Evaluating the Comparative Validity and Reliability of SERAS: Systematic Expert Risk Assessment for Suicide
There are more deaths from suicide than from motor vehicle accidents in the US and up to 80% of those who die by suicide received health care services for reasons unrelated to mental health in the year preceding their death (NCHS, 2014; Ahmedani, 2015). Most of the currently available suicide risk screening tools require expert psychiatrist or clinical psychologist assessment, or an extended interview, making it difficult to screen patients rapidly, which is especially problematic in Emergency Departments and Urgent Care settings. At present, there is a lack of efficient and validated measures of suicide-related behaviors necessary for real-time clinical decision making for near-term (defined as within the next 72 hours) risk of suicide. To address an unmet need, and in collaboration with an expert panel of psychiatrists and psychologists, we developed and pilot tested SERAS (Systematic Expert Risk Assessment for Suicide), a brief self-administered, neural-network-based decision support tool to replicate the critical thinking process of Board-Certified Psychiatrists in weighing factors to assess an individual’s risk of suicide in the next 72 hours (Desjardins et al., 2016). In this study, we assessed the validity and reliability of SERAS for suicide risk assessment by testing it against the CSSRS for predicting expert clinical assessment and risk-related events (suicide attempt, suicide, and re-presentation to the ED or hospitalization for suicide-associated events) within 72 hours.
Publications related to this work:
Althoff RR, Frering H, Maruti S, Helzer JH, Hudenko W, Cats-Baril W, Desjardins I. Construct and Predictive Validity of the Systematic Expert Risk Assessment for Suicide (SERAS) in the Emergency Department Setting. Manuscript submitted for publication, 2020 Mar.
Desjardins I, Cats-Baril W, Maruti S, Freeman K, Althoff RR. Suicide Risk Assessment in Hospitals: An Expert System Based Triage Tool. J Clin Psychiatry. 2016; 77(7):e874-82
Child Behavior Checklist-Dysregulation Profile: Genes, Environment, Life Course
This proposal describes a 5 year mentored training program to develop a research career in Child and Adolescent Psychiatry; Research will focus on the CBCL-Dysregulation Profiles as a measure of mood instability, attention problems, and aggression that is often seen in child and adolescent psychiatry clinics, but poorly studies and understood
Role: Principal Investigator
Stare-in-the Crowd Effect: Eye tracking and physiological response
A face that is looking directly at us stands out more prominently than the other faces in a crowd; this phenomenon is called the stare-in-a-crowd effect. Initially, the ability to pick out these self-directed faces played an evolutionary role. Quick identification of faces allows us to determine if another being is looking at us and whether or not they are a threat (Senju et al 2005). In our world today, the ability to detect direct gaze plays an important role in social awareness (von Grunau 1995). In particular, identifying direct gaze is important to understand how another individual is feeling (Baron-Cohen 1995) and to recognize their facial expression (Pelphrey et al 2002). Speed in identifying gaze direction is still important; once a person recognizes that a face is directed at them, they allocate more cognitive resources to detecting information about this other person (Conty et al 2007). With the importance of direct gaze detection already established, this study will employ advanced eye tracking technology to look at this effect in situations that more closely simulate real social situations. Much of the field uses photos of individuals for this research; the proposed study will use stimulus photographs of groups of people. Additionally, the eye tracking technology will allow us to manipulate the stimulus photographs in reaction to where a subject is looking.
Multi-family Group Psychoeducational psychotherapy for Dysregulation
Children with severe and profound problems with self-regulation commonly present to the clinic of a child and adolescent psychiatrist. These children often come with an array of problems in attention, cognition and behavior. While some of these children have previously been labeled as “bipolar”, the majority of these children do not fit that designation because they do not have episodes of elevated, expansive moods alternating the depression. Rather, they have chronic, nonepisodic irritability. We have been studying the nature of this kind of “dysregulation” and have demonstrated that it has both genetic and environmental influences, with the environmental influences being the most profound earlier in life. Unfortunately, there are no current treatments that have been demonstrated for these children. The proposed research protocol aims to test the utility of psychoeducational psychotherapy in children with dysregulation, but without bipolar disorder. Participants will be 20 children and adolescents ages 8-13 and their parents recruited from the Pediatric Psychiatry Clinic (PPC) at the Vermont Center for Children, Youth, and Families (VCCYF). Children and their families seeking evaluation and treatment at the VCCYF and the PPC are routinely offered the opportunity to participate in research studies (research protocol CHRMS# 09-210).
Vermont Center on Behavior and Health:
The proposed center will investigate relationships between personal behavior patterns (e.g., substance abuse, sedentary lifestyle, medication non-adherence) and risk for chronic disease and premature death. The overarching focus will be on developing and evaluating clinical interventions for these risk behaviors and examining biases in decision-making and other potential mechanisms underpinning vulnerability to unhealthy behavior patterns using a behavioral economic conceptual framework.
Role: Project PI (Higgins, PI) Multi Investigator Project
Training in Behavioral Pharmacology of Drug Abuse
(Higgins, PI) Role: Co-I