Deborah R. Medoff, PhD

1981       Bachelors of Arts, Psychology, University of Virginia, (With High Distinction) 

1984        Masters of Arts, Social Psychology, University of Maryland, College Park 

1989       Doctor of Philosophy, Quantitative Psychology, University of Maryland, College Park. Thesis: The effects of                          model misspecification on the success of model modification procedures in covariance structure analysis.

EDUCATION/TRAINING (Begin with baccalaureate or other initial professional education, such as nursing, include postdoctoral training and residency training if applicable.)

A. Personal Statement

I direct the Biostatistics Core in the Division of Mental Health Services Research at the University of Maryland and at the VISN 5 MIRECC. I have a broad background in serious mental illness with specific training and expertise in research methodology, measurement and statistics. I have been co-Investigator, evaluator and statistician on numerous VA and NIH-funded grants that focus on meeting the needs of people with serious mental illness through the analysis of administrative data and clinical trials.  For each project, I have assisted in the design of the studies; supervised data management; designed, supervised and interpreted the statistical analyses; and collaborated in the writing of manuscripts. I have worked with Dr. Kiser on numerous projects over the past 15 years. In the context of the current R01 proposal, I will provide ongoing methodological consultation and supervision of quantitative data analyses.  I enthusiastically support this important work that has the potential to address important screening for psychosocial risk in families with pediatric injury and critical time interventions matched to the level of risk are central to improving family-centered, trauma-responsive care and ultimately, psychosocial and health outcomes for this population.

B. Positions

Positions and Employment

Other Experience and Professional Memberships

C. Contribution to Science

1. Methods for the Analysis of Administrative Data Records

Records of prescriptions that can be obtained from insurance records provide a broad view of the prescribing practices and medication adherence that complement the more detailed information that can be collected in RCTs. However, there are limitations and challenges to using this data. Our center has worked extensively investigating the prescribing practices related treatments for serious mental illness. When the CATIE study suggested that the time to discontinuation of antipsychotics was less than 6 months for most participants, we felt it may have been the conditions of a research study that led to those short times. Therefore, we investigated the time to discontinuation in a large VA data set. Despite the limitations of the administrative dataset, we confirmed the CATIE findings. We have also been able to investigate possible biases in prescribing patterns across a number of factors. My contribution has been to develop methods to manage the non-independence of prescriptions within individuals and within treatment epochs. In addition, I have investigated algorithms to determine when a treatment epoch has started and stopped and the bias inherent in different sets of rules.

1. Kreyenbuhl J, Leith J, Medoff DR, Fang L, Dickerson FB, Brown CH, Goldberg RW, Potts W, Dixon LB. A comparison of adherence to hypoglycemic medications between Type 2 diabetes patients with and without serious mental illness. Psychiatry Res. 2011 Jun 30;188(1):109-14. PubMed PMID: 21459458; PubMed Central PMCID: PMC3673565.
2. Kreyenbuhl J, Slade EP, Medoff DR, Brown CH, Ehrenreich B, Afful J, Dixon LB. Time to discontinuation of first- and second-generation antipsychotic medications in the treatment of schizophrenia. Schizophr Res. 2011 Sep;131(1-3):127-32. PubMed PMID: 21576008.
3. Himelhoch S, Slade E, Kreyenbuhl J, Medoff D, Brown C, Dixon L. Antidepressant prescribing patterns among VA patients with schizophrenia. Schizophr Res. 2012 Apr;136(1-3):32-5. PubMed PMID: 22325077.
4. Schwartz E, Charlotte M, Slade E, Medoff D, Li L, Dixon L, Kilbourne A, Kreyenbuhl J. Gender differences in antipsychotics prescribed to veterans with serious mental illness. Gen Hosp Psychiatry. 2015 Jul-Aug;37(4):347-51. PubMed PMID: 25936673.
5. As the methodologist for the Division of Psychiatric Services Research and the VISN 5 MIRECC, my main scientific contribution is supporting the design and testing of novel interventions to improve the lives of people with serious mental illness. I help assure well-designed and adequately powered trials. Some interventions have proved to be promising and others have been disappointing, both results providing clear direction for future work. I also supervise and interpret all statistical analyses and in that capacity assure that the conclusions drawn are statistically sound and unbiased. Although this aspect of my work does not directly make scientific contributions, the projects I support do make important scientific contribution and my role is instrumental in that process. Listed below are some of my more direct scientific contributions.
   1. Dixon LB, Medoff D, Goldberg R, Lucksted A, Kreyenbuhl J, DiClemente C, Potts W, Leith J, Brown C, Adams C, Afful J. Is implementation of the 5 A's of smoking cessation at community mental health centers effective for reduction of smoking by patients with serious mental illness?. Am J Addict. 2009 Sep-Oct;18(5):386-92. PubMed PMID: 19874158.
   2. Dixon LB, Lucksted A, Medoff DR, Burland J, Stewart B, Lehman AF, Fang LJ, Sturm V, Brown C, Murray-Swank A. Outcomes of a randomized study of a peer-taught Family-to-Family Education Program for mental illness. Psychiatr Serv. 2011 Jun;62(6):591-7. PubMed PMID: 21632725.
   3. Himelhoch S, Medoff D, Maxfield J, Dihmes S, Dixon L, Robinson C, Potts W, Mohr DC. Telephone based cognitive behavioral therapy targeting major depression among urban dwelling, low income people living with HIV/AIDS: results of a randomized controlled trial. AIDS Behav. 2013 Oct;17(8):2756-64. PubMed PMID: 23644816.
   4. Dixon LB, Glynn SM, Cohen AN, Drapalski AL, Medoff D, Fang LJ, Potts W, Gioia D. Outcomes of a brief program, REORDER, to promote consumer recovery and family involvement in care. Psychiatr Serv. 2014 Jan 1;65(1):116-20. PubMed PMID: 24177229.
6. Statistical Models in the Analysis of Smooth Pursuit Eye Movements

Abnormal eye movements are a phenotypic marker of schizophrenia. Eye movement data are another example of a statistical challenge associated with the collection of a large amount of data. My scientific contribution was to develop statistical models that would capture the essential differences between the eye movements of healthy controls, people with schizophrenia, and their first degree relatives. In addition, I worked to develop the image analysis methods to determine the functional brain correlates of the abnormal eye movements in people with schizophrenia.

1. Ross DE, Thaker GK, Holcomb HH, Cascella NG, Medoff DR, Tamminga CA. Abnormal smooth pursuit eye movements in schizophrenic patients are associated with cerebral glucose metabolism in oculomotor regions. Psychiatry Res. 1995 Sep 8;58(1):53-67. PubMed PMID: 8539312.
2. Thaker GK, Ross DE, Buchanan RW, Moran MJ, Lahti A, Kim C, Medoff D. Does pursuit abnormality in schizophrenia represent a deficit in the predictive mechanism?. Psychiatry Res. 1996 Jan 31;59(3):221-37. PubMed PMID: 8930028.
3. Ross DE, Thaker GK, Buchanan RW, Lahti AC, Conley R, Medoff D. Specific measures account for most of the variance in qualitative ratings of smooth pursuit eye movements in schizophrenia. Arch Gen Psychiatry. 1998 Feb;55(2):184-6. PubMed PMID: 9477936.
4. Thaker GK, Avila MT, Hong EL, Medoff DR, Ross DE, Adami HM. A model of smooth pursuit eye movement deficit associated with the schizophrenia phenotype. Psychophysiology. 2003 Mar;40(2):277-84. PubMed PMID: 12820868; PubMed Central PMCID: PMC2698991.
5. Spatial Data for Social Issues

The NIMBY (Not In My Back Yard)is a fear that the presence of certain services will have unintended negative consequences if located near your home. This fear has prevented drug treatment centers to be located in neighborhoods that would potentially benefit from those types of services. However, it is difficult to determine if and what type of negative consequences might occur when a treatment center is located in a neighborhood. I worked with Dr. Boyd to map crime statistics around treatment centers and control sites. We created a novel statistical approach to measure the relationship between the distance from a site and the amount and type of crimes that occurred during a specified period. This approach provided concrete evidence of the impact of a drug treatment facility in a neighborhood compared to other types of services. The method will provide for an analytic approach to other types of potentially undesirable services.

1. Boyd S, Armstrong K, Fang L, Medoff D, Dixon L, Gorelick D. Boyd, SJ, Armstrong, KM, Fang, LJ, Medoff, DR., Dixon, LB, Gorelick, DA. The use of a microecological technique to study crime around substance abuse treatment centers. , 25, 163-173, 2007. Social Science Computer Review. 2007; 25:163-173.
2. Boyd SJ, Fang LJ, Medoff DR, Dixon LB, Gorelick DA. Use of a 'microecological technique' to study crime incidents around methadone maintenance treatment centers. Addiction. 2012 Sep;107(9):1632-8. PubMed PMID: 22385066.
3. Statistical Models for using Functional Imaging for Pharmakodynamic Assessment

In the early 1990's the capacity to study the functioning human brain became a reality. The unprecedented amount of data that could be aquired from a single individual created signficant statistical challenges. In addition, the exact nature of the nonindependence of data from different parts of the brain was unknown. My center was particularly interested in the impact of psychoactive drugs on brain function. My scientific contribution was to establish the statistical methods to determine the functional correlates of different types of drug actions. The early work with ketamine was to determine what parts of the brain were correlated with the symptoms that were provoked by the drug. Later work looked at the drug action of ketamine over time throughout the brain. I developed methods to determine pharmokodynamic characteristics such as AUC for different brain regions. Later work included looking at task activated brain regions under different drug conditions and the reliability of drug induced changes in the brain.

1. Lahti AC, Holcomb HH, Medoff DR, Tamminga CA. Ketamine activates psychosis and alters limbic blood flow in schizophrenia. Neuroreport. 1995 Apr 19;6(6):869-72. PubMed PMID: 7612873.
2. b.    Holcomb HH, Cascella NG, Thaker GK, Medoff DR, Dannals RF, Tamminga CA. Functional sites of neuroleptic drug action in the human brain: PET/FDG studies with and without haloperidol. Am J Psychiatry. 1996 Jan;153(1):41-9. PubMed PMID: 8540590.
3. c.    Holcomb HH, Lahti AC, Medoff DR, Weiler M, Tamminga CA. Sequential regional cerebral blood flow brain scans using PET with H2(15)O demonstrate ketamine actions in CNS dynamically. Neuropsychopharmacology. 2001 Aug;25(2):165-72. PubMed PMID: 11425500.
4. Lahti AC, Holcomb HH, Weiler MA, Medoff DR, Tamminga CA. Functional effects of antipsychotic drugs: comparing clozapine with haloperidol. Biol Psychiatry. 2003 Apr 1;53(7):601-8. PubMed PMID: 12679238.

D. Research Support

Ongoing Research Support

1R44MH111283-01, NIMH

      Olivet, Jeff (PI)

CSC OnDemand: An Innovative Online Learning Platform for Implementing Coordinated Specialty Care

07/01/16-06/30/19

In response to the growing need for training on interventions to address first episode psychosis, the Center for Social Innovation (C4) has partnered with experts in Coordinated Specialty Care (CSC) to develop and test CSC OnDemand: An Innovative Online Learning Platform for Implementing Coordinated Specialty Care. The product builds on the findings of the Recovery After an Initial Schizophrenia Episode (RAISE) studies, funded by the National Institute of Mental Health (NIMH). RAISE examined team-based models of care for people early in the course of schizophrenia. Through this Fast Track Small Business Innovation Research (SBIR) grant, we will prototype, test, refine, and evaluate the impact of CSC OnDemand.

Role: Co-Investigator

U79SM061256, SAMHSA

Kiser, Laurel (PI)

10/01/16-09/30/20

Family-Informed Trauma Treatment Center: National Child Traumatic Stress Network Category II

The Family-Informed Trauma Treatment (FITT) Center will lead local and national efforts to understand the impact of how trauma—especially complex trauma—impacts families, that families are the foundation through which children comprehend and cope with their traumatic experiences, and that family trauma interventions optimize healing.

Role: Co-Investigator

DOE, Maryland Department of Education

Stevphan, Sharon (PI)

10/01/14-09/30/19

Maryland Advancing Wellness and Resilience in Education

By implementing the Maryland Advancing Wellness and Resilience in Education MDAWARE initiative in three Maryland jurisdictions (Baltimore, Dorchester, and Somerset) and bringing practice and policy lessons and strategies to scale at the state level, we will improve the identification and appropriate referral of youth to behavioral services and resources, while increasing the number of children and youth who access school-based and community behavioral health services.

Role: Co-Investigator

H79TI025796, SAMHSA

Himmelhoch, Seth (PI)

09/30/14-09/29/18

STIRR-IT: Co-located HIV/HVC Prevention and Treatment

STIRR-IT (Screening & Testing for HIV/HCV, Immunization for Hepatitis A & B, Risk Reduction Counseling linked to Co-located and Integrated HIV Treatment) will provide HIV/HCV testing and care in the behavioral health setting and will provide the STIRR intervention linked with co-located HIV medical care for African American men and women receiving psychiatric treatment at the Walter P. Carter Clinic. The Walter P. Carter Clinic is a community based organization affiliated with the University of Maryland School of Medicine in Baltimore, Maryland.

Role: Co-Investigator

R21MH103543, NIMH

Bassuk, Ellen (PI)

09/09/14-08/31/17

Use of Social Media by Young Adults with Schizophrenia

Schizophrenia is a serious brain disorder that can be disabling, and often leads to fragmented social networks and isolation. With the explosion of the Information Age, social media has the potential to help those with serious mental illness enhance their social ties and support networks, an important aspect of recovery. This study explores how young adults with schizophrenia can benefit from the safe use of social media.

Role: Co-Investigator

HL128148 - 01A1, NHLBI R56

Himelhoch, Seth (PI)

06/01/15-06/01/17

Optimizing Smoking Cessation Treatments in Smokers Living with HIV/AIDS

We will use a factorial design to evaluate the most promising behavioral and pharmacologic treatments aimed at achieving maximal efficacy for smoking cessation among people living with HIV/AIDS who smoke. Results of this study will provide crucial, real world evidence of the best way for healthcare providers to help smokers living with HIV/AIDS quit smoking.

Role Co-Investigator

Completed Research Support

R34 MH80630, NIMH

Kreyenbuhl, Julie (PI)

07/01/11-06/30/15

A Smartphone Intervention to Improve Adherence to Antipsychotic Medications

We propose to develop and pilot test the effect of a mobile smartphone intervention, MedActive, on improving antipsychotic adherence among individuals with schizophrenia. We will also explore whether psychiatric symptoms and neuropsychological impairments moderate the effect of MedActive on adherence.

Role: Co-Investigator

Serious Mental Illness Health Services Schizophrenia Technology Methodology113. Kreyenbuhl J, Record EJ, Himelhoch S, Charlotte M, Palmer-Bacon J, Dixon LB, Medoff DR, Li L. Development and Feasibility Testing of a Smartphone Intervention to Improve Adherence to Antipsychotic Medications. In press, Clinical Schizophrenia & Related Psychoses. 114. Palmer-Bacon J, Miles-McLean H, Welsh C, Rugle L, Medoff D, Potts W, Himelhoch S. Impact of a Casino Opening on Gambling Behaviors of People Engaged in Methadone Maintenance. J Gambling Studies 2016 Jun 2. [Epub ahead of print] PubMed PMID: 27256373. 115. Drapalski AL, Medoff D, Dixon L, Bellack A. The reliability and validity of the Maryland Assessment of Recovery in Serious Mental Illness Scale. Psychiatry Research. 2016 May 0;239:259-64. doi: 10.1016/j.psychres.2016.03.031. Epub 2016 Mar 22. PubMed PMID: 7039010. 116. Jahn DR, DeVylder JE, Drapalski AL, Medoff D, Dixon LB. Personal Recovery as a Protective Factor Against Suicide Ideation in Individuals With Schizophrenia. Journal of Nervous and Mental Disease. 2016 Apr 22.[Epub ahead of print] PubMed PMID: 27105456. 117. Himelhoch SS, Miles-McLean H, Medoff D, Kreyenbuhl J, Rugle L, Brownley J, Bailey-Kloch M, Potts W, Welsh C. Twelve-Month Prevalence of DSM-5 Gambling Disorder and Associated Gambling Behaviors Among Those Receiving Methadone Maintenance. J Gambling Studies.2016 Mar;32(1):1-10. doi: 10.1007/s10899-015-9524-3. PubMed PMID: 25773867. 118. Dickerson FB, Savage CL, Schweinfurth LA, Medoff DR, Goldberg RW, Bennett M,Lucksted A, Chinman M, Daumit G, Dixon L, DiClemente C. The use of peer mentors to enhance a smoking cessation intervention for persons with serious mental illnesses. Statistics

1. Kreyenbuhl J, Record EJ, Himelhoch S, Charlotte M, Palmer-Bacon J, Dixon LB, Medoff DR, Li L. Development and Feasibility Testing of a Smartphone Intervention to Improve Adherence to Antipsychotic Medications. In press, Clinical Schizophrenia & Related Psychoses.

2. Palmer-Bacon J, Miles-McLean H, Welsh C, Rugle L, Medoff D, Potts W, Himelhoch S. Impact of a Casino Opening on Gambling Behaviors of People Engaged in Methadone Maintenance. J Gambling Studies 2016 Jun 2. [Epub ahead of print] PubMed PMID: 27256373.

3. Drapalski AL, Medoff D, Dixon L, Bellack A. The reliability and validity of the Maryland Assessment of Recovery in Serious Mental Illness Scale. Psychiatry Research. 2016 May 0;239:259-64. doi: 10.1016/j.psychres.2016.03.031. Epub 2016 Mar 22. PubMed PMID: 7039010.

4. Jahn DR, DeVylder JE, Drapalski AL, Medoff D, Dixon LB. Personal Recovery as a Protective Factor Against Suicide Ideation in Individuals With Schizophrenia. Journal of Nervous and Mental Disease. 2016 Apr 22.[Epub ahead of print] PubMed PMID: 27105456.

5. Himelhoch SS, Miles-McLean H, Medoff D, Kreyenbuhl J, Rugle L, Brownley J, Bailey-Kloch M, Potts W, Welsh C. Twelve-Month Prevalence of DSM-5 Gambling Disorder and Associated Gambling Behaviors Among Those Receiving Methadone Maintenance. J Gambling Studies.2016 Mar;32(1):1-10. doi: 10.1007/s10899-015-9524-3. PubMed PMID: 25773867.

6. Dickerson FB, Savage CL, Schweinfurth LA, Medoff DR, Goldberg RW, Bennett M,Lucksted A, Chinman M, Daumit G, Dixon L, DiClemente C. The use of peer mentors to enhance a smoking cessation intervention for persons with serious mental illnesses.