I have conducted extensive research combining clinical, neurophysiological, pharmacological, and human laboratory strategies to understand roles of impulsivity and catecholamine function in addictive disorders, cluster B personality disorders, and all phases of bipolar disorder, including the role of impulsivity in interactions between bipolar and addictive disorders and in suicidal behavior. These studies focus on early information processing and the balance between initiation and inhibition of action. We have shown that early, pre-attentive responses to stimuli are related to impulsive behavior and impaired response inhibition, with potential consequences including medically severe suicidal attempts. Catecholamine system function, interacting with glutamatergic and peptidergic systems, has a strong role in these phenomena. I also participated in a case control study of medically severe suicide attempts, funded by the Centers for Disease Control and National Institute on Alcohol Abuse and Alcoholism, where we studied potentially lethal impulsive and non-impulsive suicide attempts. I have carried out substantial research with lithium, including its effects on catecholamine systems in bipolar disorder and in animal models, its effects on behavior, and its pharmacology. Human behavioral research has also focused on mechanisms by which depression combines with pathological activation, an important mechanism in suicide risk. My work in animals has focused on mechanisms of behavioral sensitization that appear to link catecholamine function to development of exaggerated behavioral responses to endogenous or exogenous rewards or stressors.
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