Neuropsychology
Leader
Associate Professor Warrick Brewer
Members
Dr Kelly Allott, Mr John Dileo
Overview
Neuropsychology is undergoing an important transformation in adapting to the challenges of youth psychiatry. Our group has actively been promoting the evolution of understanding that is required to address the highly dynamic adolescent maturational phase of prefrontal neural connectivity. This involves shifting the focus from more traditional ‘bottom-up’ medical models towards ‘top-down’ frameworks that can more usefully incorporate an understanding of the significant impact of early factors such as cognitive developmental deficits, instability of the emotional environment, abuse, and the consequent impact upon dysfunctional schema formation and associated vulnerability for substance abuse. These are all potential key risk indicators for psychopathology.
With our collaborators, we have been actively mapping the emotional and psychological vulnerabilities and relating them to functional and structural imaging deficits that emerge in neurodevelopmental disorders compared to the phase of normal instability that characterises adolescence. Our methods have particular relevance for OYH clients as we provide management plans that map the relative weighting of their developmental trajectories into emerging psychopathology across biological, cognitive, personality and social learning domains. A/Prof Brewer has been trialling ongoing clinical interventions with those disengaged EPPIC clients ranked at highest risk for aggression. Moreover, utilisation of olfactory and cognitive markers for risk of violence has been a further focus of research. Dr. Allott’s research focus includes characterising cognitive dysfunction and its relationship to functional outcome in early psychosis and interventions for rehabilitation of cognitive deficit in early psychosis, which a view to improving functional outcomes in this cohort.
A general focus for our clinical intervention and for our related research involves mapping disorders in cognition and of emotion regulation for the primary purpose of clients regaining optimum control. A key research focus concerns identification of those who have experienced developmental arrest of prefrontal neural function relative to those who are more compromised in their psychological (cognitive) or environmental (family) function, with particular emphasis on olfactory identification deficits as a proxy measure of disrupted affect regulation capacity. Mr. Dileo’s work focuses on mapping physiological, cognitive and emotional risk factors for violence and aggression in a high risk cohort of children who have endured significant compromise of family attachments and multiple foster placements in the first two years of their life.
This hybrid clinical-research unit has fostered collaborations with the Cognitive Neuropsychiatry Research & Academic Unit, The University of Melbourne, the Department of Psychiatry at the Austin Hospital, the Brain Research Institute at the Heidelberg Repatriation Hospital, the Monash Medical Centre/School of Behavioral Science, the Royal Children’s Hospital, the Murdoch Children’s Research Institute, and University of Pennsylvania Taste and Smell laboratory. Finally, the Neuropsychology Unit is conducting olfactory and/or cognition collaborations with each OYHRC research team. The unit model has been highly successful in managing leadership of neuropsychology within youth psychiatry in terms of clinical placement and research supervision, teaching load, number of publications, and research grants.