Current Clinical Projects
Novel smoking cessation paradigm for those on the schizophrenia spectrum
Camden Health Research Initiative
​
Cigarette smoking may represent the single most preventable lifestyle factor associated with negative health outcomes for individuals with schizophrenia. These individuals have a 2-4x (50-70%) higher rate of smoking than the general population (18.1%). Smoking is directly implicated in premature mortality due to cardiovascular disease, pulmonary disease, and some cancers among those diagnoses with schizophrenia. Individuals with schizophrenia have a reduced life expectancy of approximately 15-25 years when compared to the general population, largely due to premature mortality related to chronic health conditions. Although about 60% of smokers with schizophrenia indicate a general desire to reduce or quit smoking, fewer indicate an intention to quit within the next 30 days (4%) than smokers without a psychiatric illness. Smoking cessation may be more challenging for this population because of an over-emphasis on positive expectations of smoking, greater distress associated with withdrawal during quit attempts, and under-emphasis on long-term costs of smoking. We propose to develop and test a protocol for delivering a hybrid face-to-face and smartphone delivered, intervention, combining psychotherapeutic counseling in acceptance and commitment therapy with incentives for quitting smoking, for individuals diagnosed with a schizophrenia spectrum disorder. More specifically, we will identify putative mechanisms of change responsible for successful smoking abstinence, including changes in positive expectancies about smoking, increased willingness to experience distress associated with quitting, and increases in commitment to quit smoking because of a greater understanding and emphasis on personal values that can be realized with quitting. Identifying the important mechanisms responsible for change in this intervention will lead to more effective and targeted interventions in this difficult to treat, high risk population.
​
.
Feasibility & effects of high-speed low-resistance cycling intervention on Parkinsonian symptoms and health in schizophrenia
Parkinsonian motor symptoms (bradykinesia, diminished postural control, and poor balance) are found commonly in people diagnosed with schizophrenia contributing to serious injuries or fatalities that occur with falls. First-generation antipsychotic medications can induce (or exacerbate) these symptoms although some individuals show evidence for motor anomalies without antipsychotic exposure. The use of anticholinergic medications to treat motor symptoms may be associated with undesired cognitive and peripheral side-effects (e.g., blurred vision, constipation, tachycardia) and are not recommended for long-term use. Therefore, there is a strong need to develop alternative strategies to improve motor dysfunction. The current study will present pilot data on a 6-week exercise intervention in outpatients (n=12) with schizophrenia-spectrum diagnoses with concurrent motor symptoms. Participants will engage in 30 minutes of pedaling on a recumbent bike with 20 bouts of high speed pedaling designed to elicit high rates of neural stimulation. The resistance of the bike was set at the lowest possible level in order to keep musculoskeletal loading minimal. This paradigm has previously shown effectiveness in improving gait and postural stability in people with Parkinson’s disease. Results will examine pre-post motor functioning of upper and lower extremities and other potential changes related to increased physical activity on health variables.