W. Edward Craighead, Psychiatry and Behavioral Sciences
Faculty Distinction Fund Recipient

 


If a parent suffers from a mood disorder, his or her child has up to a 50% chance of developing the same illness. W. Edward Craighead, Emory's first Rex Fuqua Chair in Child Psychiatry, wants to know why - and what can be done about it.

Understanding the multi-level psychological, genetic, environmental, and neurobiological components of mood disorders among adolescents is a goal of the new Childhood and Adolescent Mood Disorders Program (CAMP), which Craighead directs. Housed within Emory's Comprehensive Neurosciences Center, CAMP draws together experts from psychology, psychiatry, neuroscience, brain imaging, and genetics to conduct research, educate families, and treat young people with major depression and bipolar disorder.

Craighead, who holds a joint appointment in the Department of Psychology, has dedicated his professional life to the understanding, treatment, and prevention of mood disorders. For the past decade, he has worked with Dr. Eirikur Arnarson in co-directing a clinical research program in Reykjavik, Iceland, that seeks to prevent initial episodes of depression among adolescents at risk. Those initial episodes can cause biological or psychological "scarring" that increases a person's likelihood of having a second episode later in life. Using developmentally based cognitive behavior therapy, Craighead and his team worked with school psychologists to implement a depression prevention program among 14- to 15-year-old Icelandic youth. The program cut the rate of first episodes of depression by more than half. Some school districts in Reykjavik have gone on to make the program a permanent part of the programs.

For young people who do experience a major depressive episode, Craighead has sought to prevent a recurrence. In studies of undergraduates at the University of Colorado, he and colleagues found that young adults with personality disorders were three times more likely to have a recurrence of major depression than were those without these disorders. They also found that young people who "relapse" into depression often present with interpersonal hypersensitivity, antisocial behaviors, and/or social anxiety. Says Craighead: "To prevent a recurrence of depression, college counseling programs must be tailored to address these associated behavioral patterns."

Craighead also specializes in the treatment of bipolar disorder among adolescents. "For a long time, people thought bipolar disorder only affected adults," he says. "But in the early stages, it can present in adolescents as depression, hostility, and irritability." He has worked with Dr. Miklowitz at Colorado on the development and evaluation of a nine-month "family-focused" therapy for young people affected by the disorder. The therapy sessions are focused on psychoeducation, problem-solving skills, and assist with communication among family members. Craighead will conduct additional studies of this treatment program, as well as conducting new studies of behavior activation therapy for teens at risk of depression. In both arenas, his work will proceed in concert with Emory neuroscientists, who are trying to identify neurobiological, genetic, and personality predictors for treatment outcomes. "We want to be able to predict which patients will respond best to which treatments," he says.

Identifying the predictors of mood disorders among children and adolescents remains a challenge. Craighead and his colleagues have an important set of collaborators to aid their efforts. They are beginning to work with Drs. Zac Stowe and Jeffrey Newport of the Emory Women's Health Program, which works with pregnant and post-partum mothers who suffer from depression or bipolar disorders. They have identified 400 children born within the last ten years who are at risk for developing a mood disorder. CAMP clinicians will provide a "continuum of care" for any of these children who develop symptoms. CAMP clinical scientists also hope to collaborate with Drs. Stowe, Newport, and Kilts to study the life-long neurobiological, genetic, personality, and environmental data for these children. "This data, studied in a longitudinal fashion, will potentially give us a much greater understanding of mood disorders and their causes," Craighead says.

Emory is a great place to embark upon this kind of collaborative discovery. Craighead came to Emory, in part, because he admired the creative spirit and the initiative taken by faculty members to plan for the university's future. He intends for his work to support both the Neuroscience, Human Nature, and Society initiative of the Strategic Plan and the "Vision 2012" plan for Emory Healthcare. He is confident that the Childhood and Adolescent Mood Disorders Program will become the leading center of its kind in the Southeast. "Can we teach these adolescents developmental resiliency and some coping strengths, that will help them grow into healthier adults?" he asks. "It's very exciting to be at the precipice of major advances in our treatment of these potentially devastating disorders."