Pediatric Intervention Research in Affect Dysregulation
and Mood Disorders (PIRAMD) Director: Amy West, PhD

The PIRAMD lab’s overarching mission is to develop and test psychosocial interventions for children and adolescents at-risk for or suffering from mood disorders. The primary goal of these interventions is to address the psychosocial and interpersonal impairments that are often associated with symptoms of mood disorders. We have several ongoing research projects related to identifying risk factors for poor outcomes, testing the efficacy of psychosocial interventions, and working with high-risk community populations.

Key Findings

  • Child and family-focused cognitive-behavioral therapy (RAINBOW therapy) is a psychosocial treatment model that combines CBT and psychoeducation into an intensive manual-based family-focused therapy. Preliminary results demonstrate that it is feasible, acceptable and shows promise for efficacy in treating children 8-12 and their families (West & Pavuluri, 2009).
  • A maintenance model of CFF-CBT consisting of ongoing medication management and psychosocial booster sessions may help sustain initial treatment results and facilitate long-term management of the disorder (West & Pavuluri, 2007).
  • An adaptation of CFF-CBT RAINBOW therapy into group treatment format demonstrates promise in reducing manic symptoms and in improving children’s psychosocial functioning (West, Jacobs, Westerholm, Lee, Carbray, Heidenreich, & Pavuluri, 2009).
  • Children with bipolar disorder evidence difficult temperament styles in infancy and childhood, styles that differentiate them from children with ADHD and health controls. Difficult premorbid temperament characteristics may be a specific indicator of bipolar diathesis, or might signal underlying dysfunction in affective processes that significantly increase risk for mood disorder (West, Schenkel, & Pavuluri, 2008)
  • The Child Mania Rating Scale (CMRS), developed in our program, is a valid and sensitive measure for assessing symptom change over the course of treatment (West, Celio, Henry, & Pavuluri, (in press).
  • Certain clinical risk factors at baseline among PBD youth are associated with different trajectories of treatment response (i.e., different rates of change or differential response to medications). Higher levels of clinical risk at baseline were associated with poorer global functioning outcomes (West, Weinstein, & Pavuluri, in preparation).