In addition to the two primary research programs, I am also interested in several other areas that involve graduate student projects and/or lines of inquiry that I plan to develop into more formalized programs. One area involves sleep disturbances in UHR youth. A senior graduate student in my lab and I worked to write a comprehensive review of sleep dysfunction in populations at-risk for schizophrenia (Lunsford-Avery & Mittal, 2013), recently published a report describing association between sleep deficits and thalamic volume in high-risk youth (Lunsford-Avery et al., 2013), and are currently collaborating with a sleep lab (Monique Le Bourgeois) to process sleep-actigraph data for a follow-up publication. Another significant area I am developing involves emotion-processing abnormalities in UHR youth. This interest stems from work with my primary research with frontal subcortical and hippocampal networks, as both play a significant role modulating these hallmark deficits. To this end, I have been working together with another graduate student in my lab (Andrea Pelletier) on developing a research program examining social processing across domains, and using multiple layers of assessment (e.g., imaging, cognitive, behavioral, self-report). We have published a number of related studies including a commentary on social cognition/theory of mind (Pelletier & Mittal, 2012) and social anhedonia assessment (Pelletier & Mittal, 2013), as well as an empirical paper focusing on facial recognition deficits in young adults reporting fleeting psychotic symptomatology (Pelletier et al., 2013). We also have recently submitted a report examining the resting state correlates (using limbic seeds) of these abnormal behaviors (Pelletier et al. under review). This research is highly innovative and consistent with new NIMH Research Domain Criteria (RDoC) priorities, and as a result, Andrea was recently awarded and NRSA to continue the research. We have also recently begun recruitment for an fMRI study adapting two emotional processing paradigms for use in the prodrome, and this data will serve as the foundation for Andrea’s dissertation. In addition, I am collaborating with several colleagues (e.g., Tim Curran, Tor Wager, June Gruber) as well as a postdoctoral student, Holly Earls, to examine the psychophysiological and functional correlates of facial processing deficits, and we have recently submitted an R21 proposal to develop this work and test the potential suitability of specific targets for cognitive remediation interventions. I have also started to examine abnormalities in perception; I am very excited about a recent collaboration with Steve Silverstein, in which we are finding that high-risk youth exhibit a lack of susceptibility to depth inversion illusions (via the hollow mask paradigm). We have recently submitted an R01 proposal (P.I. Silverstein, Co-I Mittal) to determine if deficits in modulation incoming visual sensory information serve as a biomarker across several psychosis-spectrum populations.
In addition to this empirical work, I am an active contributor to peer-reviewed commentary on diagnostic issues in the high-risk period. I have written several critical commentaries, reviews, and communications pertaining to the classification of movement abnormalities in psychiatric illness (Mittal & Walker, 2010; Mittal & Walker 2011). Further, I work with students to write peer-reviewed commentaries of clinical issues that are inspired by experiences with at-risk youth in my lab (i.e., differentiating visual hallucinations from common eye issues such as floaters, Mittal, Willhite, & Cannon, 2008; confusion between psychotic symptoms and delusions of body image, Smith & Mittal, 2013; misattributed auditory anomalies with tinnitus, Dean & Mittal, 2013; inconsistencies in cannabis use reporting among UHR youth, Carrol & Mittal, 2014). I have also published case studies, and advocated for incorporating neurological and neuroimaging assessments in the course of diagnosing high-risk youth. For example I worked on a case in which an adolescent exhibited signs that previous treatment providers had assumed were intractable symptoms of psychosis, but we discovered these were the side-effects of a pineal gland tumor, and the symptoms remitted when the tumor was rescinded (Mittal, Karlsgodt, Zinberg, Cannon, & Bearden, 2010). Most recently, I have been working on a bioethical-legal review paper with Elyn Saks to evaluate ethical and legal dilemmas inherent in disclosing an attenuated psychosis syndrome diagnosis to patients and families (Mittal, Dean, Mittal & Saks, under review). Outside of the domain of psychosis, I have served as an imaging consultant on several studies surrounding eating disorders (Frank et al., 2013a,b; Schott et al., in press). Finally, I have focused on publishing work from the healthy controls in my studies to improve our understanding of gesture behavior as well as normative adolescent cerebellar and basal ganglia brain development (Bernard et al., in press; Bernard, Millman, & Mittal, under review).