Mclean Hospital

Growing, Innovating, and Improving: Update on OCD Research

By Jason Elias, PhD

December 15, 2013

The Office of Clinical Assessment and Research (OCAR) experienced a growth spurt recently and now features seven core members. I have asked Jesse Crosby, PhD, to lead this expanded team and coordinate our effort to do everything we can to help patients recover from OCD and related disorders. In this update, I have highlighted several important areas of opportunity for OCAR and what it could mean for patients and their families.

Diagnostic Evaluation

OCAR staff
OCAR Staff: Back row (Left to Right) : Leah Shorser-Gentile, Christine Andre, Jason Elias, Jordan Cattie, Brittany Mathes; Front row (Left to Right): Jason Krompinger, Jesse Crosby, Sadie Monaghan

A thorough assessment of a patient’s presenting complaints is essential for designing an effective treatment plan while also being the start of the healing process for someone who has been struggling to understand their symptoms. OCAR is proud to play a supporting role in helping patients and their families better understand their disorder by gathering information for clinical teams at the OCDI. In order to expand our commitment to this role, OCAR hired an additional clinical research fellow, Sadie Cole, to head up our diagnostic evaluation division. Sadie comes to us from Harvard University’s Graduate Program in Clinical Psychology and has helped us develop a new assessment protocol that will improve the quality of the information we gather as well as the overall patient experience.

Understanding Treatment

Most of our clinical research is dedicated to understanding predictors of response and mechanisms of change, benefitting those who are not helped by treatment. It’s important to us that you know OCAR is as focused on those who are not seeing improvements as we are on those who do. Jason Krompinger, PhD, has been promoted to senior research associate of OCAR and is leading our effort to integrate predictive diagnostics into the treatment at the OCDI. Dr. Krompinger came to McLean as a psychology intern in 2010 and has been part of the OCDI staff ever since. His innovative approach to clinical research will help us understand what happens in the brain during exposures by using mobile EEG and other real-time measures of psychophysiology. By identifying patterns of brain activity that correspond to relevant treatment processes, we might be able to use the feedback to improve the strength and speed of patients’ response to exposure therapy.

Jordan Cattie, an advanced graduate student in clinical psychology from UC-San Diego/San Diego State, will offer her expertise in psychophysiology and neuropsychological assessment to assist Dr. Krompinger on these initiatives. She has also taken the lead on a huge data management project that will allow us to interpret clinical data more easily and collaborate with other researchers.

Christine Andre, an advanced graduate student in clinical psychology from Suffolk University, will play a number of supporting roles. Christine took the lead on building our database and managing the process of collecting DNA to support the International OCD Foundation Genetics Collaborative and to provide an opportunity to link treatment response, medication response in particular, to genotype.

Finally, instead of completing monthly assessment measures that can take up to two hours to complete, we will be instituting weekly assessment measures that will only take 10 minutes. This will give us a better sense of the process of change from week to week and allow us to tailor treatment accordingly.

Providing Feedback

The paradox of having a thoughtful and comprehensive assessment package is the challenge of interpreting the data efficiently. To address this problem, Dr. Crosby will work closely with Christine Andre and our new Research Coordinator, Brittany Mathes, to create an automated report, summarizing the clinical assessment information for treatment teams. In just a few months, Brittany has learned the inner workings of the lab and made significant changes to improve its functioning. She has been charged with making sure our logistics are sound and that we make efficient use of clinical assessment information. Most importantly, our team is working on innovative ways of presenting clinical data to patients and treatment teams to help them optimize treatment strategies.

Jason Elias, PhD, is the director of Psychological Services and Clinical Research at the Obsessive Compulsive Disorder Institute (OCDI)