What does your research focus on?
When assessing patients for mental health concerns, clinicians and researchers often have to take information from multiple sources or informants to make health care decisions, such as assigning diagnoses and planning treatment. This process results in generating a great deal of information about a patient’s mental health, but the individual pieces of information often yield inconsistent conclusions. These inconsistencies create considerable uncertainty as to how best to care for patients. My research seeks to understand why mental health assessments often yield these inconsistent conclusions. Interestingly, commonly used informants of child and adolescent mental health, such as parents and teachers, often vary in where they observe children and adolescents, such as home and school settings. When assessing adult patients, self-reports and clinician reports might similarly differ in that patients base their reports on how they behave in work and home settings, and clinicians may take this information into account but also focus on how the patient behaves in the clinic setting. Thus, informants differ in their opportunities for observing mental health concerns. With an emphasis on adolescent social anxiety, my laboratory’s work focuses on identifying the circumstances in which inconsistencies in assessment outcomes reveal important information on the specific contexts in which patients express mental health concerns, and risk factors for these concerns. A greater understanding of the specific contexts (e.g., home, work or school, peer interactions) within which patients express mental health concerns may inform the development of methods for using this contextual information to personalize treatments for patients, and thus improve the efficacy of these treatments.
What drew you to this line of research and why is it exciting to you?
I began developing my research interests as an undergraduate research assistant at Florida International University, and I carried these interests into graduate school at Yale University. When I was in graduate school, I remember reading studies on these topics and to my amazement, I made three observations. First, these discrepancies among informants’ reports were some of the most robust findings in clinical research. Second, no conceptual framework existed to explain why these discrepancies exist. Third, I noticed that researchers had been publishing on these topics for decades. The general pattern I observed was a given researcher or research team publishing a handful of papers on these topics, and then abruptly stopping their work on these topics. Thus, the lack of knowledge on mechanisms of informant discrepancies, as well as the lack of sustained efforts to address these topics, really caught my attention. Along the way, perhaps the most valuable lesson I have learned is that great science involves a careful triangulation of your intrinsic excitement about what you study, the importance of the topics you address, and a strong sense that if you do not carry out your research program, no one else will.
Who were/are your mentors or scientific influences?
Much of what our laboratory has accomplished could not have been carried out without the guidance and support of many brilliant scientists. I learned that I wanted to pursue a research career from the mentorship of Wendy Silverman and her students, namely Steven Berman, Armando Pina, Lissette Saavedra, and Claudio Ortiz. In graduate school, Alan Kazdin and Mitch Prinstein taught me to think like a scientist. Many colleagues at the University of Maryland, College Park (UMCP), have provided an endless amount of support and taught me much about how to train my own students, including Carl Lejuez, Jack Blanchard, Michele Gelfand, Laura MacPherson, Andrea Chronis-Tuscano, Tom Wallsten, Luiz Pessoa, and Karen O’Brien. I also have a network of colleagues outside of UMCP who make our laboratory’s work possible. This is a fairly expansive network that includes Kimberly Goodman, Matthew Nock, Deborah Beidel, Candice Alfano, Eric Youngstrom, Mo Wang, Amelia Aldao, and Jessecae Marsh.
What’s your future research agenda?
Currently, I find clinical psychology to be headed in exciting directions with the advent of the research domain criteria or RDoC. The RDoC is a research initiative recently launched by the National Institute of Mental Health that represents a shift away from understanding mental illness from a categorical, diagnostic perspective. Instead, RDoC emphasizes dimensional perspectives on mental illness that seek to illuminate processes or pathways to mental illness. The hope is that research guided by RDoC will equip clinical psychologists with knowledge on the “active ingredients” or specific mechanisms of mental illness. If successful, the result will be the development of more potent, effective therapies targeting these mechanisms of mental illness. However, a key challenge with translating this work into improvements in patient care is that the RDoC approach emphasizes understanding mental illness from the perspective of measurement units for which clinical psychologists rarely implement in clinic settings, such as methods for directly assessing cardiovascular and brain functioning. To this end, our laboratory is working toward developing clinical assessment paradigms that effectively integrate these measurements within applied research and clinic settings.
What publication are you most proud of?
De Los Reyes, A., Thomas, S. A., Goodman, K. L., & Kundey, S. M. A. (2013). Principles underlying the use of multiple informants’ reports. Annual Review of Clinical Psychology, 9. Advance online publication. doi: 10.1146/annurev-clinpsy-050212-185617
I am most proud of a paper our laboratory just published, representing the culmination of a decade’s worth of research and theory on use of multi-informant assessment approaches in clinical psychology. I began work on this paper in graduate school. Thankfully, initial versions of the paper were rejected for publication. Over time, colleagues with whom I very much enjoy collaborating joined me on this paper’s journey to publication. My colleagues (and of course, the notices of rejection I received from journals!) forced me to think deeply, collect more data, and improve upon the theoretical framework elaborated upon in the paper. We designed the theoretical framework described in the paper to give researchers and practitioners a guide for planning for inconsistencies among informants’ reports in both research and practice settings, along with a rubric for interpreting these inconsistencies when they arise. Basically, the goal of our lab is to reduce the uncertainty that mental health care professionals encounter when they ask multiple informants the same questions, but they get different responses depending on who they ask. My hope is that with this paper, we have paved the road that leads us to our goal.
Leave a comment below and continue the conversation.