Focus on Technology
5:31 am
Fri January 18, 2013

Identifying and treating violent teens

Part of the President’s plan to reduce gun violence focuses on increased mental health services. Ann Thompson, in “Focus on Technology,” reports on Cincinnati efforts to be pro-active, involving a predictive spit test and photographing the brain.

 Dr. Jim Eliassen stands behinds glass at the University of Cincinnati Center for Imaging Research. 

“So this is the console or control room for the magnetic imaging system. So, if you were to get a clinical MRI this is where the MR tech would sit, would talk to you and review the images.”

Soon he and others will begin recruiting for a study to figure out which parts of the brain light up when potentially violent teens get frustrated.  

Nat sound of MRI (up full and then fade)

While in the machine and wearing goggles, the teens will play a video game designed to get them annoyed. The MRI will take pictures of the brain while they play. Eliassen says researchers don’t yet know the brain problem areas when it comes to mental illness.

“The hope is that once we know what the brain areas that are participating in the problem behaviors, maybe we’ll be able to identify medications or identify therapies that can be used to change the way the brain areas respond to these situations.”

Lately, police and the public have been thinking a lot about mental illness and violence. Last month 26 people were killed in Connecticut when Adam Lanza went on a shooting spree. In July James Holms walked into an Auro, Colorado movie theater killing 12 and injuring 58 others. Cincinnati Children’s Hospital psychiatrist Drew Barzman says his research involving the MRI and a separate spit test are not yet ready to be used outside the hospital.

“Our research hasn’t focused on school violence at this point. It’s focused on violence and aggression within the hospital. So we’re far from saying we can use this research to apply it to those very rare events.”

Hospital violence is a big problem. The Bureau of Labor Statistics says mental health professionals are seven times more likely to suffer assault-related injuries than the average US worker. Over the years Barzman’s developed a predictive scale. It’s used in the Children’s emergency department. Then later, once the patient is admitted, Barzman collects data on the type, severity and frequency of their aggression. He has information on 25-hundred kids. He says it’s most useful on ages 13-19.

A new test involves using spit to predict aggression. Kacey Appel is getting her PhD in epidemiology and helps collect the saliva at Children’s Hospital. Three times during the day she tells the kids to drool.

“I would sometimes have two boys at the same time and they would have a contest to see if they could fill up the spit to the line first.”

It’s then frozen to test the hormone levels. Barzman is looking for testosterone and cortisol in pre-teen boys.

“We didn’t expect the scale to perform as well as it did, but it was almost 100-percent accurate, even though it shouldn’t have been.”

Appel really liked the willingness of the patients and their parents to participate.

“All of them were so excited to spit in a tube or be part of something that just wasn’t part of their daily routine. All the parents were just ecstatic to have their kids in the study, anything that could help figure out what is going on with their kids.”

Barzman will combine the salivary hormone and fMRI tests to better understand the underlying path in the brain correlated with aggression and abnormal hormone levels. The goal is a rapid, real-time assessment where hospitals, detention centers, schools and pediatricians could eventually predict aggressive behavior on the spot and then be able to refer the teen to mental health professionals for the right preventative treatment.