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Research at The Menninger Clinic ^®

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 frequently publish in peer-reviewed journals, write books and book chapters and present research nationally and internationally.

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, the National Institutes of Health/National Institute of Mental Health, NIH/National Institute on Drug Abuse, National Science Foundation, American Foundation for Suicide Prevention, and Substance Abuse and Mental Health Services Administration, while the Research department is led by Michelle Patriquin, PhD, ABPP.

Summer Research Fellowship for Undergraduates

In addition to research projects, the Research team offers a paid summer research fellowship to help undergraduates develop a better understanding of clinical 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/.

Clinical Trial for Adults with Opioid Use Disorder

The Menninger Clinic and Baylor College of Medicine are studying brain function changes before and after non-invasive brain stimulation for adults with opioid use disorder. The purpose of the study is to examine the efficacy of rTMS in treating opioid use disorder.

The study participant cannot currently be taking medication treatment for opioid use, including methadone, buprenorphine or Naltrexone. However, prior history of medication treatment may not exclude participation in the study.

Participants receive $20 for each transcranial magnetic stimulation (rTMS) session at The Menninger Clinic — up to 5 sessions — and $25 for each of the two brain neuroimaging sessions at Baylor College of Medicine.

The clinical research study is funded by a grant from the National Institutes on Drug Abuse.

For more information, contact the principal investigator, Hyuntaek Oh, PhD, research scientist at The Menninger Clinic and assistant professor at Baylor College of Medicine.

Research Publications

Recently published peer-reviewed papers by Menninger researchers include:

The state of (mis)trust: Human-centered technology development and implementation in intensive mental health settings. Smith, R., Oh, H, Khan, R., Meltzer, G., Boland, R. and others. Journal of Affective Disorders.
When inblot imitates life: a case study of Rorschach content analysis. Rucker, J. Rorschachiana.
Assessing criterion A of the alternative model for personality disorders: the potential of performance-based personality measures. Rucker, J., Berry, B., and others. Journal of Personality Disorders.
Digital navigator training to increase access to mental health care in community-based organizations. Patriquin, M., Boyd, C., and others. Psychiatric Services.
Difficulties in emotion regulation moderates the relationship between mood symptoms and nightmares in an inpatient psychiatric sample. Rufino, K., Patriquin, M., and others. Journal of Affective Disorders.
Examination of reward processing dysfunctions in the left dorsal striatum and other brain regions among psychiatric inpatients with substance use. Myerson, J., Rufino, K., Patriquin, M., Salas, R., Oh, H. and others. Drug and Alcohol Dependence.
miR-124-3p target genes identify globus pallidus role in suicide ideation recovery in borderline personality disorder. Patriquin, M., Salas, R. and others. NPJ Mental Health Research.
Relationship between parental attachment styles and suicide in adolescents and adults admitted to an inpatient psychiatric hospital. Myerson, J., Thomas, J., Rufino, K., Noor, N., and Patriquin, M. Journal of Affective Disorders.
Volume of subcortical brain regions in social anxiety disorder: mega-analytic results from 37 samples in the ENIGMA-Anxiety Working Group. Salas, R., Oh, H., and others. Molecular Psychiatry.
A next-generation approach to mental health outcomes: treatment, time and trajectories. Montelongo, M., Poa, E., Boland, R., Rufino, K., Patriquin, M., Oh, H., and others. Journal of Psychiatric Research.
A false sense of security: Rapid improvement as a red flag for death by suicide. Rufino, K., Poa, E., Boland, R., Patriquin, M. and others. Journal of Consulting and Clinical Psychology.
Inpatient psychiatric care for children and adolescents: Increasing the integration of service and science. Patriquin, M. and others. Evidence-based Practice in Child and Adolescent Mental Health.
Turning data into better mental health: Past, present and future. Salas, R. and others. Frontiers in Digital Health.
Increased symptom severity in adults and adolescents admitting to an inpatient psychiatric hospital during the COVID-19 pandemic. Patriquin, M., Rufino, K., Poa, E., Rech, M. and others. Psychiatry Research.
Decreased brain ventricular volume in psychiatric inpatients with serotonin reuptake inhibitor treatment. Salas, R. and others. Chronic Stress.
Impact of personality dysfunction on interdisciplinary treatment team working alliance in an inpatient psychiatric population. Noor, N., Patriquin, M., Rufino, K. and others. Personality Disorder: Theory, Research and Treatment.
A novel approach to link genetics and human MRI identifies AKAP7-dependent subicular/prefrontal functional connectivity as altered in suicidality. Salas, R., Patriquin, M. and others. Chronic Stress.
An integrated phenotypic and genotypic approach reveals a high-risk subtype association for EBF3 missense variants affecting the zinc finger domain. LeMaire, A. and others. Annals of Neurology.
"All the different pieces of me being integrated:" Religion/spirituality and identity in working Christian mothers. Laney, E. and others. Journal of Psychology and Theology.
Nighttime sleep quality and daytime sleepiness predict suicide risk in adults admitted to an inpatient psychiatric hospital. Shephard, C., Rufino, K., Tran, T., Patriquin, M. and others. Behavioral Sleep Medicine.
Reward processing in psychiatric inpatients with depression. Oh, H., Patriquin, M., Salas, R. and others. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging.
Crisis preparedness in acute and intensive treatment settings: lessons learned from a year of COVID-19. Patriquin, M. and others. Journal of the American Academy of Child and Adolescent Psychiatry.
Predicting suicide attempt history in a psychiatric inpatient sample: a replication and extension. Rufino, K. and others. Psychological Assessment.
Underreporting on the MMPI-2-RF extends to extra-test measures of suicide risk. Rufino, K. and others. Psychological Assessment.
Geospatial identification of high youth suicide risk areas via eletronic health records: avenues for research and prevention efforts. Rufino, K. and others. Suicide and Life-threatening Behavior.
Evolution of genetic networks for human creativity. Salas, R. and others. Molecular Psychiatry.
Wearable technology: a promising opportunity to improve inpatient psychiatry safety and outcomes. Johnson, C., Rufino, K., Colombo. A., Patriquin, M. and others. Journal of Psychiatric Research.
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., 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., Patriquin, M. and colleagues. Journal of Psychiatric Research.
Nightmares in adult psychiatric inpatients with and without interpersonal trauma. Wiltgen, A., Rufino, K., Patriquin, M. and colleague. Dreaming.
Subcortical brain morphometry of avoidant personality disorder. 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., 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 others. 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 others. 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.

Subscribe to the Bulletin.