My research has focused on the presentation and amelioration of severe emotional and behavioral disturbances in early childhood. Specifically, my colleagues and I have examined the correlates of disruptive and aggressive behavior, self-harming thoughts and behavior, and dysregulated mood in young children presenting for psychiatric day hospital evaluation and treatment. I have also examined treatment response in these highly impaired young children. To accomplish these research goals on a busy clinical service, I established the use of quantitative assessment methods over the course of partial hospital treatment, including multiple informant admission and discharge ratings, semi-structured diagnostic interviews, daily caregiver and staff ratings of behavior, and weekly measures of family treatment expectation and satisfaction. More recently, we have piloted behavioral and neuropsychological tasks to measure cognitive and emotional processes that may be impaired in this group of children who present with current impairment and elevated risk for future serious psychiatic disorders which may emerge in adolescence and adulthood. To date, our research team has collected multiple waves of data on over 1300 patients, with published work on a number of important and clinically relevant issues in early childhood mental health.

My colleagues and I have examined the rates of persistent irritability, frequent temper loss, and comorbidity between irritability and disruptive behavior disorders in clinically referred preschool-age children. We have also examined correlates of day treatment response for very young children exhibiting severe aggression, self- harming behavior, acute impulsivity, and frequent temper loss. Recently, we have completed a study of readmission rates for young children with Oppositional Defiant Disorder and found that suicidality and PTSD predicted readmission. Taken together, these research studies document the emerging impact and long-term impairment associated with co-occurring persistent irritability, aggressive behavior, impulsivity, and suicidal thoughts and behaviors in young children who have received intensive mental health services.

My colleagues and I have conducted research on factors that influence self-regulation in psychiatrically impaired young children with serious emotional disturbances. Specifically, we have examined the impacts of emotion processes such as emotion understanding and emotion regulation, impaired sleep, caregiver depression and stress on serious emotional and behavioral disturbances in young children receiving intensive mental health services. These studies have documented that young children with psychiatric impairments are at risk for exhibiting emotion processing deficits (e.g., anger and sadness biases), and dysregulation associated with less and/or fragmented sleep. Moreover, families of these young children report very high levels of stress as a group, which may reflect child emotion and behavior dysregulation both during the day and at night.

National Association of State Fire Marshal’s Strategy Conference on Juvenile Firesetting, Invited Participant, 2002

Teaching Recognition Award, The Warren Alpert Medical School of Brown University, 2006

Dean ‘s Excellence in Teaching Award, The Warren Alpert Medical School of Brown University, 2011

BROWN AFFILIATIONS

Psychiatry and Human Behavior

RESEARCH AREAS

early childhood mental health   |   suicide   |   self-injury   |   irritability   |   executive functioning

development of disruptive/externalizing behavior   |   sleep disorders in young children

treatment outcome

MEMBERSHIPS IN SOCIETIES

American Psychological Association

Society of Clinical Psychology, American Psychology Association, Division 12

Rhode Island Psychological Association

Society in Research in Child Development

Rhode Island Association for Infant Mental Health