Research in Behavioral Medicine

The Behavioral Medicine Program at Massachusetts General Hospital is at the forefront of research focused on developing, validating and disseminating psychosocial interventions to help individuals with a variety of health and medical issues.

Overview

The research conducted by the clinicians of the Behavioral Medicine Program is focused on developing and validating new psychosocial interventions to help individuals with a variety of health and medical issues. This research is conducted both domestically and internationally across three continents.

We always have a number of studies running, many in need of participants.  If you are interested in participating in our research, please see our lists of active research to learn more:

Domestic Research

  • Harvard University Center for AIDS Research (CFAR) Behavioral and Social Sciences Core

    Conall O’Cleirigh, PhD, Associate Director

    Description: In his role as Associate Director of the Harvard University CFAR Behavioral and Social Sciences (BSS) Core, Dr. O’Cleirigh provides consultation on developing and supporting HIV-related clinical research. The Core provides services to behavioral and biomedical researchers; will leverage ongoing biomedical projects to integrate behavioral/social science and conduct add-on behavioral/social science studies; and will engages community stakeholders to increase buy-in of research and acceptance of new biomedical technologies.

  • Striving Towards Empowerment and Medication Adherence (STEP-AD)

    Principal Investigator: Sannisha K. Dale, PhD, EdM
    Funding Source: National Institute of Mental Health (NIMH)
    Project Number: 1K23MH108439-02

    Description: Among women in the U.S, Black women are the most impacted by HIV. Relevant psychosocial and contextual factors facing Black women with HIV include having a history of abuse, posttraumatic stress, racial discrimination, HIV-related stigma/discrimination, and prescribed female traditional gender roles; each of which are associated with worse HIV outcomes. Despite the need, there is currently no evidenced-based psychosocial intervention for Black women with HIV that addresses these contextual factors. The purpose of the current study is to develop and assess the feasibility and acceptability of an intervention for Black women with HIV that combines evidence-based strategies for trauma symptom reduction, strategies for coping with racial and HIV-related discrimination, gender empowerment, problem solving techniques for medication adherence, and other resilient coping techniques.

    Specific aims:

    1. Develop an intervention and conduct an open pilot trial of the intervention to initially assess feasibility of all study procedures and intervention delivery and acceptability
    2. Conduct a small randomized control trial (RCT) comparing the newly developed intervention to an enhanced treatment as usual control
    3. Prepare for conducting a large community based hybrid efficacy/effectiveness randomized control trial in community clinics through engagement with community members and potential deliverers of the intervention

    Potential Participants: If you are interested in participating in this research, please contact the study research assistant at (617) 643-4566.


  • Evaluating Recovery Coaches to Improve Treatment Outcomes and Reduce Health Care Costs among Patient

    Principal Investigator: Jessica Magidson, PhD and Sarah Wakeman, MD
    Funding Source: Partners Population Health Management
    Project Number: N/A

    Description: This grant aims to evaluate the clinical and cost effectiveness of integrating peer recovery coaches into primary care for outpatient management of substance use disorders, examining whether recovery coach involvement can improve substance use treatment outcomes and reduce health care costs among patients with substance use disorders.

    Potential Participants: N/A


  • Integrated Behavioral Treatment for Chronic Pain/Drug Use in Older MSM with HIV (Phase 2)

    Principal Investigator: Conall O’Cleirigh, PhD
    Funding Source: NIH
    Project Number: R21 DA038197

    Description: Men who have sex with men (MSM) in the US are most heavily affected by HIV, representing ~63% of all new HIV infections annually. With highly effective HIV medication and consistent engagement in HIV health care, these MSM are living longer; by 2015 it is estimated that more than 50% of Americans living with HIV will be 50 years of age or older. Evidence is emerging that chronic pain is prevalent in older HIV-infected patients and likely occurs synergistically with substance use and abuse, which predispose to non-engagement and non-retention in HIV care, non-adherence to HIV medications and sexual risk taking. Understanding these relationships and incorporating pain management strategies in health interventions will forge the development of a tailored behavioral-based, integrated intervention that has the potential to improve pain management, reduce substance use (and/or its interference in HIV disease management) and improve ART adherence and engagement in care Design. The purpose of this research application is to develop and openly pilot an integrative intervention for older HIV- infected men who have sex with men (MSM) who report chronic pain and substance-using behaviors that interfere with engagement in care and sexual risk taking. The application has the potential to change the manner in which older HIV infected MSM with chronic pain and substance abuse are treated, thus increasing quality of life and longevity in this population.

    Potential Participants: If you are interested in participating in this research, please contact the study coordinator at 617-927-6465.


  • Promoting Resiliency among Parent of Children with Learning and Attention Disabilities (LD)

    Principal Investigator: Elyse R. Park, PhD, MPH
    Funding Source: The Marino Foundation
    Project Number: N/A

    Description: According to the 2011/12 National Survey of Children’s Health, 14.6 million children in the U.S. have special health care needs (e.g., learning disability, ADD/ADHD, developmental delays, chronic mental or physical health conditions), and learning disabilities (LD) are the largest category of students receiving special education services. Having a child with LD is associated with an increased risk of problems with emotional and physical health and social well-being. Resiliency is a multidimensional construct that refers to the ability to maintain adaptation and effective functioning when faced with stressors. Resiliency provides a framework for understanding the adjustment to stress as a dynamic process. We will personalize and target the Stress Management and Resiliency Training- Relaxation Response Resiliency Program (SMART 3RP) to parents of children with LD. We will determine the feasibility, and acceptability, and efficacy of an 8-week group 3RP intervention to parents of children with special health care needs. Lastly, we will pilot test the end-of-treatment effects of the SMART 3RP on parents’ stress levels using health-relevant biomarker measures.

    Potential participants: We are recruiting parents, nationally, of children any age with learning or attention disabilities. For more information, please email ParentalStressStudy@partners.org, or contact Emma Chad-Friedman at 617-643-6036.

    This program is for parents and is once a week, for 1 hour/ week for 8 consecutive weeks. Participation will be done virtually (via videoconferencing).  To participate in this study, we ask you to complete three questionnaires over the course of 6 months, as well as to provide two hair samples to measure cortisol levels.

    If interested in participating, please complete the pre-screen questionnaire. We will contact you soon to let you know about beginning the program.


  • Integrating Tobacco Treatment into Cancer Care

    Principal Investigator: Elyse R. Park, PhD, MPH
    Funding Source: National Cancer Institute
    Project Number: 1K24 CA197381-01

    Description: The mentoring and research aims of this proposal involve expanding our knowledge of how to develop and deliver evidence-based tobacco treatment for diverse/variety of cancer patients.

    Potential participants: Mass General cancer patients who are smokers, English or Spanish-speaking, with regular telephone access.


  • Promoting Resiliency among Parent of Children with Autism Spectrum Disorder (ASD)

    Principal Investigator: Karen Kuhlthau, PhD (Elyse R. Park, PhD, MPH, Co-Investigator)
    Funding Source: HRSA
    Project Number: N/A

    Description: In addition to running the SMART-3RP with parents of LD, we are developing an adapted program for parents of children with ASD. To learn more about the experience of raising a child with ASD, we are running focus group interviews with parents of ASD. These interviews will inform an 8-week virtual-delivery program for parents of ASD.

    Potential participants: We are recruiting parents, nationally, of children any age with Autism Spectrum Disorder to take part in a 1 hour-long interview to help us learn more about parenting a child with ASD.

    Contact information: For more information, please email ParentalStressStudy@partners.org, or contact Emma Chad-Friedman at 617-643-6036.


  • Integrating Tobacco Treatment into Cancer Care: A Comparative Effectiveness Trial

    Principal Investigator: Dr. Elyse R. Park, PhD, MPH
    Funding source: National Cancer Institute
    Project number: R01 CA166147

    Description: A multi-site randomized controlled comparative effectiveness trial will enroll 295 current smokers with suspected or newly diagnosed melanoma, lymphoma, thoracic, breast, genitourinary, gastrointestinal, head and neck, or gynecologic cancer. Participants will be randomly assigned to receive the Intensive Treatment (IT) or Standard Treatment (ST) condition. Both groups will receive an initial motivational counseling session and 3 weekly follow-up counseling sessions with a tobacco treatment counselor, conducted in-person or by telephone. The IT arm has the option to also receive an additional 4 biweekly and 3 monthly proactive counseling sessions and up to a 12-week supply of FDA-approved smoking cessation medication at no cost.

    Potential participants: Mass General patients who have smoked a cigarette, even a puff, within the last 30 days with newly diagnosed or suspected cancer, who are English or Spanish-speaking may be eligible. If you are interested in participating, please contact the study coordinator at 617-643-4765 or email smokefreesupportstudy@partners.org.


  • Integrating Tobacco Treatment into Cancer Care: Supplement to Promote Diversity in Research

    Principal Investigator: Elyse R. Park, PhD, MPH
    Co-PI: Giselle K. Perez, PhD
    Funding Source: National Cancer Institute (NCI)
    Project Number: 3R01CA166147-03S1

    Description: Although there is a clear need for tobacco treatment among black and Hispanic smokers, little is known about their smoking behaviors and engagement in tobacco treatment following a cancer diagnosis and initiation of cancer care. Understanding the contribution of racial and ethnic factors on tobacco treatment during cancer care will help inform the development of tobacco programs that target the needs of this group. The proposed supplement aims to understand attitudes and barriers toward tobacco cessation treatment among black and Hispanic cancer patients.

    Potential participants: Mass General cancer patients who are racial/ethnic minorities, are current smokers, and are English or Spanish –speaking. Contact Emily Friedman or Julia Rabin.


  • Promoting Stress Management and Resiliency among Lymphoma Survivors Transitioning off Treatment

    Principal Investigator: Giselle K. Perez, PhD
    Funding Source: American Cancer Society (ACS)
    Project Number: ACS IRG 2016S000828

    Description: Lymphoma survivors are faced with a number of psychosocial and physical sequelae related to their cancer type and treatment that makes them susceptible to experiencing higher rates of distress compared to other survivor groups. This study proposes to develop and test a virtual group program to promote stress management and coping among lymphoma survivors transitioning off treatment.

    Potential participants: Mass General cancer patients who are within two years of having completed treatment for lymphoma. Contact Emily Friedman or Katharine Quain.


  • Exploring Oncology Providers’ Attitudes Toward Cancer Clinical Trials

    Principal Investigator: Giselle K. Perez, PhD
    Funding Source: Lazarex-MGH Cancer Care Equity Program
    Project Number: NA

    Description: Cancer clinical trials represent the “gold standard” of comparing and testing the safety and effectiveness of novel therapies for the treatment of cancer.   Adequate participation of eligible populations is critical to ensuring the accuracy and generalizability of trial findings across diverse groups; however, trial enrollment rates remain suboptimal. The proposed study intends to expand this body of research by using mixed methods strategies to describe oncology providers’ perspectives of enrolling eligible patients into cancer clinical trials. Specifically, we aim to describe their attitudes, experiences, and barriers with recommending and enrolling patients into cancer clinical trials, purposely attending to concerns related to the enrollment of minority and underserved groups. In addition, this study aims to identify strategies to improve trial accrual rates. Findings will help guide the development of an educational intervention for cancer care providers to improve clinical trial enrollment among vulnerable and underserved populations.

    Potential participants: Oncology providers across Boston. Contact Katharine Quain.


  • Depression, Anxiety and Opioid Adherence in Adults with Cancer Pain

    Principal Investigator: Lara Traeger, PhD
    Funding Source: American Cancer Society
    Project Number: ACS MRSG PCSM 1410701

    Description: The goal of this study is to examine and address associations of depression, anxiety and adherence to long-acting opioids among adults with chronic cancer-related pain. Study procedures currently are integrated into ambulatory care at the Massachusetts General Hospital Cancer Center. In Project 1 (a prospective observational study), we will examine the extent to which depression and anxiety symptoms are associated with poorer opioid adherence and worse pain outcomes. In Project 2 (an open pilot trial), we will use our results to develop and test a structured intervention to help patients adhere to their opioid regimens while reducing depression and anxiety symptoms. This work has the potential to increase the benefits of guideline-based treatments for chronic cancer pain and to optimize quality of life for patients at high risk for crisis-oriented pain care.

    Potential Participants: If you are interested in participating in this research, please contact the study coordinator at 617-643-9907.


  • Resiliency Training for Adolescents with NF1 and NF2 delivered via videoconferencing with Skype

    Principal investigator: Ana-Maria Vranceanu, PhD
    Funding Source: Children’s Tumor Foundation
    Project Number: 225832

    Description: Advances in genetics have led to the early and/or presymptomatic diagnosis of NF1 and NF2, resulting in an increased prevalence in children and adolescents. Even for healthy youth, childhood and adolescence are socially and emotionally challenging phases of life, in which individuals must focus on modulating emotions, negotiating relationships, developing a sense of self, and mastering academics. Further, hormonal changes and periods of rapid growth may exacerbate physical deformities at an age when appearance, peer acceptance, and social integration are of paramount importance. It seems likely that the additional burden of managing a diagnosis of neurofibromatosis may make the psychosocial functioning and coping in this population especially difficult and negatively impact quality of life, a finding that is supported by our systematic review of QoL in adolescents (Vranceanu et al, 2014, J of Neurooncology). This is a two arm, pilot RCT that will randomize a total of 70 adolescents (delivered in small groups of maximum 5 participants, to ensure mastering of skills by all participants) to either an 8 session 3RP or an 8 sessions attention placebo control. Both intervention and control will be delivered via Skype.

    Potential participants: If you are interested in participating in this research, please contact the study research assistant, Cat Pierre-Louis, at (617) 643-4566.


  • Relaxation Response Cognitive Behavioral delivered via videoconferencing

    Full Project title: A randomized controlled trial testing the feasibility, acceptability and preliminary effect of a brief Relaxation Response Cognitive Behavioral (RRCB) mind body intervention delivered via videoconferencing compared to usual medical care, in patients with acute trauma at risk for chronic pain and disability
    Principal investigator: Ana-Maria Vranceanu, PhD
    Funding Source: Orthopedic Research Education Foundation
    Project Number: 226344

    Description: This is a fully powered randomized controlled trial testing the feasibility, acceptability and effect of a 4-session Relaxation Response Cognitive Behavioral (RRCB) intervention1 delivered via live videoconferencing, plus usual care (UC), versus UC alone, in decreasing disability and pain intensity (primary outcomes) and depression, PTSD, pain anxiety and pain catastrophizing (secondary outcomes). Participants are 172 (86/group, accounting for 10% attrition) patients with acute musculoskeletal trauma (1-2 months since injury) who are at risk for chronic pain and disability. Patients in the RRCB will undergo four 45 minute video sessions of the RRCB, in addition to UC. If positive, results of this trial could completely change how care is delivered for patients with orthopedic traumas, and facilitate transition toward an evidence-based biopsychosocial model of care. Delivery of the RRCB via videoconferencing could bypass many barriers to care, including absence of skilled providers in remote areas. This may also reduce number of surgeries and narcotics prescriptions1, and prevent progression to costly chronic pain syndromes. If the project is successful, we plan to disseminate the data and start the process of fully transition the care of orthopedic trauma patients from an outdated biomedical model (where only the injury is addressed) toward an evidence based biopsychosocial model (where both the injury and mood/coping are addressed). Such biopsychosocial models of care are already employed for most medical illnesses. Specifically, we plan to provide orthopedic surgeons with educational information on the intervention, implement screening and referral strategies, train and make clinicians available for delivery of the RRCB via videoconferencing, and start using the intervention as part of standard care for all patients with acute orthopedic trauma at risk for chronic pain and disability, early on and in conjunction with medical care.

    Potential participants: If you are interested in participating in this research, please contact the study research assistant, Taylor Pong, at (617) 726-1569.


  • Resiliency Training for adults with NF2 who are deaf delivered via videoconferencing

    Principal investigator: Ana-Maria Vranceanu, PhD
    Funding Source: Children’s Tumor Foundation
    Project Number: 228516

    Description: Resiliency Training for adults with NF2 who are deaf delivered via videoconferencing with Skype and Computerized Realtime Translation. Neurofibromatosis type 2 (NF2) is a tumor suppressor syndrome characterized by bilateral vestibular schwannomas, which often result in deafness despite aggressive management, and for which there is no cure. Despite advances in neurosurgery, radio-surgery, auditory rehabilitation and molecular biology that have increased treatment options, research continues to show that patients with NF2 report decreased quality of life (QoL). As the decrease in QoL is primarily due to hearing loss and balance difficulties, those patients with NF2 who are deaf or experience severe hearing loss are the most psychosocially vulnerable group across NF2 patients. Due to loss of hearing, as well as due to the facial weakness that can accompany surgeries aimed at resecting the vestibular schwannomas, these patients report communication difficulties and considerable morbidity. Very little prior research has evaluated the psychosocial presentation of patients with NF2 who are deaf or have significant hearing loss. From a mental health perspective, the stressors associated with NF2 and hearing impairment and loss challenge inner resources of resilience, often culminating in negative affect, poor self-esteem, and severely impaired QoL. Indeed, the available research identified that patients with NF2 who are deaf or have severe hearing loss report significant social isolation stemming from avoidance of social situations due to difficulties with communication as a consequence of hearing impairment, decreased social support, unemployment and divorce or separations from significant others. Patients with NF2 who are deaf or hearing impaired also report frustration with the lack of attention to this group clinically and through research.

    Potential participants: If you are interested in participating in this research, please contact the study research assistant, William Jacskon.


  • Preventing chronic depression and PTSD in patients with stroke and their primary caregivers

    Principal investigator: Ana-Mari Vranceanu, PhD
    Funding Source: American Heart Association
    Project Number: 228671

    Description: Stroke is often a life altering event for both patients (“SP”) and their caregivers (stroke caregivers, “SC”).  Stroke occurs without warning and may result not only in death or profound disability but also substantial emotional trauma for both SPs and SCs. While revolutionary advancements in endovascular and neurocritical care have improved physical outcomes for SPs, there remains an enormous need for effective interventions to reduce the emotional toll for both SPs and their SCs (i.e., the SP-SC dyad). Aims are: (1) to determine, using semi-structured qualitative interviews, additional SP and SC factors including their perceptions of the stroke experience, hospitalization, and how they cope with its challenges; identify appropriate points to intervene (maladaptive coping styles, unrealistic expectations, inappropriate prioritization, misinformation about illness, and self care), and assess SP and SC preferences for the structure, mode of delivery (including potential for phone, video or a combination of these) and timing of an intervention and (2) To develop and test the feasibility and acceptability (primary outcomes) of a skills-based intervention for preventing chronic depression, PTS and decreased QoL in dyads at risk. The primary hypothesis is that the newly developed intervention will be feasible, acceptable and usable. Secondarily, we hypothesize that the intervention will improve outcomes in both SPs and SCs more than UC.

    Potential participants: If you are interested in participating in this research, please contact the study research assistant, Cat Pierre-Louis, at (617) 643-4566.


  • Preventing depression and Post traumatic stress in patients admitted to the Neuroscience Intensive Care Unit and their caregivers
    Principal investigator: Ana-Maria Vranceanu, PhD
    Funding Source: Brain Aneurysm Foundation
    Project Number: NA
    Description: Rupture of a brain aneurysm is a devastating life-altering event for patients and their family caregivers. These subarachnoid hemorrhages generally occur without warning, and result not only in death or profound disability among survivors but also cause substantial emotional trauma. While revolutionary improvements in surgical, endovascular and neurocritical care approaches have improved physical outcomes for patients with ruptured brain aneurysms, there remains an enormous need for effective interventions to reduce the emotional toll of these disorders on both patients and caregivers. A growing body of observational studies document not only the burden of these psychosocial sequelae, in the form of chronic depression, anxiety and post-traumatic stress (PTS), but also the adverse effect these sequelae can have on patients’ and caregivers’ ability to care for themselves and one another. As a result, affected individuals are less likely to adhere to the medications prescribed by their physicians, and become at higher risk for physical diseases like myocardial infarction and stroke. While chronic depressive, anxiety and post-traumatic symptoms can be treated once diagnosed in other populations, these treatments are limited in their effectiveness in patients with subarachnoid hemorrhages. Our guiding hypothesis, supported by prior research, is that prevention is the most efficient and effective way to reduce the suffering and morbidity that chronic depression, anxiety and PTS cause brain aneurysm patients and their caregivers. This project represents the first step toward developing a psychosocial skills-based intervention aimed at preventing chronic depression, anxiety and PTSD in both patients and their caregivers.

    We will:

    1. Report on the rates of clinically significant depression, anxiety and PTSD in both patients and caregiver at hospitalization, as well as their natural history at 3 and 6 months post hospitalization
    2. Identify modifiable psychosocial factors (e.g., potential psychosocial intervention targets) at Neuro-ICU admission, associated with chronic depression, anxiety and PTSD at 3 and 6 months post hospitalization
    3. Develop a selection model whereby we would be able to identify patients and caregivers at risk for chronic psychiatric distress at the time of hospitalization

    Our long-term goal is to use the data generated to develop a psychosocial skills based intervention and test it in a multi-center randomized controlled trial for feasibility, acceptability and effect. This innovative proposal brings together a world-class multidisciplinary team of physicians, nurses and cognitive behavioral psychologists. Given the high rates of chronic depression, anxiety a and PTS in survivors of subarachnoid hemorrhage and their caregivers, the challenges posed by treating these conditions after they develop, and their devastating impact on physical and mental health, our proposal provides an essential first step toward a preventive approach that offers the hope of substantially improving the lives of both patients and their caregivers.

    Potential participants: If you are interested in participating in this research, please contact the study research assistant, Cat Pierre-Louis, at (617) 643-4566.

International Research

Hybrid Effectiveness-Implementation Trial for ART Adherence and Substance Use in HIV Care in South Africa
Principal investigator: Jessica Magidson, PhD
Funding Source: NIDA
Project Number: K23DA041901

Description: This project aims to evaluate the effectiveness and implementation of a lay counselor-delivered cognitive behavioral therapy intervention for HIV medication adherence and substance use in primary HIV care in Cape Town, South Africa. The first phase is qualitative and consists of interviewing patients, providers, and public health officials on their views on HIV and substance use treatment integration, and how to adapt evidence-based treatment for substance use and HIV medication adherence for this setting. The intervention developed based on Phase 1 will be evaluated in a hybrid effectiveness-implementation trial in Phase 2.

Potential participants: Recruitment taking place in Cape Town, South Africa.


Nurse-Delivered CBT for Depression-Adherence in HIV Primary Care in South Africa
Principal Investigator: Steven Safren, PhD, ABPP; Conall O’Cleirigh, PhD
Funding Source: NIH
Project Number: R01 MH103770

Description: This is a proposal to conduct a two arm randomized effectiveness trial investigating whether a task shifting/sharing model of treating depression and improving adherence to ART in patients who fail first line antiretroviral therapy (ART) can occur using nurses in South Africa trained in CBT. South Africa is the country with the highest number of HIV infections in the world and the highest number of HIV/AIDS-related deaths, and where access to third line ART treatment is not currently available in the public healthcare system. Clinical depression, like elsewhere, is one of the highest comorbidities to HIV/AIDS, with estimated rates up to 34.9 percent. Depression, in the context of HIV, leads to poor self-care behavior such as non-adherence to ART and worse retention in care, which are critical for treatment success. The U.S. based investigators have developed and successfully tested an approach integrating adherence counseling into cognitive- behavioral therapy for depression in HIV. The South Africa based team, in collaboration with the U.S. based team, has conducted preliminary work to evaluate the cultural appropriateness and feasibility of integrating this approach into the South African HIV treatment setting.

Accordingly, we have

  1. Conducted an open-pilot of the treatment in Cape Town with 6 HIV-infected patients with depression using a clinical psychology PhD student as the therapist
  2. Conducted formative qualitative research on the manifestation of depression and ways to adapt this approach for the South Africa HIV care setting
  3. Successfully trained two clinic nurses in the adapted version of the intervention
  4. Completed an open pilot feasibility trial with 14 patients with these nurses as interventionists

Potential Participants: This study will be recruiting HIV-positive adults with a current diagnosis of depression and an uncontrolled viral load in South Africa.


Integrating Fostering Resilience to Psychosocial and HIV Risk in Indian Men Who Have Sex with Men (MSM)
Principal Investigator: Conall O’Cleirigh, PhD; Steven A. Safren, PhD; Matthew Mimiaga, ScD
Funding Source: National Institute of Mental Health (NIMH)
Project Number: 1R01MH100627-01A1

Description: The goal of this multi-site randomized controlled trial is to examine the efficacy of an intervention to reduce HIV and STI risk among MSM in India. This 2-arm RCT compares a self-acceptance based HIV risk reduction intervention with voluntary HIV/STI counseling and testing (VCT) to VCT among MSM in Chennai and Mumbai, India.

Potential participants: Recruitment taking place at two sites in India.


Perinatal Depression, Stigma, Social Capital Utilization and PMTCT Adherence
Principal Investigator: Christina Psaros, Ph.D.
Funding Source: National Institute of Mental Health (NIMH)
Project Number: 1K23MH096651-01

Description: The United Nations Millennium Development Goals (MDGs) illustrate key areas in which the lives of women and children worldwide are in need, including improving maternal health and a reduction in childhood mortality. The success of meeting both these goals depends on reducing rates of vertical transmission of HIV. Sub-Saharan Africa is one of the areas targeted by the MDGs and bears a substantial degree of HIV disease burden, with well over 22 million people living with HIV at the end of 2008, a significant number of whom are women of reproductive age. Depression has been associated with non-adherence to the series of health behaviors known as preventing mother-to-child transmission (PMTCT) of HIV. Women in resource limited settings are likely to face additional barriers to PMTCT adherence, including stigma and structural barriers. While structural barriers may be circumvented by relying on community resources (known as social capital), depression and stigma may make it difficult to access these resources. Thus, understanding the role of modifiable factors that contribute to PMTCT adherence is critical to meeting the goals of the MDGs.

The goals of the proposed project are to:

  1. Investigate the relationships among perinatal depression, stigma, social capital utilization, PMTCT adherence
  2. Test a pilot intervention to treat perinatal depression and improve adherence to ARVs among HIV infected women in a resource limited setting.

Potential Participants: We plan to recruit HIV infected women living in KwaZulu-Natal, South Africa in October 2016.

Completed Projects

Domestic Projects

Identifying critical elements of real-time discussions between providers, patients and families at the end of life
Principal Investigator: Lara Traeger, PhD
Funding Source: American Cancer Society

Description: The goal of this study is to examine the nature and characteristics of discussions between palliative care providers and patients/families with metastatic cancer during key transitions in end-of-life care.


Integrated Treatment for Smoking Cessation & Anxiety in People with HIV
Principal Investigator: Conall O’Cleirigh, PhD
Funding Source: National Institute of Drug Abuse (NIDA)

Description: This trial provided important information regarding the potential efficacy and mechanisms of an integrated intervention for and at risk group of HIV+ smokers, namely those who also have clinically significant anxiety problems (>60% of HIV+ smokers). Identifying efficacious treatments for smoking cessation for HIV+ adults has considerable public health significance because cigarette smoking is the leading cause of death and disability in the United States (U.S.), contributing to over 440,000 deaths each year, and HIV+ smokers comprise an overrepresented group among smokers. This study yielded important information in the treatment of drug use and anxiety symptoms in HIV+ individuals, including how best to treat this vulnerable population. Moreover, this study guided advances in the theoretical conceptualization of the mechanisms involved in HIV-anxiety- smoking relations.


Compensatory Executive Functioning Skills Training in Adolescents with ADHD
Principal Investigator: Steven Safren, PhD, ABPP
Funding Source: National Institute of Mental Health (NIMH)

Description: This is a 3-year study to investigate the efficacy of a cognitive behavioral intervention for adolescents with ADHD who are stabilized on medications but still show clinically significant residual symptoms. Self-report, parent-report, teacher report, and independent assessor (who will be blind to treatment condition) data will be used as outcomes.


Resiliency Training for Adults with Neurofibromatosis delivered via videoconferencing with Skype
Principal investigator: Ana-Maria Vranceanu, PhD
Founding Source: Children’s Tumor Foundation

Description: The neurofibromatoses (NF) comprise a group of genetically distinct disorders of the nervous system unified by the predisposition to nerve sheath tumors. These histologically incurable benign tumors can occur anywhere in the body and often cause significant morbidity including disfiguring cutaneous tumors (NF1); complete hearing loss, facial weakness, and poor gait (NF2); and chronic disabling pain (schwannomatosis). In addition to the increased risk of benign tumors, patients with these genetic syndromes are at higher risk for malignant tumors and can develop non-tumor manifestations that affect the nervous system, eyes, and skin. The current health care model for NF is almost entirely biomedical. In this model, health care providers have focused on identifying various manifestations of NF and providing medical treatments. This model of care is incomplete, as it does not address the consistent research findings showing that patients with NF, regardless of NF type, have lower quality of life, more symptoms of depression and anxiety, higher levels of perceived stress, lower levels of self-esteem and more pain as compared with general population norms. Further, there is no association between severity of NF and emotional functioning, suggesting that psychosocial factors are as important, or more important than severity of disease. The objective of the study is to test the acceptability, feasibility, preliminary efficacy and durability of the 3RP (focused on teaching mind body coping skills) vs an attention placebo control (Health Behavioral Intervention focused on providing general information on NF and healthy living without teaching skills) in improving QoL and resiliency in patients with NFs. Delivery of both intervention and control will be via groups through Skype. Findings from this study will support or refute the acceptability, feasibility and efficacy of the 3RP for NF patients delivered via videoconferencing with Skype. The results will also inform our understanding of the 3RP program in improving QoL and resiliency, and will provide insight into mechanisms of improvement in QoL in this population. Positive results from this study could serve as a basis for further research on cost effectiveness of the videoconference 3RP and serve as preliminary data for a large scale RCT in this population.


A mind body intervention for patients with orthopedic trauma at risk for chronic pain
Principal investigator: Ana-Maria Vranceanu, PhD
Founding Source: Orthopedic Trauma Association

Description: Musculoskeletal injuries represent the leading cause of hospital admissions for adults. Massachusetts General Hospital performs over 1000 trauma related surgeries a year. There are wide-ranging variations in outcomes following musculoskeletal traumas, with a substantial proportion of patients experiencing long-term disability despite objective physical recovery. Our prior work shows that approximately 53% patients meet screening criteria for clinical depression and 11% for Post Traumatic Stress Disorder at 1-2 months post trauma, and the rates maintain even at 5-8 months post trauma. Further, our work has shown a significant relationship of depression, PTSD, pain anxiety and pain catastrophizing at 1-2 months post trauma, with pain intensity and disability at 5-8 months post trauma, after accounting for injury severity. This proposal is based on our preliminary work, and will carry out the NIH-defined steps for developing and testing an evidence-based psychosocial (The Relaxation Response Resiliency Program 3RP) intervention for patients with recent (1-2 months) musculoskeletal trauma at risk for long term disability. Specific aims are to: 1) develop the intervention addressing mood (symptoms of depression and post traumatic stress) and coping (pain catastrophizing and pain anxiety), targets identified in our previous work with this population, 2) test it via an open pilot (N = 10) for acceptability and feasibility of delivery via videoconferencing, and estimate its effect, and 3) conduct a randomized controlled trial comparing the effect of the intervention delivered via videoconferencing plus usual medical care (UC) with usual medical care (N=30/group).


International Projects

Fifteen Years of Epidemic HIV: Novel Risk Behavior in South African Teens in 2010
Principal Investigator: Christina Psaros, PhD
Funding Source: National Institute of Mental Health (NIMH)

Description: Rates of HIV infection among young women in South Africa are among the highest in the world. Adolescent women in South Africa represent part of the "second generation" of HIV affected youth, a cohort that remains understudied. Adolescent women coming of age today likely have different experiences related to HIV than the generation before; we explored how the experiences of these women may impact current HIV risk behavior to learn how to best intervene in order to reduce rates of HIV in the future.

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