We’re actively engaged in a variety of research projects
designed to advance our understanding of mental illness and its effective treatment.
Our researchers participate in various studies, including biologically-based research to better understand mechanisms of mental illness, translational studies to utilize these markers to improve the measurement and efficacy of treatment and the development of novel treatments and technologies for improving patient care.
We enjoy collaborating with other researchers, including those at Baylor College of Medicine, the Texas Medical Center (TMC), TMC Innovation, University of Houston, Texas Tech, Stanford University, Virginia Tech, McLean/Harvard, Washington University and University College London.
Our research is funded by individual donors
, private foundations and the National Institute of Mental Health, while our department is led by Michelle Patriquin
, PhD, ABPP, director of Research.
Current Research Projects
Menninger is involved in a number of research projects designed to advance the field of mental health as well as improve the treatment offered at The Clinic:
Hospital-wide Outcomes Project
Principal investigator: Michelle Patriquin, PhD, ABPP
All adults and adolescents admitted to Menninger are invited to participate in this project, which evaluates clinical status during the course of their hospitalization and after discharge.
Participating patients are administered structured psychiatric interviews (SCID-5, SCID-5-PD, K-SADS) at admission, as well as a weekly battery of self-report tests that provide data on clinical symptoms, level of functioning, interpersonal relationships and treatment progress and process (working relationships with treatment team members and treatment engagement).
We have also recently added our first task-based measure to examine changes in attention, memory and processing speed that are seen after treatment. This measure, the NIH Toolbox
, is a validated iPad application.
In addition to our measures while hospitaized, patients are asked to complete a similar battery of self-report measures two weeks after discharge, as well as 3-months, 6-months and 12-months post discharge. Nearly 4,000 patients have participated in the study since it began in 2008.
Neuromodulation for Cognitive Control Impairments in Schizophrenia
Principal investigator: Raymond Cho, MD, MSc
Cognitive deficits are a strong predictor of functional outcome in schizophrenia, yet poorly remediated by current treatments. Disturbances in dorsolateral prefrontal cortex (DLPFC) function underlie core impairments such as in cognitive control and thus represent a critical target for novel therapeutics.
Initial studies indicate transcranial direct-current stimulation (tDCS) may be effective in reducing symptoms due to DLPFC dysfunction. While tDCS potentially represents an exciting, novel therapeutic advance, a number of basic questions should be addressed prior to conducting larger-scale clinical trials, including: verifying therapeutic target engagement, optimizing treatment parameters, and evaluating for meaningful clinical effects.
We are currently enrolling individuals with schizophrenia for this project.
Developing a Predictive Model of Suicidial Behavior
Principal investigator: Katrina Rufino, PhD
As death by suicide has increased 24 percent during the past 15 years, it is critical to more precisely predict suicide risk and to develop new interventions that dramatically reduce this alarming health trend.
Menninger’s specialization in treating those with complex, treatment-resistant mental disorders, and our extended hospitalization stay of four to eight weeks, offers an ideal setting to pioneer efforts in understanding, predicting and effectively treating suicidality.
We are currently recently running computational analyses of patients’ suicide data to determine a more refined predictive model of suicidal behavior, ensuring patients receive the most effective treatment faster.
A New Sleep Treatment for Inpatient Psychiatry
Principal investigator: Michelle Patriquin, PhD, ABPP
Suicide rates continue to rise in the U.S. and indicate a public health crisis. Inpatient psychiatry clinics are one of the primary locations to treat patients who have thoughts of suicide or have attempted suicide.
Often individuals who have thoughts of suicide or attempt suicide also have sleep problems. Prior scientific findings have supported that when interventions improve sleep, thoughts of suicide decrease.
Our current study is adapting a previously tested therapy manual, cognitive-behavioral insomnia therapy (CBTI), for inpatient psychiatry – cognitive behavioral insomnia therapy for inpatient psychiatry (CBTI-IP) - including Menninger. The short-term goal of this study is to develop a new CBTI-IP clinician manual and a CBTI-IP workshop for clinical staff with a CBTI-IP clinical staff manual.
This study will test how well CBTI-IP improves patient’s sleep and if suicidial thoughts and suicide attempts are reduced. The long-term goal of this study is to save lives by creating a new, effective treatment for improving sleep and reducing suicide.
McNair Initiative for Neuroscience Discovery-Menninger & Baylor College of Medicine (MIND-MB)
Principal investigator: Ramiro Salas, PhD
MIND-MB is a comprehensive, five-year neuroscience research study designed to improve the identification of anatomical, physiological and genetic abnormalities and risk factors of mental illnesses. The research aims to increase understanding of mental disease progression and factors that impact treatment outcomes
This study has created a databank of adult and adolescent brain scans, genetic samples and assessments from approximately adult and adolescent psychiatric patients suffering from multiple mental illnesses.
Participating patients underwent magnetic resonance imaging (MRI) as well as functional MRI (fMRI), which allows researchers to analyze the brain’s regions and neuronal connectivity during brain activity. Diffusion tensor imaging (DTI) was also conducted to analyze the nerve pathways in the brain.
A subset of Menninger patients were rescanned approximately 21 days after the initial brain scans are taken, once comprehensive treatment is well underway. This comparison, using the fMRI, allows researchers to see the difference in brain activity after a standard length of treatment has been completed.
The data collection for this project is now complete. Please see our publications regarding new research from this study.
ProcessGeneList: An Approach to Brain Imaging and Genetics Conjoint Analysis
Principal investigator: Ramiro Salas, PhD
Although genetics play an important role in psychiatry, little is known about how gene variants affect brain function to, in turn, influence risk for psychiatric illness.
A major reason why progress is so slow in this field is that the fields of genetics and human brain imaging tend to work in isolation. We developed a novel approach, ProcessGenesList (PGL), to study genetics and brain imaging data in conjunction.
In PGL, a list of genes known or hypothesized to be associated with a certain phenotype (for example, suicidality) is analyzed: Using the Allen Brain Atlas
, we look for brain regions in which the genes in the list are significantly more coexpressed. These regions become a-priori hypotheses for human brain imaging studies.
PGL allows researchers to create brain region hypotheses for specific phenotypes. This helps by allowing us to study only a few brain regions instead of the whole brain, which decreases the problem of multiple comparisons.
A manuscript about PGL approach is currently under review. Test a beta version of the approach (i.e. inputting a list of genes and receiving a list of brain regions where co-expression is highest) here: http://guilleai.ddns.net:3838/pgl/
Recently published peer-reviewed papers by Menninger researchers include:
Wearable technology: a promising opportunity to improve inpatient psychiatry safety and outcomes. Johnson, C., Rufino, K., Colombo. A., Patriquin, M. and others.
Sleep disturbance in patients in an inpatient hospital mediates relationship between PTSD and suicidal ideation. Rohr, J., Rufino, K., Patriquin, M. and others. Journal of Psychiatric Research.
Suicide ideation and attempts in a pediatric emergency department before and during COVID-19. Rufino, K. and others. Pediatrics.
Cingulate cortex structural alterations in substance use disorder psychiatric inpatients. Oh, H., Tran, T., Salas, R. and others. The American Journal on Addictions.
Emotion regulation difficulties are associated with nightmares and suicide attempts in an adult psychiatric inpatient sample. Rufino, K. and colleagues. Psychiatry Research.
Time in treatment: Examining mental illness trajectories across inpatient psychiatric treatment. Oh, H., Rufino, K., Fonagy, P., Oldham, J., Patriquin, M. and colleagues. Journal of Psychiatric Research.
Nightmares in adult psychiatric inpatients with and without interpersonal trauma. Wiltgen, A., Rufino, K., Paddock, K., Patriquin, M. and colleague. Dreaming.
Subcortical brain morphometry of avoidant personality disorder. Oldham, J., Patriquin, M., Salas, R. and others. Journal of Affective Disorders.
Objective measurement of sleep, heart rate, heart rate variability, and physical activity in suicidality: A systematic review. Patriquin, M., Oh, H., Rufino, K., Salas, R. and others. Journal of Affective Disorders.
Orbitofrontal, dorsal striatum, and habenula functional connectivity in psychiatric patients with substance use problems. Oh, H., Salas, R., Patriquin, M. and others. Addictive Behaviors.
Process genes list: An approach to link genetics and human brain imaging. Salas, R., Patriquin, M. and others. Journal of Neuroscience Methods.
- Q-15 checks and 1:1 observations: Are we exacerbating a problem we're trying to solve? Gazor, A., Patriquin, M. and others. Journal of Affective Disorders.
- Autonomic response in autism spectrum disorder: relationship to social and cognitive functioning. Patriquin, M. and others. Biological Psychology.
- Do psychopathic birds of a feather flock together? Psychopathic personality traits and romantic preferences. Rohr, J. and others. Journal of Personality.
- Resting-state functional connectivity of the habenula in mood disorder patients with and without suicide-related behaviors. Patriquin, M. and others. Journal of Neuropsychiatry and Clinical Sciences.
- Trajectories of self-reported sleep disturbance across inpatient psychiatric treatment predict clinical outcome in comorbid major depressive disorder and generalized anxiety disorder. Rufino, K., Shephard, C. Patriquin, M. Journal of Affective Disorders.
- Association of TPH1 and serotonin transporter genotypes with treatment response for suicidal ideation: a preliminary study. Patriquin, M., Oldham, J. and Salas, R. European Archives of Psychiatry and Clinical Neuroscience.
- Further evidence that suicide risk is categorical: A taxometric analysis of data from an inpatient sample. Rufino, K. and others. Psychological Assessment.
- Negative Reactions of Therapists Working with Suicidal Patients: a CBT/Mindfulness Perspective on “Countertransference.” Rufino, K. and others. International Journal of Cognitive Therapy.
- Treatment of Nightmares in Psychiatric Inpatients With Imagery Rehearsal Therapy: An Open Trial and Case Series. Rufino, K. and others. Behavioral Sleep Medicine.
- Body dissatisfaction and suicidal ideation among psychiatric inpatients with eating disorders. Rufino, K. and Patriquin, M. Comprehensive Psychiatry.
- Clinical utility of the DSM-5 alternative model for borderline personality disorder: Differential diagnostic accuracy of the BFI, SCID-II-PQ, and PID-5. Patriquin, M. and Oldham, J. Comprehensive Psychiatry.
- Amygdala-frontal connectivity predicts internalizing symptom recovery among inpatient adolescents. Patriquin, M. and Salas, R. Journal of Affective Disorders.
- Increased habenular connectivity in opioid users is associated with an α5 subunit nicotinic receptor genetic variant. Patriquin, M. and Salas, R. American Journal on Addictions.
- Genetic moderation of cocaine subjective effects by variation in the TPH1, TPH2, and SLC6A4 serotonin genes. Patriquin, M. and others. Psychiatric Genetics.
- Parent-Reported Problematic Sleep Behaviors in Children with Comorbid Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder. Patriquin, M. and others. Research in Autism Spectrum Disorders.
- Insula and amygdala resting-state functional connectivity differentiate bipolar from unipolar depression. Patriquin, M. and Salas, R. Acta psychiatrica Scandinavica.
- Incremental validity of the PID-5 in relation to the five factor model and traditional polythetic personality criteria of the DSM-5. Patriquin, M. and Oldham, J. International Journal of Methods in Psychiatric Research.
- Emotional rigidity negatively impacts remission from anxiety and recovery of well-being. Wiltgen, A., Shepard, C., Smith, R. and others. Journal of Affective Disorders.
- A novel approach to identifying a neuroimaging biomarker for patients with serious mental illness. Patriquin, M. and others. Journal of Neuropsychiatry and Clinical Neuroscience.
- The neurobiological mechanisms of generalized anxiety disorder and chronic stress. Patriquin, M. and colleague. Chronic Stress.
- A controlled comparison trial of the Collaborative Assessment and Management of Suicidality (CAMS) in an inpatient setting: Outcomes at discharge and six-month follow-up. Rufino, K. and others. Psychiatry Research.
- Treatment outcomes for inpatients with obsessive-compulsive personality disorder: An open comparison trial. Smith, R., Shepard, C., Wiltgen, A., and Rufino, K. Journal of Affective Disorders.
Bulletin of the Menninger Clinic
Founded in 1936, the Bulletin of the Menninger Clinic is a peer-reviewed journal that has published papers on a variety of psychiatry and psychology topics. Edited by Eric Storch
, PhD, vice chair of Psychiatry at Baylor College of Medicine, and published by Guilford Press, its primary focus now is psychopathology research.
Meet Our Researchers