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Rocky Mountain MIRECC for VA Suicide Prevention - Erin C. McGlade PhD
Updated: 9 September 2016
- Erin C. McGlade, PhD
- Co-director of the VA Advanced Fellowship Program in Mental Illness in the Salt Lake City MIRECC
- MIRECC Investigator
- Dr. Erin McGlade received her PhD in Clinical Psychology from Idaho State University and completed a pre-doctoral internship and a post-doctoral residency at the University of Utah Neuropsychiatric Institute. Her clinical training was with adolescents and adults diagnosed with serious psychiatric disorders and suicidal ideation, areas of clinical interest she has carried forward in her work at the VA.
- Dr. McGlade is a licensed clinical psychologist and a MIRECC investigator. She is interested in studying neural mechanisms of symptoms in co-morbid disorders, particularly the relationship between depressive symptoms and co-morbid PTSD and TBI. Her current studies focus on veterans with suicide risk with and without a history of depression. Dr. McGlade is Co-Director of the Advanced Fellowship in Mental Illness Research and Treatment at the Salt Lake City MIRECC and has been instrumental in developing curriculum for the new fellowship program.
- McGlade E, Bakian A, Coon H, Yurgelun-Todd D, Callor WB, Byrd J, Gray D. Male suspected suicide decedents in Utah: A comparison of Veterans and nonveterans. Compr Psychiatry. 2016 Aug;69:1-10. doi: 10.1016/j.comppsych.2016.04.014. Epub 2016 Apr 28.
- There has been significant debate regarding suicide risk in Veterans compared to nonveterans. However, few studies have examined similarities and differences between Veteran and nonveteran suicide decedents using a combination of next of kin psychological autopsy and data from a state Office of the Medical Examiner (OME). For the current study, next of kin of a one-year cohort of male suspected suicide decedents in Utah completed psychological autopsy interviews with trained research staff. Next of kin of 70 Veterans and 356 nonveterans completed the interviews, which included demographic, behavioral, psychosocial, and clinical variables. The psychological autopsy data then were combined with OME data for the presented analyses. Results showed that Veteran and nonveteran suicide decedents differed on multiple factors, including age at death. Specifically, male nonveteran suicide decedents were younger at age of death compared to Utah Veterans and to a national sample. Veteran decedents also were more likely to have a history of suicide attempts and more likely to have access to firearms compared to nonveterans. Other between-group differences, including Veterans being more likely to have lived alone and method of death (e.g., gunshot, hanging, etc.), were no longer statistically significant after adjustment for age at death. CONCLUSIONS: these findings have significant clinical and practical importance, as they highlight the risk for suicide in younger nonveterans and older Veterans in Utah.
- Keywords: Suicide Prevention
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- Lopez-Larson, M. P., Bogorodzki, P., Rogowska, J., McGlade, E., King, J. B., Terry, J., & Yurgelun-Todd, D. (2011). Altered prefrontal and insular cortical thickness in adolescent marijuana users. Behavioral Brain Research, 220(1), 164-172.
- INTRODUCTION: There are limited data regarding the impact of marijuana (MJ) on cortical development during adolescence. Adolescence is a period of substantial brain maturation and cortical thickness abnormalities may be indicative of disruptions of normal cortical development. This investigation applied cortical-surface based techniques to compare cortical thickness measures in MJ using adolescents compared to non-using controls. METHODS: Eighteen adolescents with heavy MJ use and 18 non-using controls similar in age received MRI scans using a 3T Siemens scanner. Cortical reconstruction and volumetric segmentation was performed with FreeSurfer. Group differences in cortical thickness were assessed using statistical difference maps covarying for age and gender. RESULTS: Compared to non-users, MJ users had decreased cortical thickness in right caudal middle frontal, bilateral insula and bilateral superior frontal cortices. Marijuana users had increased cortical thickness in the bilateral lingual, right superior temporal, right inferior parietal and left paracentral regions. In the MJ users, negative correlations were found between frontal and lingual regions for urinary cannabinoid levels and between age of onset of use and the right superior frontal gyrus. CONCLUSION: This is one of the first studies to evaluate cortical thickness in a group of adolescents with heavy MJ use compared to non-users. Our findings are consistent with prior studies that documented abnormalities in prefrontal and insular regions. Our results suggest that age of regular use may be associated with altered prefrontal cortical gray matter development in adolescents. Furthermore, reduced insular cortical thickness may be a biological marker for increased risk of substance dependence.
- Keywords: Brain & Biology, Substance Use Disorders (SUD)
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- Yurgelun-Todd, D.A., Bueler, C. E., McGlade, E., Churchwell, J., Brenner, L.A., & Lopez-Larson, M. (2011). Neuroimaging correlates of traumatic brain injury and suicidal behavior. Journal of Head Trauma Rehabilitation, 26(4), 276-289.
- INTRODUCTION: There is an urgent need to define the neurobiological and cognitive underpinnings of suicidal ideation and behavior in veterans with traumatic brain injury (TBI). Separate studies implicate frontal white matter systems in the pathophysiology of TBI, suicidality, and impulsivity. We examined the relationship between the integrity of major frontal white matter (WM) systems on measures of impulsivity and suicidality in veterans with TBI. METHODS: Fifteen male veterans with TBI and 17 matched healthy controls (HC) received clinical ratings, measures of impulsivity and MRI scans on a 3T magnet. Diffusion tensor imaging (DTI) data for the genu and cingulum were analyzed using Freesurfer and FSL. Correlations were performed for fractional anisotropy (FA) (DTI) values and measures of suicidality and impulsivity for veterans with TBI. RESULTS: Significantly decreased in FA values in the left cingulum (P = 0.02), and left (P = 0.02) and total genu (P = 0.01) were observed in the TBI group relative to controls. Measures of impulsivity were significantly greater for the TBI group and total and right cingulum FA positively correlated with current suicidal ideation and measures of impulsivity (P <0.03). CONCLUSION: These data demonstrate a significant reduction in FA in frontal WM tracts in veterans with mild TBI that was associated with both impulsivity and suicidality. These findings may reflect a neurobiological vulnerability to suicidal risk related to white matter microstructure.
- Keywords: Brain & Biology, Suicide Prevention, Traumatic Brain Injury (TBI)
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