre-natal or post-natal infections might have influenced the brain development of one twin in a way that put him or her at risk for schizophrenia, and that might have manifested later in life as an abnormality in neurotransmitters or hormones. One thing that has also been found in that research is that the affected twin has certain brain abnormalities that are not apparent in the other twin. So for example the schizophrenic twin has a reduction in an area of the brain called the hippocampus, when compared to their healthy co-twin.
There's been some debate about the term schizophrenia- whether it's a single syndrome or a collection of illnesses...
I think it's probably the case that there are multiple causes of schizophrenia, and that for some patients with the illness, the determinants are primarily inherited abnormalities of the central nervous system. For others it's more likely that the illness is a function of acquired brain abnormalities, for example abnormalities that have their origin that have their origins during foetal development; during development of the central nervous system.
So although schizophrenia is used to describe a variety of syndromes or combinations of symptoms, in fact most people believe that there are multiple causes, and at some point we may know enough to differentiate among classes of schizophrenia, for example those that are due to inherited neurotransmitter abnormalities, vs. types that are due to prenatal viral infections.
How did you get interested in research? What kinds of education did you pursue after that point?
When I was an undergraduate student I was initially an art major at the school of fine arts at Washington University, and I had a part-time job teaching art to patients at a psychiatric facility nearby. Within a relatively short period of time I found that I was more interested in the patients than I was in the art. So I switched my major to biopsychology. From that point on I started to develop an interest in major psychopathology- schizophrenia, bipolar disorder, and then I did my dissertation in graduate school on schizophrenia, and a post-doc dealing with schizophrenia.
What was the subject of your Ph.D. thesis?
It concerned developmental changes in the capacity of patients with schizophrenia to recognize facial affect- facial emotions and expression. That research found that there were deficits in schizophrenic patients in the ability to decode facial expressions and emotion, and that those deficits were characteristic of both children and adults with the illness.
What about the under-representation of women in the sciences, especially at the higher levels of academia?
Answering that question would take a lot of time and space...
Let me say this: there is no doubt that various forms of gender bias have been operative in science and continue to be a factor.
I think there is some progress being made. But it is slow, and there are a lot of institutional factors that play a role that are entrenched, and therefore will take some time to change.
What institutional factors are "entrenched?"
Certain characteristics of the way social networking and mentoring in science is conducted.
What interests do you have outside of work?
I'm a soccer mom, so I spend a lot of time at soccer games. I spend a lot of time with kids; taking care of a household; taking the dog to a vet; chasing the dog around the neighborhood. Those are things outside of here.
In terms of other research interests I have an interest in forensics, the insanity defense, and the implications of psychotic symptoms for individuals to use the insanity defense.
It is complicated- unfortunately the most severely disturbed psychiatric patients are the least likely to think that they are ill. That reality produces a situation in which the individuals who are most likely to be entitled to an insanity defense are the least likely to pursue it. Because of laws following the Hinckley assassination attempt, the insanity defense is now an affirmative defense, which means that a defendant has to instruct their attorney to argue for the insanity plea. And if an individual is very disturbed and does not realize they are having hallucinations and delusions, they will often insist that their attorney not do that. Attorneys cannot violate client prerogative.
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