I am currently a T32 postdoctoral research fellow in the Department of Psychiatry and Human Behavior at Brown Medical School. My early research experiences working at New York Presbyterian Hospital and as an undergraduate at Cornell University, my graduate school training at American University, and my pre-doctoral internship and postdoctoral fellowship at Brown Medical School have provided a strong background for pursuit of my long-term career goal of developing a program of research focused on innovative, technologically- sophisticated interventions to improve and advance the treatment of bipolar disorder (BD). My research and clinical focus has been on BD, depression, and dysphoria for ten years, and I have completed numerous projects using ecological momentary assessment paradigms. The pilot study proposed in this K23 application aims to evaluate the feasibility, acceptability, and preliminary evidence for efficacy of an innovative intervention designed to improve treatment adherence in BD. The intervention, My Treatment (MyT), will draw from psychoeducational and cognitive-behavioral principles to target gaps in knowledge and beliefs about illness and treatment that serve as risk factors for non-adherence. MyT will be provided using an Ecological Momentary Intervention paradigm, via personal digital assistants. We hypothesize that MyT will result in improved treatment adherence, decreased mood symptoms, and a lower rate of psychiatric re-hospitalization. We also expect that certain momentary factors (e.g., negative automatic thoughts about illness and treatment) will predict short-term treatment adherence behaviors. The proposed research training and pilot study are definitive steps towards developing one of the first interventions designed specifically to improve treatment adherence in BD. During the course of this award, I will focus on the following training areas: Psychosocial Interventions to Improve Treatment Adherence, Ecological Momentary Interventions, Clinical Trials Methodology, Focused Clinical Experiences in BD, Advanced Research Methods and Statistical Techniques, Manuscript and Grant- Writing, and Research Ethics and the Responsible Conduct of Research. Training activities will include a combination of regularly-scheduled consultation and collaboration with mentors and consultants, coursework, directed readings, workshops, tutorials, scientific meetings, clinical experiences, and committee participation. The primary site for this award will be the Psychosocial Research Program of the Brown Medical School Department of Psychiatry and Human Behavior at Butler Hospital. Cited by an external panel of peers as one of the seven benchmark academic Departments of Psychiatry in the country, the activities of the Department of Psychiatry and Human Behavior are extensive and diverse. The Department has over 80 faculty members who are currently principal investigators on over 220 research studies, funded by more than 50 external sources. It is one of the leading centers for longitudinal and interventions research in the country.

Public Health Relevance

The pilot study proposed in this K23 Mentored Patient-Oriented Research Career Development Award is a definitive step towards developing one of the first interventions designed specifically to improve treatment adherence in bipolar disorder. Bipolar disorder ranks in the top ten causes of disability worldwide and is associated with treatment non-adherence rates of up to 65%. A successful outcome to the study would likely make a significant positive public health impact by enhancing treatment outcomes, decreasing suffering, and improving functioning in BD, reducing treatment costs, and increasing treatment accessibility, thereby ultimately reducing public health burden.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Mentored Patient-Oriented Research Career Development Award (K23)
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Interventions Committee for Adult Disorders (ITVA)
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Hill, Lauren D
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Brown University
Schools of Medicine
United States
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