Brain Function and Treatment Response for Internet Addiction Across the LifeSpan

1.0 CE Credit

Presented by:
David R. Rosenberg, MD
Chair, Dept. of Psychiatry & Behavioral Neurosciences 
Wayne State University 

Internet addiction or compulsive use of the internet has become an increasingly prevalent public health concern. The relationship between the clinical phenomenology and modes of brain dysfunction remains unclear. We describe an integrated series of clinical, neurobehavioral, and functional magnetic resonance imaging (fMRI) studies in patients with internet addiction. Based on findings from these studies, there appear to be at least four subtypes of internet addiction, including impulse control subtype, obsessive-compulsive subtype, inhibited (depressed-anxious) subtype, and combined impulse control and obsessive-compulsive subtype. fMRI studies reveal significantly decreased regional brain activation in response to targeted attention and working memory tasks in patients with internet addiction compared to healthy controls. After effective treatment, there appears to be normalization in brain circuitry; however, relapse in symptoms was associated with the reappearance of brain abnormalities. The need for transdisciplinary team interventions including psychiatry, neuropsychology, and innovative brain imaging techniques will be emphasized.

After the webinar, participants will be able to:
1. Describe the critical role of neuropsychology in the elucidation of potential brain mechanisms involved in the pathogenesis of internet addiction across the lifespan.
2. Identify key neuroimaging paradigms that are delineating regional brain abnormalities in internet addiction and their potential significance for enhanced diagnosis and treatment.
3. Discuss novel neurobehavioral and cognitive probes used during functional MRI studies and their role in further elucidating the pathogenesis of internet addiction.

Target Audience: Primary care providers, mental health providers, and direct patient care providers in other disciplines

Instructional Level: Introduction

Dr. David Rosenberg is Chair of the Department of Psychiatry & Behavioral Neurosciences at Wayne State where he also serves as the Director of the Translational Neurosciences Institute and the Miriam Hamburger Endowed Chair of Child Psychiatry. His research has focused on imaging genetic studies of neuropsychiatric disorders and he has led several large NIH consortium grants as lead PI at the lead/coordinating site. He has published extensively and been the recipient of numerous honors and awards including receiving first prize in the neuropsychoparmacology competition at the International Congress of Neuropsychopharmacology, the A.E. Bennett Award from the Society of Biological Psychiatry and the Psychiatric Times Teacher of the Year. He also published the first textbook on pediatric Psychopharmacology now in its third edition. He is frequently sought out by the national media and his research has been featured several times on the NBC Today Show, ABC 20/20, Good Morning America, ABC World News Tonight, CNN, PBS and NPR.

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Characterizing Neurocognitive Heterogeneity in Bipolar Disorder: Clinical Correlates and Inflammation-based Biomarkers

1.25 CE Credits

Presented by:
Dr. Katherine E. Burdick
Associate Professor of Psychology in Psychiatry
Harvard Medical School

Many patients with bipolar disorder (BD) suffer from persistent cognitive impairments, even during periods of effective remission, which contribute directly to functional disability. At the group level, the severity of these deficits is ¾ to 1 full standard deviation below average; however, substantial cognitive heterogeneity exists. Convergent data suggest that a cumulative burden of disease (e.g., recurrent mood episodes and other comorbid features) triggers a pro-inflammatory cascade, which drives the brain changes associated with cognitive and functional decline.  

After the webinar, participants will be able to:
        1. Characterize the cognitive profile common to bipolar disorder and compare it with that seen in schizophrenia.
        2. Identify the clinical correlates and biomarkers of cognitive impairment in bipolar patients.
        3. Describe the cognitive trajectory in bipolar disorder including both neurodevelopmental and neurodegenerative processes.

Target Audience: Psychologists, Neuropsychologists, Researchers or Clinicians treating patients with psychiatric diseases or symptoms; graduate students, other psychology trainees.

Instructional Level:

Dr. Katherine E. Burdick
is an Associate Professor of Psychology in Psychiatry at Harvard Medical School. She is the Director of the Mood and Psychosis Research Program and the Associate Vice Chair for Research in Psychiatry at Brigham and Women’s Hospital in Boston, MA. She has expertise in clinical and neurocognitive assessment across a range of patients with serious mental illness, including schizophrenia and bipolar disorder. 

Dr. Burdick obtained her Ph.D. in Clinical Neuropsychology from the City University of New York-The Graduate Center and completed her clinical internship and her postdoctoral fellowship at Yale University School of Medicine. She is a licensed clinical psychologist in the state of NY.

Dr. Burdick has a strong track record of both federal and foundation funding, with a primary research focus on identifying persistent cognitive deficits in major psychiatric disorders, understanding their etiologies, and directly targeting them with treatment. She has collaborated on a wide range of projects including neuroimaging, genetics, and treatment trials in patients with bipolar disorder, schizophrenia, and major depression and has authored more than 130 peer-reviewed publications in this area.

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Developmental Aspects of Bipolar Disorder in Children, Adolescents and Adults

1.5 CE Credits

Presented by:
Gabrielle A. Carlson, M.D.
Professor of Psychiatry and Pediatrics
Stony Brook University School of Medicine

Most of the studies that have examined bipolar disorder from a developmental perspective look at age of onset and examine differences that occur within the subsets. The most sophisticated studies use procedures like “admixture analysis” to derive the subgroups. I will discuss the findings from age of onset studies though they don’t provide the clinician with much useful information. This webinar, rather, will spend more time on the phenomenology of mania/bipolar disorder from a developmental psychopathology perspective using cases with longitudinal information to illustrate major points. Beginning with a summary of the phenomenology of bipolar illness as it occurs in adults, I identify diagnostic complexities unique to children and adolescents: e.g. characterizing elation and grandiosity; differentiating mania from comorbid symptoms, rages, sequelae of maltreatment, and typical developmental phenomena; and the unique manifestations of psychosis. Finally, family history and treatment response also appear to have a significant relationship to age.

After the webinar, participants will be able to:

  1. Describe developmental differences in child, teen and adult BP.
  2. Discuss the data regarding age of onset and how that affects genetics, phenomenology and treatment response.
  3. Critique evidence based treatments for bipolar mania in children, adolescents and adults.

Target Audience: Psychologists and mental health clinicians that see patients

Instructional Level: Intermediate to Advanced (prior knowledge of psychopathology and development)

About Gabrielle A. Carlson, M.D.
Dr. Carlson has been professor of Psychiatry and Pediatrics and Director of the Division of Child and Adolescent Psychiatry at State University of New York at Stony Brook since 1985. She founded and directed the division until 2013. She did her undergraduate training at Wellesley and subsequently obtained her MD degree from Cornell University Medical College. She did her adult psychiatry training at Washington University in St. Louis and at the National Institutes of Mental Health. She completed a fellowship and research fellowship in Child and Adolescent Psychiatry at UCLA where she subsequently taught on the faculty.

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The Clinical Utility of Neuropsychological Testing for Patients with Mental Disorders

1.5 CE Credits

Presented by:
Anthony C. Ruocco, Ph.D.
Associate Professor of Psychology, University of Toronto
Clinical Psychology Program Coordinator, University of Toronto
Collaborator Scientist, Mood & Anxiety Division, Centre for Addiction & Mental Health

Cognitive deficits are a common feature of many mental disorders. Neuropsychologists are frequently called upon to evaluate cognition in these patients and make clinical decisions about the relevance of cognitive deficits to the patient’s everyday functioning and treatment approach. This webinar reviews the clinical utility of neuropsychological testing for patients with mental disorders, including depression, schizophrenia, and borderline personality disorder. The focus is on providing information on the cognitive deficits normally observed in common mental disorders and discussing how neuropsychological testing can be used to inform a variety of clinical decisions, including differential diagnosis, development of intervention approaches, and assessment of functional disability.  

After the webinar, participants will be able to:

  1. Describe patterns of cognitive strengths and weaknesses that are normally observed in patients with mental disorders.
  2. Apply this knowledge to inform diagnostic formulations and intervention approaches.
  3. Discuss how cognitive deficits can lead to functional disability in patients with mental disorders.

Target Audience: The presentation is appropriate for practicing psychologists and researchers, as well as trainees.

Instructional Level: Intermediate

About Anthony C. Ruocco, Ph.D.
Dr. Ruocco is an Associate Professor of Psychology and the Clinical Psychology Program Coordinator at the University of Toronto. He is a licensed psychologist and researcher with interests in cognition and neuroimaging in patients with mental disorders. His current research program focuses on borderline personality disorder, including the familial aggregation of cognitive deficits, prediction of treatment outcomes using cognition and neuroimaging, and the impacts of a novel brain stimulation on symptoms, cognition and brain systems underlying impulse control and emotion regulation. His research is supported by grants from the Canadian Institutes of Health Research, Brain & Behavior Research Foundation, American Foundation for Suicide Prevention, and the Province of Ontario’s Ministry of Research & Innovation.

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