ESCAP Research Academy – Madrid 2015 workshop

Abstracts and presentations

ESCAP Research Academy: Madrid workshop, June 2015. Abstracts and original presentations.

Input talks

What types of grants are there for young European researchers or EU-wide cooperation?
Dr Kent Hung
It is an essential part of a career as researcher to establish international collaborations and the EU programs are a great way to fund such collaborations, within Europe and beyond. We would like to present a variety of funding instruments for different kinds of projects and we will look shortly into the concepts of a well-structured proposal.
Kent Hung - What types of grants are there for young Euroepan researchers or EU-wide cooperation? (pdf, 25 slides).

How to write a successful grant?
Professor Christoph Correll
The four essential building blocks of a successful academic career are and mentorship, networking publications and grant funding. Successful publications and grant acquisition require overlapping skills, including a sound grasp of methodology, knowledge of the relevant literature, clear and organized thinking, (acquired or supplied) statistical expertise, and writing abilities. However, the structure and aims of publications and grants differ, requiring experience, training and adequate supervision in each of these two areas. Generally, academicians write more papers than grants, but the best publications and scientific advances are likely to be borne out of grant-funded research. This presentation will review different funding agencies and mechanisms, nuts and bolts of writing techniques, and ways to respond to reviewer comments. When beginning to write a grant, one should always focus first on what the main research question is. Thereafter, related, secondary questions should be identified. Next, aims and tightly related hypotheses need to be formulated that link directly to the statistical analysis plan for each of the hypotheses. Before starting to write a grant, consultation with a statistician needs to be sought in order to refine the aims and hypotheses and perform power calculations and determine the sample size necessary to answer the main question(s). After these steps have been accomplished, the feasibility of acquiring the sample in the available time and within the funding constraints needs to be assessed. If there are doubts about the feasibility, aims or the sample may need to be changed or additional sites may need to be included. This entire process may be iterative. Only after this preliminary work has been accomplished should one start spending time on fully developing the grant. In addition to the actual proposal (significance, innovation, approach), the applicant (training, experience, productivity, team members’ expertise) and the environment (resources, population, support) are being evaluated, which should each be considered when building a grant.

Elements of methodology in psychiatric research
Professor Bruno Falissard
Once a research question has been raised, it is necessary to draft the outline of a study design that will be likely to tackle it. The final protocol will emerge after the preliminary question has been formulated again and again, according to the limitations imposed by the designs that can be tractable in practice. We will see the main facets of these possible designs. We will consider first quantitative approaches and the duality of experimental versus observational, descriptive versus analytic, cross-sectional versus longitudinal and randomized versus naturalistic studies. We will insist on two important aspects: inclusion criteria and outcomes; outcomes that can be, in psychiatric research, subjective or objective. Quantitative approaches are not alone; there are also qualitative ones. They are less in fashion at the moment. They can nevertheless provide valuable answers to complex questions, provided the data collection and data analysis have been done rigorously.

Initiation of the European Academy of Child and Adolescent Psychiatry and Psychology to Foster European Collaborations with a Special Focus on Young Investigators
Professor Stephan Eliez and professor Johannes Hebebrand
Several young investigators in Europe have worked together in the past to set up the ESCAP Academy of Child and Adolescent Psychiatry and Psychology. Collaboration has been sought with the incoming ESCAP, President Stephan Eliez, and the editor-in-chief of European Child and Adolescent Psychiatry, Johannes Hebebrand, who have both pledged their support. Furthermore, other senior researchers have agreed to provide their input. We will use two symposia within the 16th ESCAP conference to promote our goals; we wish to particularly attract researchers in the phase of their early scientific career to boost European co-operations and to provide a forum for fruitful exchanges. We will present our plans for the initiation of annual meetings of the Academy. This presentation will be used to gather ideas of listeners regarding potential research needs and topics to be covered by future meetings of the Academy.
In the second part of the session, two young investigators, Mrs. Maude Schneider and Dr Marie Schaer, will present their ongoing projects and illustrate the bridges between fundamental research, clinical research and clinical practice.
Initiation of the European Academy of Child and Adolescent Psychiatry and Psychology to Foster European Collaborations with a Special Focus on Young Investigators (pdf, 9 slides).

Studying neurodevelopmental disorders: from gene and brain development to endophenotype and finally back to clinical practice
Professor Stephan Eliez, Ms Maude Schneider and Dr Marie Schaer
In the first part of this session, Prof. Stephan Eliez and Mrs. Maude Schneider will present their ongoing work on 22q11.2 Deletion Syndrome (22q11.2DS), a rare genetic disorder associated with an elevated risk of schizophrenia. This presentation will illustrate the potential of studying 22q11.2DS as a model for understanding the development of psychopathological states, especially psychosis. Their talk will focus on the multiple levels of understanding that such models offer, going from genetic and brain development to cognitive and clinical aspects of the disorders.
In the second part, Dr Marie Schaer will present her ongoing work in a cohort of young children with Autism Spectrum Disorder (ASD). She will illustrate how fundamental and clinical research leads to the implementation and validation of scientifically-based intervention techniques in ASD.
The potential for translational analyses between human and animal models and multidisciplinary approaches will also be highlighted during the talks.
Studying neurodevelopment disorders: from gene and brain development to endophenotype and finally back to clinical practice (pdf, 48 slides).

The challenges and opportunities of integrating clinical neuroscience to clinical care of children with ADHD
Professor Guilherme Polanczyk
ADHD is currently conceptualized as the result of numerous complex etiological mechanisms, involving genetic risk and environmental exposures. Research has demonstrated that ADHD represents the extreme of normative behavioural and cognitive domains, dimensionally distributed in the population, with significant heterogeneity and continuities and discontinuities over development. Nonetheless, these concepts have had limited impact on the clinical care of children with ADHD so far. In his talk, Guilherme V. Polanczyk will discuss the challenges researchers face and the opportunities to integrate clinical neuroscience to clinical care of children with ADHD.

How to bridge the gap between research and clinical practice: examples from anorexia nervosa research
Professor Johannes Hebebrand
Upon embarking on a scientific career one of the frequent questions is: Is my work going to influence clinical practice? Based on his own research experience of 30 years Johannes Hebebrand recounts his initial encounters with patients with anorexia nervosa (AN) in his talk “How to bridge the gap between research and clinical practice”. Their eating behavior and the resulting underweight fascinated him so much that he started to reflect the DSM criteria for this eating disorder with an initial focus on the weight criterion. Age percentiles for the body mass index were introduced thus allowing an epidemiological assessment of the underweight associated with this eating disorder. Molecular genetic research was initiated and included patients with AN as one extreme weight condition and children and adolescents with extreme obesity at the other end of the weight distribution. Endocrinological work focused on the starvation signal leptin; hypoleptinemia was identified as the initial trigger for starvation related hyperactivity in a rat model for AN. This work led to critical reflections of the DSM IV criteria; the respective discussion has contributed to the substantial changes in the DSM-5. The talk aims to illustrate why and how research questions related to AN were pursued by the speaker. The 30 minute talk will be followed by a 15 minute long discussion.
How to bridge the gap between research and clinical practice: examples from anorexia nervosa research (pdf, 42 slides).

fMRI neurofeedback in ADHD
Professor Katya Rubia (abstract: Katya Rubia, Analucia Alegria, Gareth Barker, Daniel Brandeis, Anthony David, Vincent Giampietro).
We have shown in meta-analyses of functional magnetic resonance imaging studies that children with ADHD have consistent neurofunctional impairment in right inferior frontal cortex (rIFC) relative to healthy controls and other pediatric disorders, making it a specific neurofunctional biomarker of ADHD. rIFC activation is also consistently upregulated with psychostimulants which are the gold-standard treatment of ADHD.  EEG neurofeedback has shown good effect sizes in improving ADHD symptoms. However, EEG has poor spatial resolution and cannot target deep cortical structures such as rIFC which is a key pathophysiology of ADHD. This region is hence an optimal target for fMRI-Neurofeedback (NF) in ADHD, which has far better spatial resolution than EEG-NF to allow self-regulation of deep inferior frontal structures.
In this study, 30 male adolescents with diagnosed ADHD are being trained in a randomised controlled trial to either self-upregulate rIFC or parahippocampal gyrus (PHG) activation via a computer game in which a rocket has to be moved into the sky to ultimately reach planets in space in 14 sessions of 8 min real-time fMRI-NF each (across 4 hours of fMRI scanning within 2 weeks). Outcome measures were pre and post clinical, cognitive and fMRI Stop task measures.
Preliminary findings in 25 adolescents (30 will be presented at the conference) show a significant dissociation of linear rIFC activation increase in the active (15) relative to the control group (where it decreased), and of linear PHG activation increase in the control relative to the active group (10). Both groups, however, improved significantly in ADHD clinical measures of inattention and hyperactivity as well as trend-wise in cognitive measures of sustained attention (commission errors). Clinical inattention symptom improvement correlated trend-wise with the number of NF sessions. Right IFC activation was significantly increased in the fMRI stop task in the active group after NF.
The findings so far show that ADHD adolescents can self-regulate specific brain activation in relatively few NF sessions. Furthermore, this appears to be associated with improved ADHD symptoms, cognitive attention measures and brain activation and this correlated with the number of sessions, suggesting it is related to neurofeedback and not a placebo effect.

Group/panel discussions

Alignment: your personal strategy to develop a solid reputation for a scientific career
Henk Linse
Part 1: strategy. Developing a solid reputation in this networking age involves intra vision and outlining a personal plan. In order to be perceived as a reliable player amongst peers and authorities in the scientific network, a researcher will have to take position and show the road he is walking, including successes and setbacks (the credibility stage). Communication technology allows every individual scientist to cross borders, as never before, but in the mean time no mistakes will be erased. All actions and perceptions add up to the reputation of any scientist in his broad network of stakeholders. This reputation can be developed and managed by getting to know these stakeholders, listening to them and analyse accurately what is right and what is wrong about their perceptions. To influence one’s reputation, actively maintaining sustainable relationships nowadays is indispensable in every scientist’s career.
Part 2: skills. Skills in self-presentation, communication, the use of social media and leadership are still undervalued in the education of psychiatrists. Catching up with this backlog starts with a personal SWOT: on what skills do we need to work now, not to run into a wall of misunderstanding and misperception?
Alignment: your personal strategy to develop a solid reputation for a scientific career (pdf, 19 slides).

A first step into the European arena: how to improve our training and research by making use of European diversity
Professor Johannes Hebebrand
The ESCAP Research Academy wishes to encourage young researchers to embark on an exchange as to how to derive maximum benefit from the attendance of researchers of several different European countries. The Academy intends to lay the foundation for articles to be published in the ECAP Journal with Academy participants as authors.
During this workshop, two envisioned papers will be prepared: 
a) A comparison between the different national training programs for the specialty of child and adolescent psychiatry.
b) A comparison of service provision between different European countries.
Both ESCAP and ECAP perceive a high interest in such international comparisons at the European level for clinical and political reasons. Professor Hebebrand will lead a discussion on how to best tackle these papers and the requirements for inclusion as an author will be addressed. A follow-up with additional topics will be considered. Furthermore, the participating researchers need to come up with the relevant questions/data to be answered/obtained for each country. The Research Academy intends to identify two senior experts who are willing to work with the respective groups to compile the papers.

How to combine research work, clinical work and family life?
Finding a balance between clinical responsibilities and scientific research can be a challenge for young professionals in the field of child and adolescent psychiatry. Moreover, career opportunities are manifold, and may vary across countries and professions (e.g. psychologist/medical doctor). Several professionals with different educational backgrounds and careers will take place in a panel for an interactive discussion with each other and with the audience. There will be a special focus on career options for psychologists.
Saturday June 20th, 3:00 PM – 4:30 PM.

Grant writing sessions

Generating ideas
During this interactive initial session, participants will be encouraged to come up with innovative research questions and ideas. Young investigators with different background and shared interests will be brought together.

Group work
After generating research questions and forming collaborative groups, participants will work together to further develop their ideas.

Feedback session / group presentations
Each of the working groups will present their work in progress to an audience of peers and experts in the field.

Presentation session
Each of the working groups will present their work to an audience of peers and experts in the field. Future steps to enhance further collaboration will be planned.

Peer2Peer exchange

During four intense small-group sessions, participants are invited to discuss their own work-in-progress with 4-5 peers in their scientific field of expertise. Work-in-progress (paper manuscripts or grants) will be shared prior to the workshop, to enhance in-depth discussion.