Assistant Clinical Investigator
Melissa A. Brotman, Ph.D., is the Assistant Clinical Investigator of the Neuroscience and Novel Therapeutics Unit (NNT) in the Emotion and Development Branch at the National Institute of Mental Health (NIMH) Intramural Research Program (IRP). Dr. Brotman received her Ph.D. in clinical psychology from the University of Pennsylvania, where she specialized in cognitive behavioral therapy for mood and anxiety disorders. After completing her clinical internship at the Veterans Affairs Maryland Health Care System/University of Maryland-Baltimore, she completed post-doctoral training in neuroscience, focusing on functional magnetic resonance imaging (fMRI) and clinical phenotyping of severe irritability in youth. Currently, her neurodevelopmental, translational research integrates basic and clinical approaches to the study of mood disorders in children and adolescents. Specifically, she uses affective neuroscience techniques to understand the brain-based mechanisms underlying severe irritability in youth and leverages pathophysiological knowledge to guide the development of novel targeted interventions.
Dr. Brotman is a Member of the American College of Neuropsychopharmacology (ACNP) and Chair of the ACNP Membership Advisory Task Force. She has received multiple research awards, including the NIMH IRP Seymour S. Kety Memorial Training Award, Society of Biological Psychiatry Travel Award, ACNP Young Investigator Memorial Travel Award, and Career Development Institute Award. She was awarded a 2018 NIH Bench-to-Bedside grant, is a consultant on numerous extramural grants, and is on the Editorial Board of the Journal of Affective Disorders. Finally, mentoring is a focal aspect of her career, and her mentorship was recently recognized through the NIMH Outstanding Mentor Award.
Mental illnesses impact public health significantly, and treatment advances have stalled, compounding this public health problem. Dr. Brotman’s long-term goal is to leverage neuroscience and therapeutics to develop and test novel interventions for serious psychiatric disorders. Given the impact of development on later psychopathology, she applies her expertise to studies of children. Specifically, the work of Neuroscience and Novel Therapeutics (NNT) aims to advance the field by: (1) using neuroscience to identify treatment targets; and (2) developing innovative, scalable, and cost-effective therapies based on their ability to engage these targets. While this research program currently targets pediatric and adolescent irritability, lessons learned in this area will inform complementary translational interventions and approaches for other pediatric conditions.
Severe irritability is one of the most common reasons that children present for mental health care; however, few effective treatments are available. Developing targeted, mechanism-based interventions is essential given the new DSM-5 diagnosis of Disruptive Mood Dysregulation Disorder (DMDD). NNT utilizes a translational neuroscience model of irritability that articulates core pathophysiological processes to guide novel interventions (Brotman et al., 2017). In particular, pathological irritability is conceptualized as aberrant emotional and behavioral responding to frustrative nonreward and threat. This model emerges directly from imaging studies by the Emotion and Development Branch and other groups, which have found that the circuitry underlying aberrant responding to frustration and threat involves perturbations in overlapping regions, including prefrontal cortex, striatum, and amygdala (e.g., Brotman et al., 2006; Brotman et al., 2007; Brotman et al., 2010; Kircanski et al., 2018).
Dr. Brotman is Principal Investigator on NIMH protocol 15-M-0182 examining two novel mechanism-based treatments for severe irritability in youth: (1) a computer-based treatment, interpretation bias training (IBT) that targets face emotion processing; (2) an exposure-based cognitive-behavioral research therapy. Recruitment for both studies is ongoing.
A latent variable approach to differentiating neural mechanisms of irritability and anxiety in youth. Kircanski, K., White, L.K., Tseng, W.-L., Wiggins, J.L., Frank, H., Sequeira, S., Zhang, S., Abend, R., Towbin, K.E., Stringaris, A., Pine, D.S., Leibenluft, E., Brotman, M.A. Journal of the American Medical Association Psychiatry. 75, 631-639. doi: 10.1001/jamapsychiatry.2018.0468 (2018) PMID: 29625429.
Psychosocial treatment of irritability in youth. Kircanski, K., Clayton, M.E., Leibenluft, E., Brotman, M.A. Current Treatment Options in Psychiatry. 5, 129-140 (2018)
Irritability in children and adolescents. Brotman, M.A., Kircanski, K., Leibenluft, E. Annual Review of Clinical Psychology. 13, 317-341. PMID: 28482689 DOI:10.1146/annurev-clinpsy-032816-044941 (2017)
Identifying moderators of the adherence-outcome relation in cognitive therapy for depression. Sasso, K.E., Strunk, D.R., Braun, J.D., DeRubeis, R.J., Brotman, M.A. Journal of Consulting and Clinical Psychology. 83, 976-984. PMID: 26214542 doi: 10.1037/ccp0000045 (2017)
Amygdala activation during emotion processing of neutral faces in children with severe mood dysregulation versus ADHD or bipolar disorder. Brotman, M.A., Rich, B.A., Guyer, A.E., Lunsford, J.R., Horsey, S.E., Reising, M.M., Thomas, L.A., Fromm, S.J., Towbin, K., Pine, D.S., Leibenluft, E. American Journal of Psychiatry. 167, 61-69. PMID:19917597 PMCID: PMC3075433 doi: 10.1176/appi.ajp.2009.09010043 (2015)
Prevalence, clinical correlates, and longitudinal course of severe mood dysregulation in children. Brotman, M.A., Schmajuk, M., Rich, B.A., Dickstein, D.P., Guyer, A.E., Costello, E.J., Egger, H.L., Angold, A., Pine, D.S., Leibenluft, E. Biological Psychiatry. 60, 991-997. PMID:17056393 doi: 10.1016/j.biopsych.2006.08.042 (2006)
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