As a licensed clinical psychologist within the Division of Behavioral Medicine and Department of Family Medicine and Public Health (DFMPH), I am committed to the mission to improve health through preventive, epidemiological and clinical research. I am the Director of the Health Behavior Science Track for the UCSD/SDSU Joint Doctoral Program (UCSD/SDSU JDP) in Public Health and I have been actively involved in Centers of Excellence in Research and Intervention in Tobacco Control and in Health Behavior Change in Underserved and Vulnerable Populations. I have received broad training and have developed preventive and clinical research expertise in the evaluation of vulnerable populations with mental illness and addictions. As an independent investigator since 2001, I have received continuous extramural funding from NIH and the American Cancer Society (ACS) grants for my research activities in understanding the intersection of mental health and addictions. My recent efforts have focused on developing brief motivational interventions to prevent tobacco-related disease by facilitating cessation among high-risk smokers with severe depressive disorders, military veterans with complex medical and mental health needs, and smokers with depression receiving services in primary care clinics. I also am conducting studies designed to identify individual differences and biobehavioral mechanisms that may interfere with efforts to change health behavior. These potential targets for behavioral interventions include affective reactions, regulation of wanting or cravings, reinforcement learning, and learning to extinguish previous associations that trigger seeking of drugs and other rewards including food. I have expertise in the application of psychometric methods based in item response theory to understanding key constructs in the study of health behavior and teach a course in Scale Development within the UCSD/SDSU JDP in Public Health.
Tobacco Use and Public Health
Tobacco Regulatory Science: US national survey to guide FDA regulation of tobacco products including new and emerging products such as electronic cigarettes, snus, noncombustible tobacco.
Surveillance of Tobacco use and Mental Health: Evaluate methods for screening depression and tobacco use in within ethnically diverse populations in California. This project connects evaluation of statewide screening for depression to clinical evaluations of smokers who contact the California Smokers Helpline.
Nicotine Dependence and non-cigarette tobacco use: Evaluate multiple symptoms of current and lifetime nicotine dependence, patterns of tobacco use, exposure to multiple tobacco products using methods based in Item Response Theory. This detailed analysis will enable us to evaluate the measurement of nicotine dependence across single and poly-tobacco users in a US national longitudinal survey.
Tobacco Use and Health of Military Veterans
Qualitative Approaches to inform clinical program development for veterans with spinal cord injuries who use tobacco.
Development of New Behavioral Treatments: Developing Brief Motivational Interventions to enhance engagement in evidence-based tobacco and substance abuse programs among veterans with mental health problems. This line of research includes inpatient psychiatry, outpatient psychiatry, spinal cord injury, other veteran points of service contact.
Tobacco Use and Depression In Primary Care
Screening and treating tobacco use in primary care medical settings: Evaluation of the screening and identification of smokers with depression, typical patterns of treatment, and typical service referrals in a collaborative care environment where behavioral health providers and electronic referrals to statewide behavioral treatments are integrated into service delivery.
Behavioral Science: Mental Health Risk Factors for Substance Use
Experimental Psychopathology: In a laboratory setting, we use computer-based behavioral tasks and physiological recording to evaluate behavioral models of risk for substance use. Current studies include evaluation of emotional learning, stress reaction, distress tolerance, extinction memory, and reinforcement learning among smokers with a history of recurrent depressive disorder.