Bridgeway Rehabilitation Services, Inc "When Hard Science Meets Psych Rehab” Session 1: Introductory concepts Tuesday March 4, 2008 UMDNJ/SHRP, Scotch Plains, NJ http://www.slideshare.net/johnfossella

Two people are standing on the edge of a fast-moving river. They spot someone being washed down the river. The first of the two people on the bank dives in to save the person; the second one just watches. More time passes, and another person is carried down the river. Again, the first person leaps in, while the second watches. This happens a third, then a fourth time. Finally, the first person yells at the second, “Why don’t you help?” And the second answers, “I’m trying to figure out why people keep falling into this river.” The first person is a clinician, and the second is a scientist .

Goal of introductory session: To make brain science more accessible and to relate the ways in which YOUR clinical interventions "change the brain" leading to positive outcomes. YOU are helping to repair and remediate brain circuits !

PART 1: Basic human brain anatomy PART 2: What goes awry in mental illness ? -late appearance of developmental deficits for attention -fear system and effects of stress PART 3: The synapse and how we can “change the brain”

“ doing things in the scanner ” is a way to get at Where interventions target

Take home message: Your interventions may have engage specific neural circuits . This may be a good thing and allow subjects to exercise specific circuits that are functioning poorly. We will try and get at these in subsequent sessions

PART 2: WHAT GOES AWRY IN MENTAL ILLNESS ? Dr. David Lewis “ developmental deficits of attention and control systems ” Dr. Bruce McEwen “ stress diathesis ”

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Neuobiology of “Attention” is central dorsolateral frontal cortex

http://www.tnp.pitt.edu/research/resframe_mb.htm

Take home message: Mental illness can have very deep biological roots. Even though many of the symptoms present in late adolescence, the biological problems may have occurred before birth or during early childhood. One system of particular vulnerability is the attention and control system.

over-active “fear” system & effects of stress

amygdala

chronic stress leads to vicious cycle of cognitive decline

Using cognition to turn off the amygdala

Take home message: Mental illness also has an environmental aspect where the fear and anxiety circuits are especially active leading to stress and cognitive decline. Care and sensitivity !

PART 3: Can we change the brain ? Dr. Helen Mayberg

Synapses

Take home message There is much neuroscience showing that your care and intervention can “ change the brain ” irrespective of and in conjunction with medication. We have discussed some methods, and some basic anatomical systems ( attention and fear ) as a foundation for our joint discussions on interventions and their effects on brain systems.