I'm June Gruber an Associate Professor of Psychology at the University of Colorado Boulder, and director of the Mental Health Expert series. I'm here today with Dr. Sherrie Johnson and a professor of psychology at the University of California Berkeley to talk with her about her work on impulsivity and psychopathology. Thanks for been with us here today, Sherrie. Thanks so much for having me here. Sherrie, I'm wondering if you could start off by telling us a little bit about the kind of mental health work and research that you do. Sure, over the last years, I've gotten really fascinated by people who are not otherwise impulsive. But once they're in a state of high emotion, become very impulsive and so say, and do things that they regret, in those moments. So how did you go about getting started in this line of work? Looking at the kind of impulsive tendencies People have in certain moments that as you said, it may lead to consequences that they might otherwise regret? Well, I had been studying people with bipolar disorder for many, many years, a couple decades, and I was very interested in the idea that for them there were these state dependent shifts into impulsivity. I started studying the phenomenon in bipolar disorder, and they were certainly endorsing high levels and it had a lot reading for them. They were talking about, this is very relevant. When we looked quantitatively, we could see that it was really profoundly related to the quality of their life, to their suicidality history, to their struggles with aggression when those were present. I was really intrigued by it. Then in the literature other people were talking about how important it was for other psychopathologies. When we began to study this more trans diagnostically, I just was seeing effect sizes that I hadn't seen in other areas. That drew me in and got me focused on this train of thought and research. Were there certain findings that really picked your interests when you looked at these effect sizes that made you say "Wow, there's something really fascinating going on here."? There was a meta-analysis that I didn't do, but showing that the effects for this form of impulsivity went large across many kinds of psychopathology. In our own team, I think one of the things that was compelling is that it was a form of impulsivity that was related to things you wouldn't think of as been impulsive. So things like problems with depression. That got me really curious about failures of constraints and those systems and how they might play out across psychopathologies. I think the other thing that hooked me was that the effect sizes for understanding suicidality and aggression were so large and we were seeing that in folks with bipolar disorder, and students samples and community samples. That made me just think, wow, maybe we have a [inaudible] public health problem here. So along the way, when you've been doing this incredibly meaningful work especially as you're saying looking at links between suicidality and aggression among many other outcomes. I'm wondering what do you see as the most significant frustrations along the way as well as successes that you've been savoring? That's such a sweet question, I'm going to start with the successes and maybe that's the wrong order. We should end on a high note and I'm going to do it in reverse. I think that one piece of success has been the collaborators along the way and working with such a great team of people in the field and as grad students. Another success would be just a really broad range of outcomes that we've been able to see or tied to this. So that is important to me that it feels like we're chasing something that has meaning. I guess the third thing that I would think of instance success is just recently we publish that we can make a difference in emotional relief impulsivity with a really short online cognitive-behavioral intervention. We've also seen success with very brief cognitive remediation. My grad student, Andrew Peck comes for work on that front. That part has been really exciting. Plenty of successes that I can savor and I feel good about that. I think what's really hard is that it's been hard to figure out what this actually is. Here's this great self-report. There's a couple of self-report scales whose parents scales, there's interview based assessments and they all say, "Okay, this is an important phenomenon.", but then why does it happen to people? What's the process? What's the mechanism? We've had some success in looking at executive control deficits and how those work in the context of emotion and arousal. But I still feel like those effect sizes are pretty small. I feel like the neuroimaging literature findings are pretty scattered. That's tricky because I have my heart set on understanding this thing, and I think there's still a lot about it, but we just don't know what's inside the black box. So both successes and making real-world impacts and frustrations and getting to the bottom of what the phenomenon is? Yeah, we still have a big puzzle. I guess that's then the goal of clinical science research, right? There's more work to do. There always is. It's funny, I can't imagine the day we wake up and there's no puzzle left on the table. Yeah, I think that's a good thing. You've alluded to this in a way in terms of the studies and ideas and puzzles that are keeping you and your lab team busy. But more specifically, I suppose, what do you see as the most important next steps in the field? If I keep my answer down, much and related and possibly, I think there's two things I really want to understand. One is that we've seen important links with ideation and with tendencies to make suicidal behaviors in the context of ideation. But it's pretty clear that not everybody who's suicidal has problems with emotion and impulsivity. I really want to think harder about how this interfaces with other risk factors for suicidality. Who, why, and when is it most relevant for. I've been collaborating more with other suicidality researchers to understand more about that process and I'm really excited about what that could do to enrich our sense of understanding and intervention in that area. I think when it comes to mechanisms, I think there's two ways to contemplate it. One is that maybe we just need better measurement of what happens to executive control in the face of arousal. We're working on that; different measures of executive control, different measures of arousal, different ways of thinking about how do we catch people in moments of high arousal. We're still working around that, but I also think that it's incredibly likely that there's more than one route into becoming impulsive during states of high emotion. We've just been going back to the drawing board and scratching our head and saying, okay, what other mechanisms need to be at play here? That's been a really fun process in the past year, just imagining what other things might be at play. That's exciting. As you're working on imagining all the things at play in looking at emotional impulsivity and your career, more generally in clinical science and mood disorders, what advice would you have for other people watching this interview today, whether they're students or scholars or the public who just might be interested in the field? First, I would say jump on in. We need more answers, more people solving these puzzles, and I think it's a really rewarding area to make a difference in. I think one thing that's going well for me is that I've had the fortune of having a couple of puzzles in my lifetime that I was really passionate about. First bipolar disorder and then emotional elated impulsivity, and so I think one piece of advice is, choose a puzzle that you're going to wake up in the morning and think about, you're going to fall asleep at night and think about. It's just going to absorb you and compel you. Have patience. It can take 10 years, I think, to stumble onto something that you feel that kind of passion for. But let's imagine we're lucky enough to have something that wakes us up in the morning, with, "Oh my gosh, what is it?" kind of experience. I think our field is huge and you want to learn as deeply as you can. But one way to do that is to seek really good mentors who care about the same kinds of puzzles. Then have the humility to realize that our science is too complex to understand everything there is that goes into a puzzle and sub-forming a summit of collaborators who, if you're lucky, each person will bring something that's just sparklingly different into this enterprise. I feel like one of the best things about being a professor is trying to create a mind meld of all these different people who each have a corner of expertise and think about how do we bring this together into a unified diagram. I think that's a really beautiful part of science that I would encourage as many people to be a part of as they can. Thank you so much, Sherrie. That's a beautiful advice and wise advice too, and thank you too for just speaking with us today, it's always such a pleasure to get to chat with you. It's always great to see you and chat, June. Thank you for doing this and for putting it together.
