About
206
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Introduction
My research focuses on inflammation and the development of depression in response to illness and stress. I aim to translate neurobiological findings into novel pharmacological and behavioral interventions. These interventions range from the application of cytokine antagonists to treatment resistant depression to teaching compassion meditation as a preventive health strategy.
Additional affiliations
January 2012 - present
August 2011 - present
Education
August 1987 - May 1991
August 1985 - May 1986
August 1982 - May 1985
Publications
Publications (206)
There has been a burgeoning interest in psychedelics among the public, state legislatures, psychiatrists and other clinical providers, and within the research community. Increasing numbers of studies evaluating psychedelics for depression, anxiety, posttraumatic stress disorder, and substance use disorders have been conducted or are underway. While...
Importance:
Psilocybin shows promise as a treatment for major depressive disorder (MDD).
Objective:
To evaluate the magnitude, timing, and durability of antidepressant effects and safety of a single dose of psilocybin in patients with MDD.
Design, setting, and participants:
In this phase 2 trial conducted between December 2019 and June 2022 at...
Importance:
Mounting evidence supports the role of spiritual, existential, religious, and theological components in mediating psychedelic-assisted therapy, yet integration of these elements into the clinical setting is lagging.
Observations:
Although psychedelic-assisted therapy commonly produces spiritually, existentially, religiously, or theol...
Whole-body hyperthermia (WBH) shows promise for the treatment of major depressive disorder (MDD). Because MDD is associated with increased inflammation, and anti-inflammatory agents show some promise as antidepressants, the current study sought to identify the acute and longer-term immune effects of WBH in participants with MDD and to explore wheth...
Given its centrality in scholarly and popular discourse, morality should be expected to figure prominently in everyday talk. We test this expectation by examining the frequency of moral content in three contexts, using three methods: (a) Participants’ subjective frequency estimates (N = 581); (b) Human content analysis of unobtrusively recorded in-...
Despite advances in neuroscience, limited progress has been made in developing new and better medications for psychiatric disorders. Available treatments in psychiatry rely on a few classes of drugs that have a broad spectrum of activity across disorders with limited understanding of mechanism of action. While the added value of more targeted thera...
Importance
Novel treatments for opioid use disorder (OUD) are needed to address both the ongoing opioid epidemic and long-standing barriers to existing OUD treatments that target the endogenous μ-opioid receptor (MOR) system. The goal of this review is to highlight unique clinical trial design considerations for the study of emerging treatments for...
Background
The psychedelic 5-MeO-DMT has shown clinical potential due to its short duration and ability to induce mystical experiences. However, a phenomenon known as “reactivations” (similar to “flashbacks”) is a poorly understood and frequently reported phenomenon which appears associated with 5-MeO-DMT use and warranted further investigation.
A...
Inflammatory physiology has been linked to behavioral and emotional symptoms in a variety of contexts and experimental paradigms. Hematopoietic cell transplantation (HCT) represents an intersection of significant immune dysregulation and psychosocial stress, and this biobehavioral relationship can influence important clinical outcomes. For those un...
Objectives
Although hospital chaplains play a critical role in delivering emotional and spiritual care to a broad range of both religious and non-religious patients, there is remarkably little research on the best practices or “active ingredients” of chaplain spiritual consults. Here, we examined how chaplains’ compassion capacity was associated wi...
Objectives
Extensive research suggests that short-term meditation interventions may hold therapeutic promise for a wide range of psychosocial outcomes. In response to calls to subject these interventions to more methodologically rigorous tests, a randomized controlled trial tested the effectiveness of a mindfulness meditation intervention and a com...
Over the last decade, numerous interventions and techniques that aim to engender, strengthen, and expand compassion have been created, proliferating an evidence base for the benefits of compassion meditation training. However, to date, little research has been conducted to examine individual variation in the learning, beliefs, practices, and subjec...
Survey-based studies suggest naturalistic psychedelic use provides mental health benefits similar to those observed in clinical trials. The current study sought to confirm these findings in a large group of psychedelic users and to conduct a novel examination of associations between amount of psychedelic use and behavioral outcomes, as well as freq...
Anxiety is prevalent among hospital inpatients and it has harmful effects on patient well-being and clinical outcomes. We aimed to characterize the sources of hospital distress and their relationship to anxiety. We conducted a cross-sectional study of inpatients (n = 271) throughout two Southeastern U.S. metropolitan hospitals. Participants complet...
Background: Depression is the largest source of global medical disability, highlighting the importance of translating and validating depression screening instruments to improve our understanding of differences in the prevalence of depression in divergent cultures around the world. The aim of this study was to translate and evaluate a widely used de...
While oncology clinical research coordinators (CRCs) experience a combination of factors that are thought to put them at increased risk for burnout, very little research has been conducted to understand the risk factors associated with burnout among CRCs. We used a mixed-method approach, including self-report questionnaires to assess burnout and co...
PURPOSE
Oncology clinical research coordinators (CRCs) and team-based coordinator care are critical for the success of clinical trials. However, CRCs typically report elevated anxiety and burnout and many oncology centers have high levels of coordinator attrition. To address the need for a team-based intervention to reduce burnout and promote resil...
Because medical illness is associated with increased inflammation and an increased risk for treatment-resistant major depressive disorder, anti-cytokine therapy may represent a novel, and especially efficacious, treatment for depression. We hypothesized that blockade of the interleukin (IL)-6 signaling pathway with tocilizumab would decrease depres...
Sighing is a common nonverbal everyday behavior thought to signal the experiencing of negative emotions. Prior research from a small-scale study suggests that observed daily expressions of sighing is associated with subclinical depression (Robbins et al., 2011). This paper replicates and extends these findings, hypothesizing that individual differe...
Accumulating evidence suggests that disrupted insulin signaling is involved in bipolar disorder (BD) pathogenesis. Herein, we aimed to directly explore the potential role of neuronal insulin signaling using an innovative technique based on biomarkers derived from plasma extracellular vesicles enriched for neuronal origin (NEVs). We leveraged plasma...
Objectives
Cognitively-Based Compassion Training (CBCT) aims to cultivate participants’ compassion and enhance their well-being. CBCT was developed for college students and has been adapted for several unique populations, such as children in foster care, but it has only recently been used with parents of infants and young children. This analysis of...
Sighing is a common nonverbal everyday behavior thought to signal the experiencing of negative emotions. Prior research from a small-scale study suggests that observed daily expressions of sighing is associated with subclinical depression (Robbins, Mehl, Holleran, & Kasle, 2011). This paper replicates and extends these findings, hypothesizing that...
Over the last decade, empirical research on compassion has burgeoned in the biomedical, clinical, translational, and foundational sciences. Increasingly sophisticated understandings and measures of compassion continue to emerge from the abundance of multidisciplinary and cross-disciplinary studies. Naturally, the diversity of research methods and t...
Past research using the Electronically Activated Recorder (EAR), an observational ambulatory assessment method for the real‐world measurement of daily behaviour, has identified several behavioural manifestations of the Big Five domains in a small college sample (N = 96). With the use of a larger and more diverse sample of pooled data from N = 462 p...
Accumulating evidence suggests that neuroinflammation is involved in bipolar disorder (BD) pathogenesis. The tumor necrosis factor-alpha (TNF-α) antagonist infliximab was recently reported to improve depressive symptoms in a subpopulation of individuals with BD and history of childhood maltreatment. To explore the mechanistic mediators of inflixima...
This study examines the effectiveness of incorporating compassion meditation training into a clinical pastoral education (CPE) curriculum to enhance compassion satisfaction and reduce burnout among hospital chaplain residents. Specifically, a longitudinal, quasi-experimental design was used to examine the impact of Cognitively-Based Compassion Trai...
This study tests a group-based secular contemplative practice intervention, Cognitively-Based Compassion Training (CBCT), with parents of young children. We report on a randomized controlled preliminary efficacy study. Certified teachers administered CBCT for 20 hr across 8 to 10 weeks in two cohorts of parents with infants and young children. The...
The amygdala has been repeatedly implicated in emotional processing of both positive and negative-valence stimuli. Previous studies suggest that the amygdala response to emotional stimuli is lower when the subject is in a meditative state of mindful-attention, both in beginner meditators after an 8-week meditation intervention and in expert meditat...
Mindfulness has seen an extraordinary rise as a scientific construct, yet surprisingly little is known about how it manifests behaviorally in daily life. The present study identifies assumptions regarding how mindfulness relates to behavior and contrasts them against actual behavioral manifestations of trait mindfulness in daily life. Study 1 (N =...
Evidence suggests that affective disorders are associated with altered thermoregulation, and it has been hypothesized that therapeutic strategies targeting body-to-brain thermosensory systems may be effective for treating depression. Consistent with this hypothesis, a recent randomized, double blind, placebo-controlled clinical trial has suggested...
In the present study, we aimed to replicate and extend findings by Mehl, Vazire, Holleran, and Clark (2010) that individuals with higher well-being tend to spend less time alone and more time interacting with others (e.g., greater conversation quantity) and engage in less small talk and more substantive conversations (e.g., greater conversation qua...
Mounting evidence suggests that aberrations in immune-inflammatory pathways contribute to the pathophysiology of major depressive disorder (MDD), and individuals with MDD may have elevated levels of predominantly pro-inflammatory cytokines and C-reactive protein. In addition, previous meta-analyses suggest that antidepressant drug treatment may dec...
Circulating concentrations of interleukin (IL)-6, an inflammatory biomarker widely assessed in humans to study the inflammatory response to acute psychological stress, have for decades been quantified using enzyme-linked immunosorbent assay (ELISA). However, biobehavioral researchers are increasingly using cytokine multiplex assays instead of ELISA...
The present study aimed to replicate and extend findings by Mehl, Vazire, Holleran and Clark (2010) that individuals with higher well-being tend to spend less time alone and more time interacting with others (e.g., greater conversation quantity), and engage in less small talk and more substantive conversations (e.g., greater conversation quality)....
The present study aimed to replicate and extend findings by Mehl, Vazire, Holleran and Clark (2010) that individuals with higher well-being tend to spend less time alone and more time interacting with others (e.g., greater conversation quantity), and engage in less small talk and more substantive conversations (e.g., greater conversation quality)....
Significance
Social genomics research has identified a conserved transcriptional response to adversity (CTRA) that may contribute to social disparities in health. This study identified systematic individual differences in natural language use that track CTRA gene expression more closely than do conventional self-report measures of stress, anxiety,...
Mindfulness has seen an extraordinary rise as a scientific construct, yet surprisingly little is known about how it manifests behaviorally in daily life. The present study identifies assumptions regarding how mindfulness relates to behavior and contrasts them against actual behavioral manifestations of mindfulness in daily life. Study 1 (N = 427) s...
Mindfulness has seen an extraordinary rise as a scientific construct, yet surprisingly little is known about how it manifests behaviorally in daily life. The present study identifies assumptions regarding how mindfulness relates to behavior and contrasts them against actual behavioral manifestations of mindfulness in daily life. Study 1 (N = 427) s...
Increasing data suggest that for medical school students the stress of academic and psychologicaldemands can impair social emotions that are a core aspect of compassion and ultimately physiciancompetence. Few interventions have proven successful for enhancing physician compassion inways that persist in the face of suffering and that enable sustaine...
Background:
Open and randomized, double blind, placebo-controlled clinical trials have demonstrated clinical efficacy of infrared whole-body hyperthermia in treatment of major depressive disorder (MDD). Demonstration of antidepressant-like behavioral effects of whole-body hyperthermia in preclinical rodent models would provide further support for...
Objective:
To conduct a systematic review and meta-analysis of studies that measured cytokine and chemokine levels in individuals with major depressive disorder (MDD) compared to healthy controls (HCs).
Method:
The PubMed/MEDLINE, EMBASE, and PsycINFO databases were searched up until May 30, 2016. Effect sizes were estimated with random-effects...
Dysregulated immune responses to stress are a potential pathway linking close relationship processes to health, and couples? abilities to cope with stress together (dyadic coping) likely impact such immune responses. Most stress research has focused on immune reactivity, whereas knowledge of immune recovery remains limited. The present study examin...
Increasing data suggest that for medical school students the stress of academic and psychological demands can impair social emotions that are a core aspect of compassion and ultimately physician competence. Few interventions have proven successful for enhancing physician compassion in ways that persist in the face of suffering and that enable susta...
Significant attention has been paid to the potential adaptive value of depression as it relates to interactions with people in the social world. However, in this review, we outline the rationale of why certain features of depression including its environmental and genetic risk factors, its association with the acute phase response and its age of on...
In Reply
We appreciate the insightful observations and questions raised by the letters from Fink and Shorter and Berk et al regarding our article.¹ Here, we respond to each letter in turn. Fink and Shorter query whether whole-body hyperthermia (WBH) might have appreciable efficacy for major depressive disorder (MDD) with melancholic features. To en...
The hygiene or “Old Friends” hypothesis proposes that the epidemic of inflammatory disease in modern urban societies stems at least in part from reduced exposure to microbes that normally prime mammalian immunoregulatory circuits and suppress inappropriate inflammation. Such diseases include but are not limited to allergies and asthma; we and other...
This review provides a critical perspective on recent meta-analyses suggesting that several anti-inflammatory modalities, including nonsteroidal anti-inflammatory drugs (NSAIDs), omega-3 fatty acids, and cytokine antagonist, possess generalizable antidepressant properties. By examining confounds and limitations in the available literature it is sug...
Chronic low-grade inflammation and insulin resistance are intimately related entities that are common to most, if not all, chronic diseases of affluence. We hypothesized that a short-term intervention based on “ancient stress factors” may improve anthropometrics and clinical chemical indices. We executed a pilot study of whether a 10-day mimic of a...
Significance
The hygiene, or “old friends,” hypothesis proposes that lack of exposure to immunoregulatory microorganisms in modern urban societies is resulting in an epidemic of inflammatory disease, as well as psychiatric disorders in which chronic, low-level inflammation is a risk factor. An important determinant of immunoregulation is the microb...
Importance
Limitations of current antidepressants highlight the need to identify novel treatments for major depressive disorder. A prior open trial found that a single session of whole-body hyperthermia (WBH) reduced depressive symptoms; however, the lack of a placebo control raises the possibility that the observed antidepressant effects resulted...
In this chapter, we provide an overview of how stress affects immune functioning and examine evidence in the literature regarding various intrapersonal and interpersonal factors that may exacerbate or buffer the health effects of stress and its related immune manifestations. We first review some basic information concerning the immune system to pro...
Food consumed during the 10 day trip (table S2) and based on the food intake of current hunter-gatherer populations (table S1). Correlations between all measured parameters (table S3).
This chapter is built on increasing evidence that individuals diagnosed with a wide range of currently recognized psychiatric diseases show significant increases in peripheral inflammatory biomarkers and CNS markers of immune activation, while simultaneously evincing reduced effectiveness of immune elements important for protection against pathogen...
Crosstalk between inflammatory pathways and neurocircuits in the brain can lead to behavioural responses, such as avoidance and alarm, that are likely to have provided early humans with an evolutionary advantage in their interactions with pathogens and predators. However, in modern times, such interactions between inflammation and the brain appear...
Major medical illnesses are associated with increased risk for depression and alterations in hypothalamic-pituitary-adrenal (HPA) axis function. Pathophysiological processes such as inflammation that occur as a part of medical illnesses and their treatments have been shown to cause depressive symptoms, and may also affect the HPA axis. We previousl...
Despite decades of interest in moral character, comparatively little is known about moral behavior in everyday life. This paper reports a novel method for assessing everyday moral behaviors using the Electronically Activated Recorder (EAR)—a digital audio-recorder that intermittently samples snippets of ambient sounds from people’s environments—and...
This study assessed the feasibility of a meditation-based program called Cognitively-Based Compassion Training (CBCT) with breast cancer survivors. Enrollment and participant satisfaction with a novel intervention, adherence to program requirements, and differences between the intervention group and wait list controls on self-report measures were a...
In recent years, it has become clear that chronic systemic low-grade inflammation is at the root of many, if not all, typically Western diseases associated with the metabolic syndrome. While much focus has been given to sedentary lifestyle as a cause of chronic inflammation, it is less often appreciated that chronic inflammation may also promote a...
Mounting data suggest that there is a reliable association between inflammatory markers and depression. This association has led to the speculation that anti-inflammatory drugs may have antidepressant activities. Although an increasing number of studies have addressed this issue, there are several considerations that have confounded attempts to int...
This Viewpoint reports on the accumulating data indicating that inflammation may play a role in a host of psychiatric illnesses.
Accumulating data indicate that inflammation may play a role in a host of psychiatric illnesses.¹ These data reveal reliable associations of inflammatory markers with psychiatric disorders, the induction of psychiatric s...
