Author: pricilagran

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Michael O’Hearn, MSW, LISW-S

Odum’s Paradigm

Odum’s (1988) Self-Organization, Transformity, and Information is a conceptual framework for this intervention.  It is supported by two traditional pillars of economic theory: (1) the production-consumption model (“supply and demand”), and (2) production-consumption growth equilibrium.  This is a social currency system, not a monetary system; the currency is energy and information.  Odum adds “recycling” to the first component, constituting the following model:

Source > Production > Consumption > Recycle >

The output from production-consumption-recycle iterations is recycled into more concentrated and refined products (components) and by-products (process fractals).  Both are recycled as source input of subsequent iterations, and simultaneously constitutes a control parameter fortifying production (Odum, 1988).  Products and by-products of partner interactions are recycled as source input, control production, and either fortify or inhibit development over time.

Production components are contributions and defections; each generates products and by-products.  Gottman (2012) outlines behavioral correlates that sustain or erode cooperation and trust in relationships.  These are discerned as inventories of contribution products and by-products, and defection products and by-products.

Contributions.  Contribution products and by-products can help regulate autonomic nervous system (ANS) triggering, fortify cooperation, and trust in relationships.  Four advantages of demonstrated trust in relationships are: (1) trust reduces complexity of all transactions, (2) trust permits action with incomplete information (benefit of the doubt), (3) trust minimizes transaction costs, and (4) trust increases relationship resilience as complexity naturally increases over time (Gottman, 2012, p.78).

Some partner contribution products can include: (1) neutral narrative of subjective views, (2) minimum 4:1 positive to negative interaction frequency, (3) soft start to difficult conversations, (4)  accept influence, change behavior to meet partner’s needs, and recognize partner’s change efforts, (5) tolerate partner’s negative emotion, and focus on the problem at hand, (6) set limits on behavioral expression of negative emotions, (7) accept responsibility and apologies, and (8) make positive statements of needs (Gottman, 2012).

Examples of contribution by-products can include: (1) overall positive perspective and “us-ness,” (2) shared meaning, purpose, fondness, and admiration, (3) eye contact and touch are soothing in conflict, (4) prioritize understanding, (7) non-defensive listening to partner’s negative emotion, (8) effective dialogue and problem solving on perpetual issues, (9) offer and accept apologies, and (10) cooperation and trust (Gottman, 2012).

Defections.  Defection products and by-products reinforce elevated and protracted ANS activation, entropy conservation, and erosion of cooperation and trust in relationships.  Criticism, contempt, defensiveness, and stonewalling are correlates of marital dissatisfaction and divorce (Gottman, 2012).

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Lindner Center of HOPE is pleased to announce that Chris Tuell, EdD, LPCC-S, LICDC-CS, Clinical Director of Addiction Services and Assistant Professor, Department of Psychiatry & Behavioral Neuroscience, University of Cincinnati College of Medicine, was a winner in the provider categoy for the Business Courier’s 2019 Health Care Heroes awards.

The Health Care Heroes Awards dinner was February 21 at the Hyatt Regency Cincinnati.

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Dr. Nicole Bosse appeared on FOX19’s Morning Show (Cincinnati) to talk about Seasonal Affective Disorder and how local residents can recognize the signs of SAD in themselves and others, help themselves avoid seasonal depression and find help through treatment at the Lindner Center of HOPE.

Seasonal affective disorder (SAD) is a form of depression triggered by a change in seasons.

In fact, more than half a million people in the U.S. suffer from SAD.  In fact, 4 in 5 people who suffer from SAD are women.

“It is important to not think of seasonal depression as a minor case of the “winter blues,” said Nicole Bosse, PsyD, staff psychologist and member of the OCD and anxiety team at the Lindner Center of HOPE. “SAD is a type of depression and needs to be treated seriously. We urge people to seek professional help if they feel their mood is atypical this time of year.”

Your donation can help the Lindner Center continue state-of-the-science research and treatment to help patients get the care they need for a number of conditions, including SAD. Donate here:

 

Watch more:

Link: http://www.fox19.com/video/2019/01/11/how-combat-seasonal-affective-disorder-sad/

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Study Evaluating Spinal Stimulation in the Treatment of Major Depressive Disorder

The Research Institute at Lindner Center of HOPE is exploring a novel “Neuroscience of the Body” research approach that considers psychiatric disorders not only affect the brain, but also the body. Likewise, the body also affects the brain. A current study specifically looks at the communication between the brain and the body and the role the spinal pathways play in the origins of psychiatric disorders. The hypothesis is that the communication between the brain and the body is disturbed in patients with Major Depressive Disorder which contributes to depressive symptoms and consequently may elevate the risk of medical comorbidity.

The study, led by investigators at The Research Institute at Lindner Center of HOPE, is looking at the impact of non-invasive spinal stimulation for the treatment of Major Depressive Disorder. The team is testing an exclusively investigational device to apply a small electrical current through the skin to modulate spinal pathways and modify the disturbed communication between the brain and the body.

The study is currently recruiting participants between the ages of 18 and 50 who are currently moderately depressed for at least one month and not currently on medication for the treatment of depression. Participants would be required to complete a phone screening, attend a screening visit that includes labs and other tests, attend a baseline visit and attend 20-minute stimulation sessions three times per week for eight weeks. Eligible participants will be compensated up to $250 for their time and travel.

The Research Institute at Lindner Center of HOPE’s Associate Chief Research Officer, Francisco Romo-Nava, MD, PhD, received the 2017 Young Investigator Award from the National Alliance for Research in Schizophrenia and Depression (NARSAD) granted by the Brain and Behavior Foundation for this study.

“It is an honor to receive this prestigious award for the most promising young investigators developing neuroscience research in the field of mental health,” said Romo-Nava. “This is a world-wide competition that funds the most innovative ideas for research for all sorts of psychiatric disorders.”

Lindner Center of HOPE  provides excellent, patient-centered, scientifically advanced care for individuals suffering with mental illness. A state-of-the-science mental-health center and charter member of the National Network of Depression Centers, the center provides psychiatric hospitalization and partial hospitalization for individuals 12 years and older, outpatient services for all ages, diagnostic and short-term residential services for adults and adolescents, intensive outpatient program for substance abuse and co-occurring disorders for adults and research. The center is enhanced by its partnership with UC Health as its clinicians are ranked among the best providers locally, nationally and internationally. Together Lindner Center of HOPE and UC Health offer a true system of mental health care in the Greater Cincinnati area and across the country. The center is also affiliated with the University of Cincinnati (UC) College of Medicine.

 

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Lindner Center of HOPE’s Harold C. Scott Foundation Eating Disorders Program team is hosting members of the public for a free movie night to view Happy on Thursday, February 28, 2019. The goal of the evening is for the audience to embark on a journey towards finding their own happiness.

Community members, professionals and families (recommended ages 10 and up) are invited to participate in viewing the documentary Happy. Happy combines powerful human stories from around the world with cutting edge science to give a deeper understanding of the most valued emotion … happiness.

Following the movie, Harold C. Schott Foundation Eating Disorders clinical team members will facilitate audience discussion.

The movie night will be held in the gymnasium/conference center at Lindner Center of HOPE, 4075 Old Western Row Rd., Mason. Doors open at 6p.m. for networking and a light dinner. The movie will begin at 6:30p.m. Discussion will wrap up by 8:30p.m.

A reservation is required by contacting Pricila Gran at 513-536-0318 or [email protected] by Friday, February 22, 2019.

Preview the trailer at thehappymovie.com.

 Lindner Center of HOPE  provides excellent, patient-centered, scientifically advanced care for individuals suffering with mental illness. A state-of-the-science mental-health center and charter member of the National Network of Depression Centers, the center provides psychiatric hospitalization and partial hospitalization for individuals 12 years and older, outpatient services for all ages, diagnostic and short-term residential services for adults and adolescents, intensive outpatient program for substance abuse and co-occurring disorders for adults and research. The center is enhanced by its partnership with UC Health as its clinicians are ranked among the best providers locally, nationally and internationally. Together Lindner Center of HOPE and UC Health offer a true system of mental health care in the Greater Cincinnati area and across the country. The center is also affiliated with the University of Cincinnati (UC) College of Medicine.

 

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Danielle Johnson, Lindner Center of Hope

 

Lindner Center of HOPE is pleased to announce that Danielle Johnson, MD, FAPA, Chief of Adult Psychiatry and President of the Medical Staff was recognized as a top doctor in the psychiatry category in Cincinnati Magazine’s 2019 list.

Doctors recognized were selected by their peers in a survey asking the physicians who they would turn to for care. The survey was conducted by Professional Research Services Company of Troy, Michigan.

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Nicole Mori RN, MSN, APRN-BC
Nurse Practitioner
Lindner Center of HOPE

Obesity is an important comorbidity among psychiatric patients and is associated with increased morbidity and a complicated clinical course.  Many frequently used psychotropic medications can contribute to weight gain, which commonly accompanies adverse metabolic outcomes.  Weight gain is distressing to patients and leads to decreased quality of life and lower adherence.  Psychotropic-mediated weight gain is particularly problematic for patients with bipolar disorder who, regardless of treatment status, experience higher rates of overweight and metabolic abnormalities than the general population.  Patients with bipolar disorder face additional risks for weight gain because the mainstay treatments for bipolar disorder such as mood stabilizers (e.g., Lithium and Valproate) and atypical antipsychotics carry a risk for accelerated weight gain and metabolic disturbances. The effect of many psychotropic medications on histamine, alpha-1 and serotonin 5HT 2A and 5HT 2C receptors has been associated with higher weight gain potential.  In addition, many psychotropic medications can interfere with the activity of leptin, which regulates food intake.  The effects of antipsychotics and mood stabilizers can also lead to dysregulation in lipid biosynthesis, insulin resistance and increased risk for type 2 diabetes.

Strategies for managing weight changes include lifestyle interventions aimed at improving diet and increasing physical activity, selecting medications with a lower weight gain liability and prescribing medications aimed at promoting weight loss or mitigating the weight gain effects of psychotropics.  Selecting medications with lower risk for weight gain or switching medications can be helpful but this may not always be possible due to efficacy considerations.  Studies show that lifestyle modifications can be modestly helpful in mitigating the effects of psychotropic medications on weight, but weight loss is often insufficient and difficult to maintain.

Some medications have been studied and used off label for their potential to attenuate the effects of antipsychotics and mood stabilizers on weight.  Metformin has the most data for efficacy and safety, especially when used in combination with lifestyle modification.  In addition, metformin has shown significant benefits in improving glycemic control and dyslipidemia.  Metformin requires monitoring of renal function and carries a risk for metabolic acidosis (rare) and hypoglycemia.  Gastrointestinal adverse effects associated with metformin (flatulence and diarrhea) can be a barrier to dose escalation and tolerability.  There is some evidence supporting the use of topiramate for mitigating the weight gain effect of psychotropics.  However, rates of discontinuation are high due to adverse events such as dizziness, paresthesia and cognitive impairment.  Norepinephrine reuptake inhibitors have shown a marginal effect on weight gain, and carry a potential for adverse effects on heart rate, blood pressure and psychiatric symptoms, which limits their use.

Although the FDA has approved a handful of new antiobesity medications in the past decade (lorcaserin (Belviq), topiramate/phentermine (Qsymia), bupropion/naltrexone (Contrave) and liraglutide (Saxenda)) there is little research on the efficacy and safety of anti-obesity medications in patients for bipolar disorder.  Orlistat is one of the few FDA-approved medications with clinical trial data for use in psychiatric patients but study results were mixed and the subject population was limited to patients with schizophrenia.  Although orlistat carries a relatively low risk for mood destabilization, it can decrease the absorption of certain medications (including antiepileptics, warfarin and levothyroxine) and is associated with intolerable gastrointestinal side effects (flatulence and incontinence) that lead to discontinuation.  There is no published data on the use of the new antiobesity medications for patients with bipolar disorder.   Most antiobesity medications are combinations of drugs that target the central nervous system and modulate neurotransmitters, raising concerns for risk of destabilization and drug-drug interactions for patients with bipolar disorder.  Liraglutide is the only recently approved medication that primarily targets the gastrointestinal system, and in theory, carries a lower potential for effects on the central nervous system.

There is a need for safe and effective treatments to prevent psychotropic-induced weight gain or enhance weight loss in overweight patients with bipolar disorder. Until research brings new treatments to market, timely detection and management of weight gain and metabolic abnormalities remains the most important intervention to reverse or attenuate these undesirable effects from psychotropic medications.

References

Dent, R., Blackmore, A., Peterson, J., Habib, R., Kay, G. P., Gervais, A., … & Wells, G. (2012). Changes in body weight and psychotropic drugs: a systematic synthesis of the literature. PLoS One, 7(6), e36889.

G Fiedorowicz, J., D Miller, D., R Bishop, J., A Calarge, C., L Ellingrod, V., & G Haynes, W. (2012). Systematic review and meta-analysis of pharmacological interventions for weight gain from antipsychotics and mood stabilizers. Current psychiatry reviews, 8(1), 25-36.

Saunders, K. H., Umashanker, D., Igel, L. I., Kumar, R. B., & Aronne, L. J. (2018). Obesity pharmacotherapy. Medical Clinics, 102(1), 135-148.

The Lindner Center of HOPE is conducting a randomized, placebo-controlled study of Liraglutide in overweight patients with Bipolar disorder.  For information, please call 513-0704 or visit https://is.gd/weightlossbipolar

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The Webcast is the First in a Series for 2019

Lindner Center of HOPE is hosting a free webcast Better Together:  How parents and professionals can work as a team to help a child with an Eating Disorder on Tuesday, February 12, 2019 from 5:30 to 6:30p.m. EST. The topic will be presented by Harriet Brown, author and Professor of Magazine Journalism and Scott Bullock, MSW, LISW-S, CEDS, Lindner Center of HOPE, Clinical Director and Family Therapist Child/Adolescent Services and Proximi Program, Harold C. Schott Foundation Eating Disorders Program.

Participants in the webcast will be able to:  Exhibit how families and professionals could work as an effective team, describe how families can let go of blame, describe how families can help in the recovery process.

 Lindner Center of HOPE  provides excellent, patient-centered, scientifically advanced care for individuals suffering with mental illness. A state-of-the-science mental-health center and charter member of the National Network of Depression Centers, the center provides psychiatric hospitalization and partial hospitalization for individuals 12 years and older, outpatient services for all ages, diagnostic and short-term residential services for adults and adolescents, intensive outpatient program for substance abuse and co-occurring disorders for adults and research. The center is enhanced by its partnership with UC Health as its clinicians are ranked among the best providers locally, nationally and internationally. Together Lindner Center of HOPE and UC Health offer a true system of mental health care in the Greater Cincinnati area and across the country. The center is also affiliated with the University of Cincinnati (UC) College of Medicine.

 

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Peter White, M.A., LPCC, Lindner Center of HOPE, Addictions Counselor

Many loved ones of people with substance use disorders are often discouraged by the severity and duration of distress initiated and endured by their loved ones. In a related manner, many professionals working with people with substance use disorders become disillusioned and discouraged by the extent of problems, and a lack of progress in treatment. It seems that experiencing burnout, or feeling just plain burnt, are two common emotional consequences of committing time and energy in trying to help people with substance use disorders. I would argue that one of the most important things we can do, being the people who care, is revisit our understanding of the fundamentals of substance use disorders, and reorient our recovery approach in a manner that aligns with these fundamentals.

Substance use disorders are chronic, behavioral disease conditions that if not addressed will progress into increasingly diseased states up to critical illness and death.  They do not have a cure.

It is easy to be initially discouraged by this reality, until we consider an additional reality – substance use disorders are imminently recoverable. That is to say, at any time a person with a substance use disorder can make the changes that stop the progression of his or her disease process, ( a major accomplishment in itself,) and begin the process of establishing and consolidating a healthy and rewarding recovery. The bad news is that there is no cure. The good news is that once we accept this, we are then free to focus on the ever present possibility of sobriety, health and growth taking root as our loved one’s lifestyle.

Our real challenge is to remain continually present, authentic and hopeful as we develop interventions and support over the course of a disease and recovery process that will often endure for decades. Think about that. If we appreciate the nature of a chronic condition, then we acknowledge that the process of growth, as well as the potential threat to growth, is never over. In a way, I would say that the experience of burnout isn’t logical, because people with terrible conditions can and do get better all the time. It is the maintenance of this very realistic hope for the advancement of recovery in the face of the loss and distress of alcohol and drug use that is the most effective way to help our loved ones, as well as to prevent burnout for ourselves.

I once asked clients during a group to state what their definition of recovery was. I noticed that their answers really focused on the establishment and expansion of behaviors that were in line with their values much more than they were focused on the cessation of drug use  -“Dealing with responsibilities, ”Complete change of focus, ”Knowing I can change and grow,” Doing my best- healthy, clean, sober, ”Becoming self-reliant.” It was a very reassuring moment for me as a helping professional in that the clients were not searching for a tabulation of “clean” days vs. “using” days. What they were really focused on was a direction that would incorporate every part of their lives away from risk, disease and loss, and towards the pride and enjoyment of health and growth that I think all people desire.

Let me end on a note where we do acknowledge that substance use disorders are often very destructive. If you are a loved one or a professional who is becoming overwhelmed or burdened too long by the losses you’ve encountered, lets acknowledge that disengagement and the establishment of boundaries are often the healthiest option for all involved. Disengagement does not need to be related to the rejection of people or the abandonment of hope for recovery. It is most often a very appreciable need for self-care in the face of risk and loss. Just as we help those with substance use disorders by decreasing our focus on the multiplicity and duration of problems, let’s help ourselves by not focusing on all the problems that we find we can’t deal with. Instead let’s focus ourselves on our limits relative to all the help we have or might offer, and remind ourselves that our own growth is imminently available, and that we should honor any rest we need until we able to make ourselves available for help once more.

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Professorship Created as a Result of Landmark Pledge by Fath Family

 

MASON, Ohio (UPDATED: 10.30.18) – Lindner Center of HOPE has announced Susan L. McElroy, MD, will be named the first Linda and Harry Fath Professor of Psychiatry. Dr. McElroy has been with the Center for more than 10 years and is also the chief research officer. The position was announced in  recognition of a $50 million pledge from Linda and Harry Fath.

“I’m honored to be named to this new role and excited about the Lindner Center of HOPE’s future,” said Dr. McElroy. “Thanks to the generous gifts from the Fath and Lindner families, we look forward to new opportunities in developing leading-edge research and patient care programs. At the same time, we will continue to work hard to remove barriers for those who lack access to mental healthcare and fight stigma through education.”

McElroy is a Global Leader in Psychiatry

Dr. McElroy oversees the Center’s numerous ongoing studies on mood, anxiety, eating and impulse control disorders, genetics and psychopharmacology.

She has published more than 400 scientific papers in leading psychiatry and psychology journals and is the 8th most-cited scientist in the world in those fields since 1996. Dr. McElroy is the editor or author of four scientific books, serves on the editorial boards of five medical journals and has authored more than 150 reviews and chapters in major psychiatric textbooks.

Dr. McElroy has received numerous honors including being recognized among the Best Mental Health Experts by Good Housekeeping Magazine; Best Doctors in America, and, as one of America’s Top Psychiatrists, by the Consumer Research Council. Additionally, she has received a number of national awards for her teaching and research efforts.

She completed her residency in psychiatry at McLean Hospital in Belmont, Massachusetts and her internship in internal medicine at Columbia Presbyterian Hospital in New York City. Her bachelorette degree is from Colgate University (Hamilton, NY) and she earned her MD from Cornell University Medical College (New York City, NY).

About the Lindner Center of HOPE
Lindner Center of HOPE in Mason is a comprehensive mental health center providing patient-centered, scientifically advanced care for individuals suffering with mental illness. A state-of-the-science, mental health center and charter member of the National Network of Depression Centers, the Center provides psychiatric hospitalization and partial hospitalization for individuals age 12-years-old and older, outpatient services for all ages, diagnostic and short-term residential services for adults and adolescents, outpatient services for substance abuse through HOPE Center North location and co-occurring disorders for adults and research. The Center is enhanced by its partnerships with UC Health and Cincinnati Children’s Hospital Medical Center as their clinicians are ranked among the best providers locally, nationally and internationally.  Learn more at LindnerCenterofHope.org.