We undertake a broad range research activity: exploring basic mechanisms in the origin and maintenance of common and disabling mental disorders; investigating the potential effectiveness and acceptability of innovative treatment approaches; and evaluating the effects of pharmacological and psychological treatments and variations in the delivery of mental health services on clinical outcomes. We strive to conduct clinically relevant research and to investigate how biological, psychological and social mechanisms interact in patient groups, and the impact of treatment and services on important clinical outcomes. We are particularly interested in mood and anxiety disorders, psychosis, and alcohol use disorders; and undertake studies across a range of participant groups, not just in patients attending health services, but also in other groups such as healthy volunteers and first-degree relatives of patients.
Current areas of activity include investigation of neuropsychological factors in patients with anxiety disorders, before and after pharmacological treatment or psychological interventions, with similar studies in first-degree relatives and healthy controls, designed to reveal ‘endophenotypes' (hidden markers) for anxiety disorders ( Baldwin , Garner ). We focus on cognitive and neural mechanisms involved in emotion processing, by integrating methods from a range of perspectives including experimental cognitive psychology (computerized behavioural tasks, eye-tracking methods), psychophysiology (fear-potentiated startle, autonomic arousal), cognitive neuroscience (event related brain potentials) and psychopharmacology (pharmacological challenge).
We have an interest in assessing biases in selective attention and attention control; in examining fear-potentiated startle (blink) responses to contextual threat using virtual reality techniques; in investigating emotion processing outside of conscious awareness; in the pharmacological modulation of cognition and emotion processing; in examining relationships between sleep, cognition, the regulation of arousal and emotion processing; in assessing the effects of psychological treatments (e.g. mindfulness based CBT) on mood, cognition and emotion processing; and in developing and evaluating translational experimental models of anxiety in humans (such as the effects of carbon dioxide inhalation on cognition and emotion processing).
We are also interested in applying insights from health psychology research in functional somatic syndromes, such as chronic fatigue syndrome and post concussion syndrome. We have recently started to explore interactions between the central nervous system and the immune system, to determine how these affect cognitive function and behaviour. We wish to identify modifiable inflammatory processes or molecules; to assess the effects of currently available and novel psychotropic medications on these processes; and to identify new behavioural and psychopharmacological intervention targets, with the potential to alter neuro-immune mechanisms and hopefully improve clinical outcomes ( Hou ).
We have a long standing interest in improving the efficacy and tolerability of antidepressant and anxiolytics, and in improving the design of randomised controlled trials, in order to gain better understanding of their relative efficacy and safety. This has led to improved understanding of the mechanisms underlying antidepressant-associated sexual dysfunction; of the relationship between an early onset of clinical effect and the likelihood of responding to pharmacological treatment; and of the value of long term treatment in patients with generalised anxiety disorder ( Baldwin ). In the area of psychological treatment, current studies include collaborations with Oxford (the MRC EME Worry intervention trial for psychosis (‘WIT') study), London (NIHR DIALOG - a user-centred intervention in psychosis ( Kingdon ), and MRC ACTAD trial for patients with alcohol dependency [ Sinclair ]), Exeter (MRC EME REFRAMED - treatment-resistant depression), Sussex (NIHR Mindfulness for voices). In addition we are involved in randomised controlled trials of cognitive therapy for psychosis with the Veterans Administration in Los Angeles and with Anding Hospital in Beijing. A pilot study of adaptation of cognitive behaviour therapy for psychosis in black and minority groups funded by the Department of Health is near completion, and a new study of cognitive behaviour therapy for psychosis in homeless groups is being prepared. We are part of a developing research group in ‘health literacy', specifically examining the impact of low health literacy in patients with alcohol use disorders ( Sinclair ).
We also assess the effectiveness and acceptability of treatment interventions in wider clinical practice. Current collaborative studies include an evaluation of clinical and cost-effectiveness of antidepressant drugs in the treatment of negative symptoms of schizophrenia (the ‘ACTIONS' study), and an investigation of the effects of mindfulness-based cognitive therapy in patients with highly recurrent unipolar depressive disorder and persistent mild depressive symptoms ( Baldwin ). There is an ongoing collaboration with the University of Oxford evaluating the new Mental Health legislation of Community Treatment Orders, and the role of leverage in community care ( Sinclair ), (NIHR programme grant), and a recently completed Wellcome Trust study (with Queen Marys College, University of London) exploring the ethics of offering financial incentives to patients to adhere to treatment (Sinclair). Other areas with proposals submitted include use of lamotrigine in patients with the diagnosis of borderline personality disorder; in self-stigmatisation and psychosis; cognitive behaviour therapy in clozapine-resistant patients with schizophrenia and the use of health trainers to improve outcomes from substance misuse in probation populations. We are also interested in identifying more accurately those patient groups at particular risk of poor outcomes. This includes identification of demographic and clinical factors associated with completed suicide after discharge from psychiatric inpatient care: this includes an investigation of suicides and open verdicts on the island of Jersey between 2000 and 2009 ( Baldwin , Sinclair ).
We have a long track record of working in partnership with pharmaceutical and biotechnology companies, through the University Research and Enterprise service, to refine the design of randomised controlled trials and facilitate development of improved psychotropic drugs.