5 Clinical Trials for Various Conditions
This is a 2 -year NIDA funded grant (Co-PIs: Joseph P. Newman, John Curtin, and Carl Lejuez) that examines whether recent progress in characterizing the cognitive deficits associated with psychopathic and externalizing offenders may be used to develop better therapeutic interventions to treat their substance abuse and other self-control problems. Inmates with externalizing or psychopathy will receive one of two computer-based interventions to remediate the core cognitive skills that have been linked to self-regulation deficits in the two groups. One intervention (ACC) targets the affective cognitive control deficits associated with externalizing offenders whereas the other intervention (ATC) targets the attention to context deficits associated with psychopathic offenders. The specific components of the project include: selection and randomization of inmates; pre- and post-treatment behavioral and brain-related (ERP and Startle) measures to evaluate the impact and specificity of the ACC and ATC treatments; and 6 sessions of behavioral (e.g. computerized) and verbal training in ACC or ATC.
This study will examine the role of a brain chemical called norepinephrine in thinking, decision-making, and emotional processing. After norepinephrine is released from a brain cell, it binds to another brain cell's receptor. Some of the receptors it binds to are called alpha-2 adrenergic receptors. This study will use medicines called yohimbine and guanfacine to look at the function of norepinephrine in the brain when it binds to the alpha-2 adrenergic receptors. Yohimbine increases norepinephrine's function and guanfacine decreases its function. Healthy volunteers between 20 and 50 years of age who do not have heart disease, high blood pressure, psychiatric illness, or other serious medical conditions and who are not allergic to lactose may be eligible for this study. Candidates are screened with a medical and psychiatric history, physical examination, neuropsychological testing, blood and urine tests and electrocardiogram. Women are screened with a urine pregnancy test. Participants are given a pill of yohimbine, guanfacine, or placebo and undergo the following tests and procedures: * Blood pressure and heart rate measurements: Blood pressure and heart rate are measured before the medication is taken and several times after. * Blood draws: Blood is drawn before the medicine is taken and 90 minutes after to measure levels of norepinephrine and the hormone cortisol. * Neurocognitive testing: Participants do neurocognitive tasks on the computer for up to 90 minutes. The tasks involve looking at pictures or words on a screen and responding according to instructions given. * Magnetic resonance imaging (MRI): Patients may undergo neurocognitive testing MRIs. This test uses a strong magnetic field and radio waves to show changes in brain activity. The subject lies on a table that slides into a narrow cylinder (the MRI scanner). Images of the brain are obtained while the subject performs the computer tasks.
Substance use among criminal offenders constitutes a major public health problem and is tied to negative consequences for offenders, their families, and their communities. One of the direst of these consequences is repeated incarceration; thus, interventions that reduce criminal recidivism are needed. Forensic populations are often viewed with considerable therapeutic pessimism. However, offenders exhibit heterogeneity in personality traits, and the assessment of individual differences among offenders may provide valuable information that guides the use of psychotherapeutic interventions. Among offenders, psychopathy has emerged as an important personality construct for the understanding of violence and criminal recidivism. Moreover, core traits of psychopathy such as lack of empathy, deceitfulness, and lack of remorse may have negative implications for the efficacy of psychosocial interventions. A foundational premise of the present work is that understanding the moderating role of psychopathic traits on substance use treatment outcomes among offenders is essential to determining what works, and for whom. The current proposal is a Phase II randomized clinical trial that aims to examine the impact of psychopathic traits on the efficacy of a brief substance use intervention for offenders in a jail diversion program. Hypotheses that will be examined include: 1) that a Motivational Interviewing (MI) - based treatment will reduce substance use and related consequences relative to a Standard Care only condition, 2) that the reduction in substance use in the intervention group will mediate a reduction in later criminal recidivism relative to the Standard Care condition, and 3) that core psychopathic traits will moderate the efficacy of the intervention such that individuals with lower levels of these traits will derive greater benefits with regard to decreased substance use, decreased drug use consequences, and decreased criminal recidivism at a one-year follow-up.
This study seeks to correlate microbiome sequencing data with information provided by patients and their medical records regarding autism.
This study is directed toward a better understanding of how the brain regulates emotions and social and antisocial behavior. It will look at the use of the orbital frontal cortex and amygdala of the brain. Brain changes are involved in solving conflicts and the feelings that such conflicts produce. Conflicts may occur with other people or with general social rules. The researchers' expectations are that the findings will be useful in developing therapies that may improve people's ability to solve social conflicts and reduce antisocial behavior. Adults ages 20 to 50 years of age with psychopathy and a second set of comparison adults, all of whom have been released from the Fairfax County Adult Detention Center, may be eligible for this study. The neurocognitive component of the study, the one pertaining to performance of various tasks, will involve 20 adults with psychopathy and 20 comparison adults. The neuroimaging component, in which a magnetic resonance imaging (MRI) scan is used, will involve 18 adults and 18 comparison adults. Two visits by participants will be entailed. At the first visit, patients will undergo the following procedures and tests: * Physical examination * Test of vital signs, lying and standing. * Electrocardiogram. * Collection of blood for chemistry and hematology. * Urinalysis and liver function tests. * Screen for HIV and hepatitis. * Pregnancy test, if applicable, at the first visit and at all further visits. Depending on the group to which they are assigned, at the second visit, patients will undergo an MRI scan or take part in a variety of computer-based tasks to measure different forms of thinking skills, emotional responses, and decision making. During the MRI scan, patients will lie still on a table that will slide into the enclosed tunnel of the MRI scanner. They will be asked to lie as still as possible. As the scanner takes pictures, patients will hear knocking or beeping sounds, and they will wear earplugs to reduce the noise. Patients will be able to communicate with the MRI staff at all times during the scan, and they may ask to be moved out of the machine at any time. While lying in the MRI scanner, patients will be asked to perform tasks presented via a screen. These tasks will involve looking at pictures or words, and patients will be asked to make decisions about the pictures. The MRI scan will take no more than 2 hours. In regard to the computer-based tasks that participants will perform, the tasks are often games presented on a computer. Via computer, or on paper, there may be presentations of pictures that bring about an emotion. There will be no direct treatment or therapeutic benefits to participation in this study. However, the knowledge gained may help people in the future.