Family Ties; Betting It All

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At the NRLC I am working on a longitudinal research study of childhood Substance Use Involvement (SUI). To address multiple aims, this study uses several areas of focus, including: Impulse Control Prior to Substance Use, Adolescent Development of Impulse Control, and Influences on Impulse Control Development.

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SUI enrolled boys and girls, between ages 10-12 years old, who had not previously initiated in drug use. There was a sample of children without family substance use history, Family History Negative (FH-), matched demographically to a sample with family substance use history, Family History Positive (FH+). The children and an accompanying parent/guardian are assessed every 6 months for impulse control, substance use, psychiatric status, family and environmental stress, and physical development. Monday through Saturday, 1-6 participants (parent and child) are scheduled each day to come in for their 6-month interval assessments. This is where I come in: my first day here I began training to administer forms and tests that measure changes in development.

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SUI uses computerized behavioral tasks that are designed to measure impulse control, along with, a few written questionnaires offering a series of alternating (A. vs. B.) choices to monitor impulse control and sensation seeking changes. Some of these tasks are enjoyed more so than others by the adolescents.

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One of the least favorites is the GoStop Impulsivity Paradigm (GoStop). This task displays a series of 5-digit numbers printed in black color for 500ms, and a new one comes up every 1,500 ms. When the numbers flashing one after another are matching, the adolescent is asked to click the mouse to signal they have acknowledged the repeated number, as opposed to withholding clicking when the subsequent numbers are off even by one single digit. However, note the task becomes rather tricky as some of the numbers, will suddenly turn from black to red font. When a number switches to red the adolescent is supposed to abstain from clicking, reflecting measureable inhibition. Inhibition is measured through their total overall responses and response-times. Some children find this task difficult and do not enjoy it. In my opinion focusing on the quickly-changing visual stimuli is rather irritating.

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A more popular task is the Balloon Analogue Risk Task for Youth (BART-Y) where adolescents are presented with an image of a balloon which they can mouse-click to inflate; the goal is to obtain the most possible points. Each balloon’s points are summed as it inflates; the larger the balloon, the more points it is worth. The adolescent must click ‘Save Points’ to collect the current balloon’s sum. A meter on the side of the screen records the level of points ranging from ‘0’, to ‘small prize’, to ‘large prize’. The trick here is that each balloon can pop at any given amount of clicks. Thus the number of click is a measure of willingness to take risks. One balloon may not pop until 40 clicks, but the next may pop at only 3 clicks. For each session, only 30 balloons will be given. Adolescents seem to regard this task as a game, therefore it is well-liked.

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            Psychiatric status, substance use, and family and environmental stress are evaluated at each visit using a combination of self-report survey and interview methods. The children and their parent/guardian fill out questionnaires regarding such things as academic status, sport/club/organization involvement, and chore performance. They also complete forms by agreeing of disagreeing with statements that may or may not be true about themselves, their families, and their relationships with their parent/guardian. Additionally the Timeline Follow-back Procedure (TFLB) is used for recording substance use and the Stressful Life Events Schedule (SLES) is used to assess family conflict, child abuse/neglect, housing threats, financial difficulties, peer conflicts, health problems, academic issues, and/or delinquent behaviors. To test for recent substance use, the adolescent completes a urinalysis (and for females a pregnancy test) at each visit.

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Lastly, the adolescents’ physical development is recorded using the Pubertal Developmental Scale, a self-report questionnaire developed to measure changes in perception of current pubertal staging. Research assistants administer the Pediatric Health Update, where they record the adolescents’ height and weight. Menarche and menstruation cycle records are included for female adolescents.

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SUI is a holistic study, inclusive of the multidisciplinary NRLC faculty and their alternating approaches to study substance use through these different tests and measurements. Each method of testing and interviewing participants accounts for a particular perspective of psychology and research. Through continuously collecting, recording, and analyzing the results of these comprehensive data sets we are able to locate statistically significant relationships between family drug histories, adolescent developmental stages, initiation of substance use, and associated varying risk factors. The identification of significant relationships allows for an objective understanding of how an individual’s unique personal characteristics contribute to or inhibit the promotion of Substance Use Disorders (SUDs). The scientific community expanding knowledge about SUD development benefits the population with an opportunity to reduce frequent co-occurrences of psychiatric disorders, disease, accidental overdose, and suicidal behaviors.

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Cultivating Culture

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In preparation for a Summer Research Internship, the UROC Scholar Seminar Series at CSUMB provided training on how to effectively manage relationships in laboratory environments. After rehearsing unusual but commonly occurring situations that may arise between students and faculty, I came to UTHSCSA ready for many variants in relationships, hierarchies, and organizational structures within the laboratory. For instance, I might be on a team of multiple undergraduates, perhaps even high school students. I could work side by side with a graduate student on a particular project. I may be extremely limited in interaction with the primary investigator (PI) seldom seeing them or the graduate students. On the contrary I might work directly with the PI at this site. I might share a desk on a top floor in an open-office floor plan, or be secluded to my own office tucked down below the ground level in a basement lab with little to no interaction with other students or faculty.

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UTHSCSA is unlike other summer research internship sites in that it is not a liberal arts university, although it is an extension of the University of Texas system. UTHSCSA is a medical school with more than 100 affiliate hospitals, clinics, and health care facilities. My research placement is taking place in The Neurobehavioral Research Laboratory and Clinic (NRLC) which is a division within the UTHSCSA Psychiatry Department. The NRLC is unique; composed of a multi-disciplinary team of researchers. A difference in the medical school setting is that many of the researchers are paid technicians rather than students. This means that there would be no graduate students, and aside from other NIDA Summer Research Internship students, there would be no undergraduate students besides myself.

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Often times a singular perspective may experience opposition from other perspectives, causing tension within the scientific community. What came first; the chicken, or the egg? “Neither” nor “both” are not acceptable answers to this inquiry. Particularly within America there is a dominant argumentation culture. To make progress or prove information to be true or give it value, there needs to be an assertion for what is right, more right, and that any alternates are wrong. One can trace back the origin of this culture to the roots of knowledge; acquiring truths, facts, and principles from investigation. Investigation requires scrutiny and exploration of an idea. Terminology must be defined, and hypotheses need to be disputed to be proven incorrect, in order to be accepted as true. While these core concepts may be necessary for the attainment of knowledge, especially in scholarly settings, the processes by which argumentation takes place are not limited to debate. Productive argumentation across multiple disciplines and for the purpose of research consists of establishing similarities. Acknowledging similarities engages alternate sides of the topic, allowing them to form mutual goals. It is becoming increasingly clear that understanding today’s problems and discovering tomorrow’s solutions will require the cultivation of scientists with varying and often contrasting research backgrounds, perspectives, concepts, and theories from an array of scientific fields. The contemporary approach in the scientific community is showing interest and appreciation for a diverse population of researchers and perspectives when engaging in scholarly discussions and in designing research studies, and analyzing data.

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Here at NRLC, Drs. Donald Dougherty, Charles Mathias, and Ashley Acheson have been running an on-going longitudinal study. Dr. Dougherty is the Director of the NRLC as well as the Deputy Chair for Research in the Department of Psychiatry. He focuses on studying impulsive behavior in association to drug abuse and suicide. Part of his research includes identifying biological and behavioral risk factors for psychopathy. Dr. Acheson is an Assistant Professor in the Department of Psychiatry as well as the Research Imaging Center at UTHSCSA. He is trained in studying laboratory models of decision-making and impulse control in both rodents and humans. He specializes in examining neural differences in adolescents at risk for developing substance use disorders. Dr. Mathias is also an Associate Professor within the Department of Psychiatry. His research approach adapts laboratory behavioral procedures including psychophysiological measurements to assess impulsivity. This approach reveals physiological mechanisms that underlie behaviors among individuals with psychiatric symptoms and disorders. While their backgrounds and expertise are varied, bringing together these perspectives results in more powerful advances in science.

In addition to the primary investigators listed above, and other NRLC faculty, there are several post-doctorate fellows and staff making up the NRLC team. While there are not graduate students per say, having people with these varying levels of academic training and research experience really make for a rich and diverse training environment. Each person has a specific focus area and brings these approaches and their unique experiences and ideas to the table. This allows for an inclusion of different fields simultaneously when discussing one idea, or conducting one study. Participants’ experiences and time, and collected data are efficiently collected and analyzed this way. The NRLC truly is an interdisciplinary community.

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Texas Expectations; Coming in for a Landing

Before arriving to Texas, I was told I would awake each morning to find myself drenched in sweat due to the extreme combination of high temperatures and humidity. I added San Antonio to a weather application on my cell phone. I planned ahead. I monitored these claims in hopes of discovering people’s warnings to be exaggerations. After noticing the temperature seldom fell below 75 degrees with a 70-90% humidity level during several severe lightning storms in the middle of the night, I was convinced of the extreme humidity and heat I was soon to encounter.

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I prepared for a dramatic shift in weather upon landing. There I was, a beach-going, sun-tanning, heat-loving Californian, packing a separate cooler outfit in my carry-on. I wore sandals and had fastened my hair up in a bun. Even before going to luggage claim I changed into my shorts and a light tank top. As I walked towards the exit I was met with heavy moist air. I could feel my temperature rise as I lugged all of my suitcases and bags out into the streets in search of a taxi. The further I trudged along; I felt more and more like I was cooking in a microwave on the baked potato pre-setting.

I suddenly became very aware of how despite my thorough planning I did not account for the lack of taxi service or help with my bags. I was hot, exhausted, did not know where I was, and I was alone. Before this trip I had only flown alone once before, and never with more than one suitcase on wheels. I wondered why I had not made plans to meet up on my arrival day with Ms. Losey, the UTHSCSA project coordinator who had been guiding me in travel and housing arrangements. Perhaps she would have been able to pick me up from the airport even; if only I had asked. But it was too late for that. I continued down the walkway until I finally spotted a line for taxi-service, and the man guiding travelers helped me load into a new Toyota Prius taxi. The air conditioning could not have been blowing hard enough that entire 30-minute drive to my apartment complex.

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The apartment complex I’m staying at is on the University of Texas San Antonio (UTSA) campus. An extension of the UT system, UTSA has about 29,000 students. Their mascot is the road runner, which is indigenous to this part of south Texas. My apartments are not particularly close to where I’m working, however, they are conveniently located along the way Ms. Losey drives to work. This makes picking me up just a quick pit stop. The taxi dropped me off at what we thought was the leasing office. Apparently the correct office would be found after a fairly long walk across the scorching pavement in the sweltering heat on the opposite side of the complex. Office staff managed to locate some keys and assign me to an apartment. I was so excited. And would you believe it? My home for the next eleven weeks was now back on the far edge of the opposite side of the entire complex. Thankfully, a brave lady from one of the offices volunteered to help me carry my things to my new apartment.

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I got settled as best I could and ventured back out into the heat, this time to walk to the nearest bus stop. I rode the bus nervously, worrying I had missed my stop, and hoping I had not taken the wrong bus or misread the schedule and routes. Minutes ticked by slowly making my 20-minute ride feel like an hour-long voyage. I was glad the bus had air conditioning. I walked to a nearby store enjoying carrying my seemingly weightless purse as opposed to the immense weight of my luggage earlier. This shopping trip should be a breeze. There would be no difficulties snagging front row parking or navigating an overloaded shopping cart through vehicle and pedestrian traffic to my trunk. I gathered basic items keeping in mind I would need to haul my purchases back home on foot and bus.

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My route to return home encompassed some surprises. For one, buses did not run every 5, 10, or even 15 minutes. Bus 603 ran every hour. And although it passed my apartments along its path toward the stores in town, in the reversed direction going back home, it did not. 603 brought me to a halting stop nearly 2-miles from my apartments before turning into another bus route traveling a different direction away from my home. Of all the times I had regretted having to commute hundreds of miles, hours and hours, from city to city, or that I spent trapped sitting in traffic only to go a few short miles up the road, I had never missed having a car as much as I did in that moment.

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When I finally arrived home, I immediately contacted Ms. Losey asking if she would be willing to help me get to the store the next day to finish shopping. While weather was not particularly helpful in this excursion, I had clearly underestimated the task of traveling into town, shopping, and returning home on public transit. I made my bed, called it a day and went to sleep. Tomorrow would be a new day; a day with a car, an air conditioned car, and more importantly another person, a local resident who knew the area, who was willing to accompany me, to help me navigate this foreign land.