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Science is catching up with something students have always known: College is stressful. Nearly half of college students across the country have experienced overwhelming anxiety, and one in four adults age 18 to 24 has a diagnosable mental illness, according to the American Psychological Association and the National Alliance on Mental Illness, respectively.
UT Arlington researchers from engineering, nursing, and social work are making breakthroughs in this important area, as they collaborate to develop better ways to screen teens for depression, create a genetic network that eventually could predict behavioral disorders, and discover more effective treatments for post-traumatic stress disorder among veterans.
Could a computer model predict a person’s likelihood of suffering from mental illnesses such as bipolar disorder or schizophrenia? Jean Gao, professor of computer science and engineering, is developing technology that does just that by examining mental disorders down to the genes.
“When we’re looking at psychiatric disorders like bipolar and schizophrenia, we’re wondering if there’s any kind of deep reason for them,” Dr. Gao says. “We try to examine this deep reason at the genetic level.”
She and Dong-Chul Kim, a recent graduate of UTA’s doctoral program in computer science and engineering, looked at the genetic expressions of 131 patients who had been clinically diagnosed with a psychiatric disorder. They then compared the patterns to their own genetic regulatory network (SGRN), which examines single nucleotype polymorphisms—gene regulators that can signal how individual genes will act, including the probability of disease. The SGRN inference method is a way for researchers to look at changes among individual genes and perhaps link those changes to the physical symptoms of illnesses like bipolar disorder.
“First we want to find the perturbations that affect those disorders—not all the changes of those [genetic] beads may be related,” Gao explains. “But then we’ll check how those perturbations regulate the functionality of the genetic regulator network.”
While investigating the gene perturbations of people with psychiatric disorders is an ongoing process, the goal is to use this genetic inference model to detect mental disorders before they manifest.
“We want to provide patients with early diagnosis, instead of just looking at the after-effects,” says Gao, who published her team’s findings in the June 2014 edition of Biomed Research International. “If we can relate early change at the genetic level to a later stage of psych disorders, we can prevent or treat it early. For a lot of physical symptoms, by the time they show up it’s a little late. We want to do something at an early stage.”
When it comes to identifying signs of depression, Sharolyn Dihigo thinks five minutes and 20 questions may be all you need. The nurse practitioner and clinical assistant professor in the College of Nursing and Health Innovation believes that adding a simple paper test called a CES-DC to a teenager’s well visit can be a quick, reliable way to screen him or her for depression.
Jean Gao, Sharolyn Dihigo, Hanli Liu, and Alexa Smith-Osborne
In May 2014, she published a systematic review in Women’s Healthcare of current medical evidence on using depression screening tools for adolescents. Her paper concluded that using the CES-DC is free, easy, and patient-friendly for teens.
“I think adolescents feel more comfortable filling it out in privacy in the waiting room than when you just ask questions verbally,” Dr. Dihigo says.
The process, she explains, is a no-brainer. Once the patient receives the sheet, he or she writes responses to questions such as, “Have you felt sad or felt like crying in the past two weeks?” and “Have you felt just as good as other kids?” The health care provider quickly scores the sheet and reviews the findings before seeing the patient. The subsequent interview can then determine whether further mental health screenings or treatment are necessary, and the provider can arrange follow-up appointments or referrals.
Dihigo believes screening young patients can be key to both diagnosing depression and getting them help early.
“The average adolescent has had symptoms for approximately two years before they are identified, and even fewer ever receive any treatment,” she says. “If we screen and address their emotional health, then their mental health concerns can be identified and treated much sooner.”
Of UT Arlington’s nearly 48,000 students worldwide, about 3,000 are veterans or their dependents. For those students, the University offers outreach programs like the Veterans Project, which helps them reintegrate into non-military life and further their education.
Still, wartime service takes a toll. Between 11 and 20 percent of veterans who served in Operations Iraqi Freedom or Enduring Freedom have struggled with PTSD, according to the U.S. Department of Veterans Affairs. Research on how best to work with PTSD-stricken veterans is still ongoing, but bioengineering Professor Hanli Liu and social work Associate Professor Alexa Smith-Osborne may have made a breakthrough.
Drs. Liu, Smith-Osborne, and their collaborators identified limited prefrontal cortex activity among student vets with PTSD when they were asked to perform simple memorization tasks. The 16 combat vets were hooked up to a portable brain-mapping device, known as functional near infrared spectroscopy (fNIRS), during the questioning.
The fNIRS is a non-invasive, helmet-type covering that goes over the front part of the head. It works via fibers that emit light into the brain, revealing the parts of the brain that are receiving more oxygenated blood (a signal of increased mental activity), then translating that information into “hot spots” that light up on an image scan.
“That whole patch of fibers delivers light and detects it,” Liu explains. “The parts of the brain that are doing more work need more oxygen, so they receive increased blood flow. The detectors can read where this fresher blood is.”
Once linked to the fNIRS, the student veterans were asked to test their short-term memory by memorizing a series of six numbers, then recalling the numbers both in the order they were given and in reverse order. In comparing the scans of the veterans with a control group, Liu and Smith-Osborne’s team noticed a difference in the prefrontal cortex activity (the area of the brain involved in cognitive processing), which showed that the veterans had a smaller increase in blood flow.
But the real difference was in the final phase—recalling the numbers—during which the veterans had significantly less activity (i.e., less increased oxygenated blood).
“They have no problem encoding the memory—putting things into storage—but after that, they can’t retrace it effectively,” Liu says. “They can’t remember things because they can’t recall them.”
The fNIRS device provides researchers with a non-invasive, portable way to map brain activity, something Smith-Osborne, principal investigator for UTA’s Veterans Project, had been searching for in recent years. After her arrival at the University in 2006, she conducted studies and clinical trials looking at ways to provide treatment and supportive education services for student veterans, including therapeutic methods like horseback riding.
“Of course, for that kind of treatment, [the imaging device] needs to be able to go into the stable,” she says with a laugh. “I was looking for a portable brain-imaging method that could be used in endeavors like that.”
While on the hunt, she teamed with bioengineering faculty like Liu and learned about fNIRS.
“It had the advantage of being exactly what I was looking for—designed to image the prefrontal cortex, designed to be used during functional tasks, and portable,” she says.
Smith-Osborne uses the study’s findings as an additional advanced assessment measure, informing her treatment of student veterans and particularly monitoring their responses to certain strategies. She hopes that continued research will enable care providers to offer treatment more tailored to the challenges student veterans with PTSD face, like experiencing other medical issues at the same time.
“It’s often not just PTSD,” she says. “It’s very rare that you just have PTSD in a military population. There’s almost always something else going on, like pain, muscular or skeletal injuries, or traumatic brain injuries. We need to continue research to see how the brain functions differently with different clusters of symptoms.”
Smith-Osborne notes that UT Arlington recently was designated among the top 100 colleges in the nation for U.S. military veterans by Military Times. The Veterans Project, she says, is one way the University offers treatment and support to student military members, particularly by fostering resilience on their return.
“Instead of intervention being solely diagnostically and symptom-driven, it’s recovery and reintegration-driven.”
Top Photo by C.J. Burton/Corbis
