Category: Lindner Center of HOPE

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By: Chris Tuell Ed.D., LPCC-S, LICDC-CS
Clinical Director of Addiction Services Lindner Center of HOPE
Assistant Professor, Department of Psychiatry & Behavioral Neuroscience University of Cincinnati College of Medicine

Fifty years ago, I was six years old.  My family, like many families of the day, subscribed to Life magazine.  On the cover of the magazine for the week of September 16, 1966 was a picture of Sophia Loren.  The Hollywood starlet was portrayed wearing a black see-through lacy dress that covered all the necessary parts, and covered all the necessary standards for 1966.  But the picture left an image upon my brain that I can easily recall to this day.

Fifty years later, digital pornographic images are now easily accessible.  The Internet has made it possible for thousands of images and videos to be accessed within seconds.  The Internet has made it available for instant digital infidelity to occur.  Such images and encounters can easily be accessed on any smartphone, tablet, and computer.

So how concerned should we be as a society?  Do we accept this dark digital domain as a part of our technological culture?  How harmful can pornography and digital infidelity be?  Is it possible that sexual images and/or compulsive sexual behaviors reside within the same realm as problematic alcohol and drug use?  The answer is plain and simple.  It does.  Pornography and cybersex can become addictive.  In the long run, this behavior rewires the brain, and can lead to abusive and destroyed relationships for men and women.

Sixty-eight percent of young men and 18% of young women view pornography at least once a week, and those numbers are growing. A sexual addictive epidemic is on the rise, not only because of easier access, but also the lack of information people have had on the negative and harmful effects associated with this addictive behavior.

Many researchers and clinicians in the field of mental health no longer discriminate between behavioral addictions (i.e., pornography, sex, gambling) and chemical addictions (i.e., alcohol, drugs).  Simply stated: The brain doesn’t care.  The brain doesn’t care whether you pour it down your throat, place it in your nose, see it with your eyes, or do it with your hands.  Pornography and sex, along with other addictions, flood the brain with dopamine and make the recipient feel good.   They help you to escape, as you seek the behavior over and over again.  Over time, as more dopamine is released, the individual will begin to feel the effects of this neurochemical less and less. This leads one to search for more graphic images, increase high-risk sexual behaviors, escalating the addictive behavior in order to obtain the desired effect.

Researchers indicate that nearly 80% of individuals who have an alcohol or drug issue will also have a mental illness issue as well.  This is the rule rather than the exception.  So what is the relationship that pornography, cybersex, and other addictive behaviors have with mental illnesses like depression and anxiety?  This could be better understood by the CUBIS model, an acronym that represents five areas that I believe demonstrates this relationship between addiction and mental illness.

Chemical Imbalance 

Within the field of psychiatry a basic premise is that some individuals may have issues of mental illness as a result of a chemical imbalance. When an individual experiences challenges of depression and/or anxiety, for example, particular neurochemicals within the brain may not be producing at desired levels, resulting in symptoms of mental illness (e.g., depression, fear, anxiety, paranoia).  This is where medications can be helpful.  However, addictive behaviors like sex and pornography, as well as alcohol, drugs and gambling, can also serve to temporarily regulate this imbalance, resulting in the individual feeling better and distracting his or herself with undesirable and destructive behaviors.

Unresolved Issues

For many, issues of trauma, abuse, grief, loss and/or abandonment, can lead some individuals to seek out ways to escape and numb one’s self from the aforementioned mental health challenges.  Whenever these problems bubble up to the top, the individual doesn’t want to think about or feel the emotions associated with these particular issues.  Cybersex and pornography, like other addictive behaviors, serve a purpose in suppressing these thoughts or feelings and help the individual to escape, distract, or forget about mental health concerns.

Beliefs (that are distorted)

We all grow up with a belief system.  This system consists of the messages we receive from our parents, relatives, neighbors, and society in general.  It’s how we see the world, and how we see ourselves.  But what if some of these beliefs are untrue, irrational, or distorted?  What if one had the belief that the only way to be social is to have a drink, or the only way to relax is to smoke a joint?  These beliefs, of course, are untrue.  Anyone is able to relax and become social without substances.  But how do these distorted beliefs materialize with sexual acting-out behaviors?  Typically within healthy relationships, the initial element is one of friendship.  This is usually followed by trust, increased commitment, and closeness through intimacy (love), and then sex.  But for some, the way one develops friendship, establishes trust, makes commitment, is by being sexual.  Sex provides a way to meet his or her unmet needs.  One’s distorted and irrational beliefs may perpetuate this unhealthy cycle of addiction.

Inability to Cope

Think for a moment of someone who has been a best friend. A best friend is someone that you can always count on, and is always reliable, 24/7.  This is the same relationship that the addict has with pornography, sex, and other addictive behaviors.  Our digital world has made cybersex and pornography readily available 24/7.  It is accessible during good times and bad.  It always delivers what it promises to do when reality can be so unpredictable.  In addition, the area of the brain affected by addiction is the same area where meaningful relationships are developed.  One’s addiction becomes on par with his or her spouse, children, parents, and friends. Sometimes, unfortunately, it becomes number one.  For the addict with mental illness issues, in order to get well, I have to give up my best friend.

Stimulus-Response Relationship

When it comes to the brain and addiction, there are two main areas of the brain which play an important role with the other: the prefrontal cortex (PFC) and the midbrain.  The prefrontal cortex is the executive functioning part of the brain.  The PFC is where   decision-making, morality, and personality exist.  Everything about who one is as a person resides in the PFC.  The main role of the midbrain is to reinforce behaviors which are necessary for the organism to survive.  The midbrain does this by the release of certain neurochemicals, especially dopamine.  Dopamine provides pleasure. Behaviors that are necessary for survival are reinforced with dopamine.  If food and sex were not pleasurable, humankind would have expired thousands of years ago.

The midbrain reinforces behaviors necessary for our survival by the release of the pleasure chemical, dopamine.  But addictive behaviors also trigger dopamine.  Behaviors such as sex and pornography, as well as other addictions (drugs, alcohol, gambling) do this too.  When dopamine is released from the midbrain and begins to flood the PFC, there is a shutting down of the rational, logical, decision-making part of the brain.  The midbrain overrides the PFC which now no longer functions correctly. A hijacking of the brain’s reward system occurs.  When this happens, the memory neurochemical Glutamate is released and informs the midbrain:  “Don’t forget this!  Go out and get it!”

The brain now believes and remembers that addictive behaviors are essential for survival.  Logically, one knows that one does not need alcohol, drugs and other addictive behaviors to survive, but the brain does not realize this.  As a society, we have unfortunately responded and treated addiction as an issue of morality, a weakness, a lack of will power, a character flaw, an addictive personality, sociopathy, etc.  Our society has unfortunately responded to addiction with shame, guilt, blame, coercion, and incarceration for many years.  This old approach has and continues to be a failure.  Addiction starts earlier and deeper within the brain and hijacks its reward system by believing the addictive behavior is necessary for survival.

Treatment

What should the treatment be for these issues?  When it comes to pornography, gambling, alcohol, heroin, or in fact any addictive behavior, a strong correlation exists with mental illness.  Treatment approaches must include integration of the co-occurring disorders.  For years substance use disorders and mental illness have been treated separately from one another.  Unfortunately, this view continues in many treatment communities.  Research indicates that an effective treatment model of addiction must integrate with the individual’s mental illness issues.  If only the addiction is addressed and not the mental illness, both will get worse.  Likewise, if only mental illness is treated and not the addiction, both will get worse.

The CUBIS model provides a template for treatment:

  • Medication management:  For individuals who experience a chemical imbalance, medication management can be beneficial in assisting the individual in regulating issues of anxiety, mood, and depression.  The development of medication-assisted treatment for those in recovery has also proven to be therapeutically beneficial for individuals suffering from addiction.

 

  • Psychotherapy:  Therapy serves as a means to relieve symptoms, resolve problems in living and/or seek personal growth.  The utilization of psychotherapy can be helpful in assisting individuals with unresolved issues of trauma, abuse, grief, loss, abandonment, etc.

 

  • Cognitive-behavioral therapy:  Individuals experiencing issues of irrational, maladaptive, or distorted beliefs may benefit from cognitive-behavioral therapy.  This therapy approach focuses on issues of thoughts, perceptions, attitudes and actions in choosing healthier behaviors.

 

  • Skill development:  For individuals who need to find better ways of coping, developing skills to assist in the regulation of mood and anxiety can be helpful.  These skills may consist of various ways of coping including mindfulness, meditation, community support groups, exercise, dialectical behavior therapy, spirituality, etc.

 

  • Education:  Knowledge serves as a means of increasing understanding and awareness for individuals and family members in how addiction impacts the brain.  This level of education and awareness can hopefully reduce elements of shame, guilt and blame of the individual who suffers from addiction and mental illness.  Individuals suffering from addiction may lie, cheat and steal, but bad acts do not necessarily mean bad actors.

Final thoughts

For this clinician, a simple cover from a 1963 Life magazine has left an imprint.  It remains unclear what the long-term effect of exposure to pornography and digital images have upon the brain and especially on the developing brains of young people.  The Internet and the digital world have made many aspects of our lives more productive, informative, connected and creative.  However, in today’s world of social media, chat rooms, digital pornography, interactive webcams, instant messaging, “adult friend finder” apps and sexting, our digital world also provides more destructive means to escape from life stressors, depression, anxiety and all other forms of mental illness.  Individuals suffering from mental illness may be easily drawn into other means of regulating mood, thoughts, and behaviors by high-tech addictive behaviors.  No longer can humanity afford to turn a blind eye as men, women, and children are pulled into the seductive charms of the dark side of the digital world. There is nothing romantic about pornography. Instead, it promotes an unrealistic and unhealthy view of relationships and true intimacy.

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On October 28, 2015, Dr. Elizabeth Wassenaar, Lindner Center of HOPE Psychiatrist and Williams House Medical Director, joined Lon Woodbury on the Woodbury Report radio show.  Their discussion focused on outlining the benefits of a residential assessment for mental health concerns in adolescents.

Click here to listen.

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Susan L. McElroy, MD

Lindner Center of HOPE, Chief Research OfficerUniversity of Cincinnati College of Medicine, Professor of Psychiatry and Neuroscience

Intermittent Explosive Disorder (IED) is a common and serious disorder that is often unrecognized and untreated. People with IED are periodically unable to restrain impulses that result in verbal and physical aggression. The aggressive behaviors are unplanned, out of proportion to provocation, and cause distress and psychosocial impairment, including interpersonal difficulties, divorce, school suspension, job loss, and financial and legal problems.

The violent behaviors of IED, often called explosive outbursts or rage attacks, are often preceded by aggressive or violent impulses, described as “the need to attack,” ‘the need to defend oneself,” “the need to strike out,” “seeing red,” or “an adrenaline rush.” These impulses are associated with tension, anger, increased physiological arousal, and increased energy. The explosive outbursts are brief, lasting 10 to 30 minutes, and usually followed by feelings of depression, remorse, guilt, and fatigue.

Once thought to be rare, we now know that IED is very common. Research has shown that the lifetime prevalence of IED in the general population is 1 to 7 percent. The average age of onset is 14 to 18 years among adults, and 13 among adolescents. IED is most common males and younger people. Of note, people with IED often have other psychiatric disorders, like depression, bipolar disorder, alcohol or drug abuse, and anxiety.

The cause of IED is unknown but biological, psychological, and social factor are thought to be involved. Importantly, IED runs in families suggesting that genetic factor are involved. Research also suggests that abnormalities in serotonin function in the central nervous system plays a role in IED.

IED is usually treated with medications and/or cognitive behavioral therapy (CBT). Medications that may be helpful include serotonin reuptake inhibitor s (like fluoxetine), anti-epilepsy medications (like carbamazepine ), or mood-stabilizers like lithium. When treating IED, it is crucial that other psychiatric conditions are identified and properly managed.

No medication, however, is approved by the United States Food and Drug Administration for the treatment of IED.   Hence, Azevan Pharmaceuticals is sponsoring a study to see if a novel medication is efficacious for IED in adults. This medication affects vasopressin, a hormone in the brain thought to play an important role in regulating aggressive behavior. This medication has been shown to reduce aggressive behavior in animals. The Research Institute at the Lindner Center of HOPE will be participating in this study which is scheduled to begin in late August. The Research Institute will be recruiting volunteers with IED to participate at that time. If an individual has questions about the study and might be interested in participating, they can call 513-536-0710 for further information.

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HP-PIC-green-ribbonWhen we think about cancer, heart disease, or diabetes, we don’t wait years to treat them. We start before Stage4—we begin with prevention. When people are in the first stage of those diseases, and are beginning to show signs of symptoms like a persistent cough, high blood pressure, or high blood sugar, we try immediately to reverse these symptoms. We don’t ignore them. In fact, we develop a plan of action to reverse and sometimes stop the progression of the disease.

So why aren’t we doing the same for individuals who are dealing with potentially serious mental illness?

When you or someone close to you starts to experience the early warning signs of mental illness, knowing what the risk factors and symptoms are will help to catch them early. Often times, family and friends are the first to step in to support a person through these early stages. Experiencing symptoms such as loss of sleep, feeling tired for no reason, feeling low, feeling anxious, or hearing voices, shouldn’t be ignored or brushed aside in the hopes that they go away. Like other diseases, we need to address these symptoms early, identify the underlying disease, and plan an appropriate course of action on a path towards overall health. Mental health conditions should be addressed long before they reach the most critical points in the disease process—Before Stage 4.

Many people do not seek treatment in the early stages of mental illnesses because they don’t recognize the symptoms. Up to 84% of the time between the first signs of mental illness and first treatment is spent not recognizing the symptoms.

Mental Health America’s screening tools can help. Taken online at www.mhascreening.org, a screening is an anonymous, free and private way to learn about your mental health and see if you are showing warning signs of a mental illness. A screening only takes a few minutes, and after you are finished you will be given information about the next steps you should take based on the results. A screening is not a diagnosis, but it can be a helpful tool for starting a conversation with your doctor or a loved one about your mental health.

This May is Mental Health Month; Lindner Center of HOPE is raising awareness of the important role mental health plays in our lives and encouraging members of the community to learn more about their own mental health and to take action immediately if they are experiencing symptoms of a mental illness.

Mental illnesses are not only common, they are treatable. There is a wide variety of treatment options for mental illnesses ranging from talk therapy to medication to peer support, and it may take some time for a person to find the right treatment or combination of treatments that works best for them. But when they do, the results can be truly amazing and life changing. Lindner Center of HOPE wants to help people learn what they can do both to protect their mental health and know the signs of mental illness #B4Stage4.

It’s up to all of us to know the signs and take action so that mental illnesses can be caught early and treated, and we can live up to our full potential. We know that intervening effectively during early stages of mental illness can save lives and change the trajectories of people living with mental illnesses. Be aware of your mental health and get screened #B4Stage4 today!

 

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Lindner Center of HOPE’s Chief Research Officer, Dr. Susan McElroy, was recently cited in a Forbes article about her work in the investigation of an experimental drug that could be used in the treatment of depression.

Naurex, a private company founded by a Northwestern University professor in Evanston, Ill., is reporting that this experimental drug works to help push patients out of a major depressive state within 24 hours of getting a single intravenous shot.

Click here to read the Forbes article.

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Susan L. McElroy, MD, Chief Research Officer, Lindner Center of HOPE, co-authored study published online by Jama Psychiatry

At some doses, the medication lisdexamfetamine dimesylate, a drug approved to treat attention-deficit/hyperactivity disorder, was effective compared with placebo in decreasing binge-eating (BE) days in patients with binge-eating disorder (BED), a public health problem associated symptoms of mental illness and obesity and for which there are no approved medications, according to a study published online by JAMA Psychiatry.

BED is characterized by recurrent episodes of excessive food consumption accompanied by a sense of loss of control and psychological distress. Cognitive behavioral therapy, as well as psychotherapy, can reduce BE behavior but implementation of these treatments has not been widespread. Consequently, many patients with BED are undertreated despite having functional impairments and difficulties in their social and personal lives. The U.S. Food and Drug Administration has not approved pharmacologic treatments for BED, according to background information in the study.

Susan L. McElroy, MDSusan L. McElroy, M.D., of the Research Institute, Lindner Center of HOPE, Mason, Ohio, and coauthors compared lisdexamfetamine with placebo in adults with moderate to severe BED in a randomized clinical trial from May 2011 through January 2012. The study included 259 and 255 adults with BED in safety and intention-to-treat analyses, respectively. The medication was administered in dosages of 30, 50 or 70 mg/day or placebo.

BE days per week decreased in the 50-mg/d and 70 mg/d treatment groups but not in the 30 mg/d treatment group compared with the placebo group, according to the study results. Results also indicate the percentage of patients who achieved four-week BE cessation was lower with the placebo group (21.3 percent) compared with the 50-mg/d (42.2 percent) and 70-mg/d (50 percent) treatment groups.

“In the primary analysis of this study of adults with moderate to severe BED, lisdexamfetamine dimesylate treatment with 50 and 70 mg/d, but not 30 mg/d, demonstrated a significant decrease (compared with placebo) in weekly BE days per week at week 11. Similarly, BE episodes decreased in the 50- and 70-mg/d treatment groups. The one-week BE episode response status was improved in the 50- and 70-mg/d treatment groups, and a greater proportion of participants achieved four-week cessation of BE episodes and global improvement of symptom severity with all lisdexamfetamine dosages. … Confirmation of these findings in ongoing clinical trials may results in improved pharmacologic treatment for moderate to severe BED,”  the study concludes.

(JAMA Psychiatry. Published online January 14, 2015. doi:10.1001/jamapsychiatry.2014.2162.  at http://media.jamanetwork.com.)

Editor’s Note: Authors made conflict of interest disclosures. This study was supported by Shire Development, LLC, including funding to Scientific Communications & Information and Complete Healthcare Communications, Inc., for support in writing and editing the manuscript. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Susan L. McElroy MD, James I. Hudson MD, ScD, James E. Mitchell MD, Denise Wilfley PhD, M. Celeste Ferreira-Cornwell PhD, Joseph Gao PhD, Jiannong Wang PhD, Timothy Whitaker MD, Jeffrey Jonas MD, Maria Gasior MD, PhD

JAMA Psychiatry. 2015;72(3):-. doi:10.1001/jamapsychiatry.2014.2162

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REELABILITIES LOGO with hashtag

Festival Runs February 27th – March 7th, 2015

ReelAbilities is the largest national film festival dedicated to celebrating the lives, stories and art of people with disabilities.

Lindner Center of HOPE is proud to be a part of the 2015 ReelAbilities Film Festival organized by Living Arrangements for the Developmentally Disabled (LADD) which runs February 27th through March 7th 2015 in Greater Cincinnati. For the first year, ReelAbilities is including films touching on the subject of mental illness in the festival. For more information about the film festival, click here.

Lindner Center of HOPE is the Host Agency for HERE ONE DAY, a documentary that chronicles filmmaker Kathy Leichter’s move back into her childhood home after her mother’s suicide. The film will be shown at Kenwood Theater on Monday, March 2, 2015 at 7:30 p.m.

Leichter discovered a hidden box of audiotapes. Sixteen years passed before she had the courage to delve into this trove, unearthing details that her mother had kept secret for so long. HERE ONE DAY is a visually arresting, emotionally candid film about a woman coping with mental illness, her relationships with her family, and the ripple effects of her suicide on those she loved. Click here to view trailer.

Following the film, Lindner Center of HOPE will host a brief panel discussion with question and answers with the audience. Jessica Noll, WCPO, will emcee the discussion.

Panel members will include:

Kathy Leichter, HERE ONE DAY filmmaker

John M. Hawkins, MD, Lindner Center of HOPE, Chief of Psychiatry, Deputy Chief Research Officer, Director TMS Services, University of Cincinnati College of Medicine, Adjunct Associate Clinical Professor of Psychiatry

Charles F. Brady, PhD, ABPP, Lindner Center of HOPE, Staff Psychologist, OCD/CBT Psychotherapist, Professor the University of Cincinnati’s Department of Psychiatry

Angela Ostholthoff, CPRP, CPS, Training Coordinator for The Recovery Center of Hamilton County

Shirley Benoit, Patient/Advocate

Here One Day imageHERE ONE DAY

Kathy Leichter / USA / English / 2012 /

76 min. / Documentary / Open Captions

Monday

March 2nd, 2015 – 7:30pm

at the Kenwood Theater

Benefiting the Lindner Center of HOPE,  Buy Tickets Here.

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Giving TuesdayDecember 2, 2014 marks the third celebration of Giving Tuesday, a day that promotes a charitable response to the frenzied shopping days that follow Thanksgiving.

Conceived by New York’s 92nd Street Y and the United Nations Foundation along with other partners, Giving Tuesday encourages people to celebrate generosity and give back by donating to and volunteering for their favorite nonprofit organizations. In 2012, the campaign raised nearly $10 million for US charities. In 2013, that number rose to over $19 million. Giving Tuesday continues to expand its reach around the globe, with over two dozen countries participating in 2014.

 

Mental illness affects everyone, and ranks among the leading causes of disability in the world. Since opening, Lindner Center of HOPE has served more than 23,000 individuals from 48 states and seven countries. Support is needed to continue to provide Hope to those struggling with mental illness and addiction. Giving Tuesday is a great time to show support, no matter how big or how small.

 

“For it is in giving that we receive”- St. Francis of Assisi

 

 

 Please donate today:

www.lindnercenterofhope.org/donate

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Mason, OH, November 24, 2014 – Lindner Center of HOPE staff psychologist, Charles Brady, PhD, ABPP, is a finalist for the 18th annual Business Courier Health Care Heroes awards in the provider category. Dr. Brady is one of 19 total finalists and one of five in the provider category.

Winners will be announced at a dinner on Thursday, February 12, 2015.

Dr. Brady directs the Center’s Obsessive Compulsive Disorder and Anxiety treatment program and oversees the Supported Employment program. He leadsCharles Brady Ph.D_0027 the research and development of the Center’s psychiatric rehabilitation programming. He also currently serves as the president of the board of managers of Lindner Center Professional Associates.

Dr. Brady is a clinical psychologist with more than 20 years of experience on the staff and faculty of the University of Cincinnati’s Department of Psychiatry. In addition to providing clinical service to thousands of patients at UC, he trained and supervised numerous psychology interns, doctoral students, post-doctoral fellows, psychiatric residents, psychiatric fellows, and psychiatrists.

Approximately 2 to3 million adults and ½ million children in the United States have OCD, but more than any other psychological conditions, individuals with OCD encounter obstacles that are estimated to cause an average of 14-17 years between the onset of symptoms and accurate diagnosis and effective treatment. Common obstacles include a shortage of properly trained health professionals and inaccurate or insufficient public awareness. On many levels, Dr. Brady works to address these challenges.

Dr. Brady’s positive impact as a provider is not limited to merely the population of patients he works with directly, instead his focus has always been on devising the best and most efficient ways to reach as many individuals as possible. Having established a well-respected reputation as one of the nation’s Obsessive Compulsive Disorder experts, Dr. Brady’s unique understanding of OCD and his experience in achieving positive, measurable progress is highly sought after by patients and families across the country.

It was obvious to Dr. Brady early on that, individuals suffering with OCD were underserved. To that end, Dr. Brady made it his personal mission to address the need of those struggling with OCD, seeking specialized training on his own and rising to among the most respected OCD specialists in the country.

With a keen understanding of the rarity of his training and expertise, Dr. Brady has devoted his career to sharing his knowledge and talents with those who can take it forward and multiply the impact on the suffering caused by OCD.

Heath Care Heroes is the Business Courier’s recognition of those who have made an impact on health care in our community through their concern for patients, their research and inventions, their management skills, their innovative programs for employees and their services.

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 age 12-years-old 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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Paul Keck image smallMason, OH, November 19, 2014 – Lindner Center of HOPE’s President and CEO, Dr. Paul E. Keck, Jr., was named amongst Thomson Reuters Highly Cited Researchers, a listing of the world’s leading scholars in the sciences and social sciences, in honor of his landmark contributions to research in the field of Psychiatry/Psychology.

Thomson Reuters, evaluates and recognizes excellence in the scholarly community as demonstrated by the quantitative impact of the sciences by consistently monitoring the undeniable link between citations and influence. Dr. Keck was selected as a Highly Cited Researcher due to the number of citations his work has received from fellow researchers. Essentially, his peers have identified his contributions as being among the most valuable and significant in the field of Psychiatry/Psychology.

The global nature of this study highlights the researchers, institutions and countries on the cutting edge of science, those who are developing innovations that will lead to a brighter tomorrow. The listing of the Highly Cited Researchers was compiled by assessing papers indexed within the Web of Science™ between 2002 and 2012 in 21 broad fields of study. Analysts tracked authors who published numerous articles ranking among the top one percent of the most cited in their respective fields in a given year of publication. View the list and methodology at highlycited.com.

Dr. Keck was also listed in The World’s Most Influential Scientific Minds: 2014. This report is at ScienceWatch.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 age 12-years-old 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.