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Our research program focuses on the connections between mental health, behavior, and cardiac outcomes.
We are interested in the impact of mood and anxiety disorders on cardiac health, and how different treatments for these disorders may impact quality of life and function. Depression and anxiety have been identified as risk factors for poor cardiac outcomes and death, independent of traditional cardiac risk factors such as high blood pressure, smoking, or diabetes. Unfortunately, depression and anxiety go unrecognized and untreated in the vast majority of patients with heart disease, despite the existence of safe and effective treatment. We have performed two randomized trials of care management for cardiac patients who have depression or anxiety disorders to determine whether having a care manager helps these patients to have better outcomes and better quality of life, and have examined the impact of psychiatric medications on cardiac health.
In addition, we are increasingly interested in the role of positive thoughts and emotions in cardiovascular health. There is some suggestion that positive psychological states, like optimism and gratitude, may independently predict superior cardiovascular health, yet these connections have not been closely studied in patients who have existing heart disease. We are examining the impact of optimism and gratitude on medical outcomes in both depressed and nondepressed patients who had a recent cardiac event. In addition, we have adapted positive psychological exercises to this population to determine if such exercises can boost optimism, gratitude, and self-efficacy in persons with heart disease. We are performing ongoing studies to better develop these exercises and to determine whether they may affect biology, health behaviors, and key cardiac outcomes. We are also working to adapt these positive psychological interventions to patients with other medical illnesses.
Finally, we are exploring the use of positive psychological interventions for patients with serious mood disorders or recent suicide attempts, to determine whether cultivating these positive states provides benefit in these populations as well. Optimism and other positive states have been linked to lower rates of suicidal thoughts and suicide attempts, and an approach that focuses on this aspect of mental health may be a novel and powerful approach.
Click on the tabs to learn more about our team, our projects, and our publications.
Jeff Huffman, M.D. is the Director of the Cardiac Psychiatry Research Program (CPRP), Director of Inpatient Psychiatry Research, and an Associate Professor of Psychiatry at Harvard Medical School. He currently serves as principal investigator for over ten projects, and has been awarded grants from the American Heart Association, the Templeton Foundation, American Foundation for Suicide Prevention, and the National Institutes of Health. He has many peer-reviewed publications, including over 80 first-author or senior-author publications, and has mentored medical students, psychiatry residents, research fellows, psychologists, social workers, and junior psychiatrist faculty. His areas of interest include the impact of psychiatric illness on patients with cardiac disease, and the development and use of positive psychological interventions in a wide range of populations.
Christopher Celano, M.D. is an attending psychiatrist at MGH and an Instructor in Psychiatry at Harvard Medical School and has worked on CPRP projects since 2010. He is the recipient of a K23 career development award sponsored by the National Heart, Lung, and Blood Institute to develop a psychological intervention to improve health behaviors patients with heart failure. He has published over 20 articles with the team and is an active co-investigator on several projects. His areas of interest include the impact of depression and anxiety on cardiac health as well as the promotion of positive psychological states in patients with mental illness and cardiovascular disease.
Scott Beach, M.D. is a faculty psychiatrist at MGH and an Instructor in Psychiatry at Harvard Medical School. He has been awarded the Livingston and Dupont-Warren Fellowships by Harvard Medical School for his project examining galvanic skin response in heart failure patients with and without depression. He is an active co-investigator on multiple projects and has had ten articles published, in press, or submitted in the past 12 months. Scott’s areas of interest include QTc prolongation with psychotropic medications, the physiologic effects of depression in patients with heart disease, and catatonia.
James Januzzi, M.D. is an Associate Professor of Medicine in the Division of Cardiology at Harvard Medical School, and the Director of the Cardiac Intensive Care Unit at MGH. He is a well-established researcher at MGH with over 200 peer-reviewed research publications, over 100 review articles and chapters, and has edited 3 text books. He is internationally known as an expert in the study of biomarkers in patients with heart failure and other cardiac illnesses, and has served as a section editor on the recent American College of Cardiology/American Heart Association clinical practice guidelines for heart failure, and was the lead for the heart failure section for the Universal Definition of Myocardial Infarction Global Task Force. He has served as the primary cardiologist on projects for the CPRP for the past 9 years, including collaborative care depression and anxiety management trials in hospitalized cardiac patients, and studies of positive psychological states in persons with heart disease.
Ana Claudia Villegas, M.D. graduated from Universidad de Los Andes medical school in Bogota, Colombia in 2014. Ana was recently enrolled as a research fellow and currently completes participant chart reviews and manages both patient censuses and the CPRP databases. While completing her fellowship, she plans to write papers, present posters at scientific meetings, and help develop written materials for the team’s projects. After the completion of her fellowship Ana intends to attend a residency program in neuro psychiatry with a special focus on addiction.
Carol Mastromauro, M.S.W., L.I.C.S.W. is one of the interventionists for the CPRP. She is a clinical research social worker who has been with the team for seven years. Carol specializes in anxiety and depression treatment and positive psychology interventions for cardiac populations. She has administered interventions to more than 200 subjects during her time at the CPRP, and recruited and evaluated over 350 cardiac inpatients for the SUCCEED and MOSAIC studies. Prior to joining the CPRP, Carol worked in geriatric research on memory disorders as well as working with Huntington’s disease patients and their families.
Rachel Millstein, Ph.D., M.H.S. is a clinical and research post-doctoral fellow in her second year with the CPRP. She graduated from the SDSU/UCSD Joint Doctoral Program in Clinical Psychology, with a focus on Behavioral Medicine. She also holds an M.H.S. in Epidemiology from the Johns Hopkins Bloomberg School of Public Health and a B.A. in Psychology from Wellesley College. Rachel is a primary interventionist for the PEACE trial. Her research interests focus on chronic disease and obesity prevention, specifically multi-level nutrition and physical activity interventions, having authored or co-authored many peer-reviewed articles and book chapters in these fields. Her clinical interests include evidence-based therapies, positive psychology, and mindfulness techniques for improving mood, anxiety, and well-being.
Christina DuBois, B.A. graduated from Skidmore College in 2011 summa cum laude with a degree in psychology. She serves as the lead research coordinator for the CPRP and is in her third year with the program. She has delivered positive psychology interventions, performed qualitative interviews, and coordinated several of the team’s projects. Currently, she is the interventionist for a collaborative positive psychology project with the Diabetes Outpatient Center. Previously, Tina interned at a hospice, a group home for runaway youth, and a domestic violence center as a financial resource coordinator. She is currently pursuing her MSW at the Boston University School of Social Work.
Eleanor Beale, B.A. graduated from Skidmore College in 2012 summa cum laude with a degree in psychology. In her fourth year with the program, she is the lead research coordinator for the REACH study, developing a positive psychology intervention to promote health behaviors in Heart Failure patients, and runs eight of the other studies at the CPRP. Previously, Ellie developed functional behavioral assessments for a day program for individuals with developmental disabilities, and interned at a substance abuse center. Currently, Ellie is applying to Clinical Psychology PhD programs to start in Fall 2016.
Kirsti Campbell, B.S. graduated from the University of Virginia in 2012 with a degree in biology with highest distinction. She is currently a fourth year M.D. candidate in the New Pathway program at Harvard Medical School (HMS), and she completed her Principal Clinical Experience at MGH during the 2014-2015 academic year. With funding through the CPRP and HMS, Kirsti will work as an interventionist for the PEACE study and is conducting a study of patient factors associated with engagement in positive psychological interventions.
Ariana Albanese, B.A. graduated from Harvard College in 2015 magna cum laude with a degree in history and literature and a secondary degree in psychology. She is in her first year with the program and primarily manages the NIH-funded PEACE study which is currently in its third stage. In this role she performs a variety of tasks ranging from subject recruitment to data organization. Ari also works as a project coordinator in Dr. John Weisz’s Laboratory for Youth Mental Health at Harvard University, participating in research projects which focus on youth internalizing disorders and emotion regulation.
Emma Lenihan, B.S.c graduated from the University of Greenwich, London with a degree in psychology. She has been with the CPRP for over 8 years, and has conducted study assessments for a wide range of projects. She is also a former member of the study teams at the Depression Clinical and Research Program and Center for Addiction Management at MGH.
Brian Healy, Ph.D. is an Assistant Professor in the Department of Neurology at Harvard Medical School, a member of the Biostatistics Center at Massachusetts General Hospital, and an Instructor in Biostatistics at the Harvard School of Public Health. Dr. Healy is also the lead biostatistician for the Partners Multiple Sclerosis Center, which is affiliated with Brigham and Women's Hospital. His primary research interest is statistical methods development and application for modeling of multiple sclerosis. He has been working with the CPRP for the past 5 years, and he has participated in the design and analysis of several studies.
Dr. Elyse Park (qualitative research and motivational interviewing): Mongan Institute for Health Policy
Dr. Steven Safren (behavioral intervention development): Behavioral Medicine Service
Dr. Andrés Bedoya (behavioral interventions)
Dr. Hanna Gaggin (cardiology)
The Benson-Henry Institute for Mind-Body Medicine, MGH
Dr. Matthew Nock (prediction and prevention of suicide/self-harm), Department of Psychology, Harvard University
Dr. Linda Collins (novel methods of optimizing and evaluating multicomponent behavioral interventions), the Methodology Center, Penn State University
Dr. Todd Kashdan, (positive psychology and interventions to increase well-being), the Center for Consciousness & Transformation, George Mason University
Dr. Julia Boehm, (positive psychology), Department of Psychology, Chapman University
Bruce Rollman (treatment of depression and anxiety in cardiac patients) University of Pittsburgh Medical Center
Medical Students:Gillian SowdenChris DoughtyChristina Carr
Residents:Curtis WittmannAmy TaylorLeah BauerKeri Oxley
Faculty/Fellows:Felicia SmithAndres CaroTrina ChangGiselle Perez-LougeeOriana Vesga-LopezLaura Suarez
Research Coordinators:Marguerite BeiserRita SeabrookShannon Moore
Social Work and Nursing Interventionists:Rachel RodmanStephanie MahnksMeaghan Morrison
Special thanks: Our work has also been generously supported by the esteemed Avery D. Weisman, MD, of the eponymous MGH Psychiatry Consultation Service and a long-standing national leader in psychosomatic medicine. His support has allowed the CPRP to continue to investigate the associations between positive and negative emotional states and physical health and well-being, and we are forever indebted.
Positive Emotions after Acute Coronary Events (PEACE)Developing a positive psychology intervention to improve cardiac health behaviorsNational Institutes of Health: National Heart Lung and Blood Institute (1R01HL113272-01A1)This project aims to systematically develop a positive psychological intervention for patients with a recent acute coronary syndrome to determine if such an intervention leads to greater participation in health behaviors (e.g., better diet, more physical activity) in the weeks and months following the acute cardiac event.Principal Investigator (PI): Jeff Huffman
Assessment of autonomic dysfunction in patients with heart failure Dupont-Warren and Livingston Fellowships, Harvard Medical SchoolThis study aims to examine the impact of depression on autonomic nervous system function in patients hospitalized with heart failure. Matched patients with and without major depression will have measurements taken of galvanic skin response and urinary catecholamines, and we hypothesize that autonomic dysfunction will be greater in depressed patients, independent of the severity of cardiac illness. PI: Scott Beach
Positive Psychology for Bipolar Disorder (PPBP)Development of a positive psychology intervention to reduce suicide risk in patients with bipolar disorderDupont-Warren and Livingston Fellowships, Harvard Medical SchoolThis is a pilot study of a 4-week positive psychological intervention (planned N=30) for patients hospitalized for bipolar disorder. Subjects in the intervention arm will complete a positive psychological exercise in the hospital, followed by exercises over the subsequent 4 weeks; participants in the control arm will compete cognitive/recollection tasks. Outcome measures include assessments of feasibility, acceptability, and clinical impact.PI: Christopher Celano
Mind Brain and Behavior Extension of the Gratitude Research in Acute Coronary Events (GRACE) StudyPresident and Fellows of Harvard College AwardThis project extends the work of the GRACE study by examining connections between optimism/gratitude, health behaviors, and cardiac events for a longer period of time (up to 3 years).Principal Investigator (PI): Jeff Huffman
Researching Emotions and Cardiac Health (REACH)Developing a positive psychology intervention to improve health behaviors in patients with heart failureThe National Heart, Lung, and Blood Institute (K23 2015P000069)This project aims to methodically create a positive psychological intervention for patients with heart failure to examine if this type of intervention leads to improvement in health behaviors such as diet and physical activity. Principal Investigator (PI): Christopher Celano
Positive Psychology for Diabetes Mellitus (PPDM)Developing a positive psychology intervention to improve health behaviors in patients with type II diabetesThis project aims to generate a positive psychological intervention for patients with type II diabetes to ascertain if such an intervention leads to improved health behaviors such as better diet and increased physical activity.Principal Investigator (PI): Jeff Huffman
Management of Sadness and Anxiety in Cardiac Disease (MOSAIC)A collaborative care program to improve treatment of anxiety disorder in hospitalized patients with cardiac diseaseAmerican Heart Association Grant-in-AidThis was a randomized controlled trial of a care management program to manage depression and anxiety disorders among patients hospitalized for cardiac illness (N=183). A multidisciplinary collaborative care intervention, led by a social work care manager, was initiated in the hospital and continued by phone for 6 months after discharge. The intervention was associated with improvements in mental-health related quality of life at 6 months, reduced depressive symptoms, and better overall functioning. Patients randomized to the collaborative care intervention also had higher rates of treatment of a mental health disorder. PI: Jeff Huffman
Positive Psychology for Suicidal Inpatients (PPSI)Development of a positive psychology intervention to reduce suicide riskCenter for Disease Control (R01 DP000339)This was an exploratory study of nine positive psychological exercises in patients hospitalized for suicidal thoughts or a suicide attempt. Participants (N=61) were administered exercises in random order during their admission, and rated the ease of completion and impact of the exercises before and after completion. Overall, the exercises were feasible, well-accepted, and associated with short-term improvements in key symptoms in this cohort. PI: Jeff Huffman
Happiness in HealthMind-body interventions in cardiac patientsCenter for Disease Control (R01 DP000339)This was a three-arm pilot study examining the feasibility of three positive psychological exercises (on gratitude, optimism, and altruism) in patients hospitalized for heart failure or an acute coronary syndrome. The exercises were well-accepted, and the positive psychology exercises appeared to lead to greater improvements compared to the active (relaxation response) and attentional (recollection) control conditions. PI: Jeff Huffman
Gratitude Research in Acute Coronary Events (GRACE)The impact of gratitude on biology and behavior in persons with heart diseaseGreater Good Science Center/Templeton Foundation This project aims to prospectively study the connections between positive psychological states (e.g., gratitude, optimism), measured 2 weeks after an acute coronary syndrome, and improvements in biomarkers and health behaviors at 6 months. Enrollment is complete (N=164) and we are beginning data analysis. We hypothesize that patients who report higher levels of positive emotions/thoughts will have greater improvement in biology and behavior.PI: Jeff Huffman
Happiness, Optimism, and Positive Emotions (HOPE))Development of a positive psychology intervention to reduce suicide riskAmerican Foundation for Suicide Prevention Standard Research GrantThis is an exploratory study of a 6-week positive psychological intervention (planned N=50) for patients hospitalized with major depressive disorder and who had suicidal thoughts prior to admission. Participants in the intervention arm will complete a positive psychological exercise in the hospital, followed by exercises over the subsequent 6 weeks; participants in the control arm will compete cognitive/recollection tasks. Outcome measures include assessments of suicidality/hopelessness, mood symptoms, and overall intervention feasibility.PI: Jeff Huffman
Boosting Emotions and Happiness in Outpatients Living with Diabetes (BEHOLD)A positive psychology program for patients with type 2 diabetes: Pilot studyThis is a pilot study of a 10-week positive psychological intervention (planned N=15) for outpatients who have type 2 diabetes and poor adherence to one or more diabetes-related health behaviors. Participants will complete 7 exercises over the course of 10 weeks. Outcome measures include assessments of feasibility, acceptability, and clinical impact of the intervention.PI: Jeff Huffman
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