ROBERT R. ALTHOFF

Assistant Professor

Psychiatry, Psychology, and Pediatrics

Ph.D., Neuroscience
University of Illinois Urbana-Champaign, 1998

M.D. University of Illinois Urbana-Champaign, 1999

Residency:

• Pediatrics, Washington University, St. Louis, 1999-2001
• Psychiatry, University of Vermont, 2001-2004
• Child Psychiatry, Massachusetts General Hospital/McLean, 2004-2006

Robert.Althoff@uvm.edu

We need a better way to understand children who exhibit profound problems with irritable, dysregulated moods who also have problems with attention and behavior. Clinical neuroscience has struggled to adequately characterize children who have profound problems regulating their affect, behavior, and cognition but who do not meet the criteria for the most severe form of mood dysregulation - pediatric bipolar disorder. These children are best described as having dysregulation (or impaired self-regulation). Twin studies have revealed significant roles of both genetic and shared environment components to childhood dysregulation. This phenotype has a different genetic architecture and different life course than children with ADHD, oppositional defiant disorder, or depression. Work in our lab has demonstrated that children with problems in self-regulation go on to have severe problems in adulthood.

By characterizing these children as having profound problems with attention, mood swings, and aggression, work in the Althoff laboratory strives to identify modifiable genetic and environmental factors to reduce depression, personality disorders and substance use in adolescence and adulthood. The most fundamental questions about these children remain. How are these children different from children with bipolar disorder? What are the neuroscientific pathways associated with the development of self-regulation? How does dysregulation look throughout the lifespan? How can we characterize these children in a developmentally sensitive and specific way? What are underlying genetic and environmental influences on self-regulation and how do they interact?

The Althoff lab uses a multi-method approach to answering these questions. This work is done in close collaboration with Drs. Hudziak and Rettew in the Vermont Center for Children, Youth, and Families at UVM. We have additional collaborators in Amsterdam, Rotterdam, Washington University in St. Louis, and McGill University. There are studies specifically designed towards phenotypic definition using statistical models of dimensional and categorical approaches (latent class and latent profile models). Psychophysiological studies are being performed in a cohort of children with and without dysregulation using eye movement and heart rate variability monitoring. Genetic and environmental contributions to this phenotype are being investigated using behavioral genetic (twin and family studies) and statistical/molecular genetic (pedigree-based association of candidate genes and whole genome/copy number variation) approaches. Neuroimaging (structural and functional connectivity) is being performed with our colleagues at McGill and Washington University in St. Louis. Epigenetic studies (whole genome methylation) are being performed with our colleagues in Amsterdam and New York. Examination of early precursors, longitudinal outcome, and associations with suicidality are being performed with colleagues at UVM and in The Netherlands. Intervention and prevention studies are currently being planned.

Althoff RR, Ayer LA, Rettew DC, Hudziak JJ. Assessment of Dysregulated Children Using the Child Behavior Checklist: A Receiver Operating Characteristic Curve Analysis. Psychological Assess. 2010; 22(3):609-17.

Althoff RR, Rettew DC, Ayer LA, Hudziak JJ. Cross-informant agreement of the Dysregulation Profile of the Child Behavior Checklist. Psychiatry Res.2010; 178(3):550-555.

Albaugh M, Harder V, Althoff RR, Rettew DC, Ehli E, Nelson T, Davies G, Ayer L, Sulman J, Stanger C, Hudziak JJ. COMT Val158Met Genotype as a Risk Factor for Problem Behaviors in Youth. J Am Acad Child Adolesc Psychiatry. 2010; 49(8):841-849.

Hannula DE, Althoff RR, Warren DE, Riggs L, Cohen NJ, Ryan JD. Worth a glance: Using eye movements to investigate the cognitive neuroscience of memory. Front Hum Neurosci. 2010; 4:166. doi:10.3389/fnhum.2010.00166

Althoff RR, Verhulst F, Rettew DC, Hudziak JJ, van der Ende J. Adult Outcomes of Childhood Dysregulation: A 14-year Follow-up Study. J Am Acad Child Adolesc Psychiatry. 2010; 49(11):1105-16.

Bartels MB, Althoff RR, Boomsma DI. (2009). Anesthesia and Cognitive Performance in Children: No evidence for a causal relationship. Twin Res Hum Genet., 12(3):246-53. PMID: 19456216

Althoff RR, Rettew DC, Boomsma DI, Hudziak JJ.(2009). Latent Class Analysis of the Child Behavior Checklist Obsessive-Compulsive Scale. Comp Psychiatry, 50(6):584-92. PMID: 19840599

Ayer L, Althoff RR, Ivanova M, Rettew D, Waxler E, Sulman J, Hudziak J. (2009). Child Behavior Checklist-Juvenile Bipolar Disorder (CBCL-JBD) and CBCL–Posttraumatic Stress Problems (CBCL-PTSP) Scales are Measures of a Single Dysregulatory Syndrome. J Child Psychiatry Psychol., 50(10):1291-300. PMID: 19486226

Rettew DC, Althoff RR, Dumenci L, Ayer L, Hudziak JJ. (2008). Latent Profiles of Temperament and Their Relations to Psychopathology and Wellness. J Am Acad Child Adolesc Psychiatry, 47(3):273-281.PMID: 18216734

Hudziak JJ, Achenbach TM, Althoff RR, Pine, DS. (2007). A Dimensional Approach to Developmental Psychopathology. Int J Methods Psychiatr Res., 16 Suppl 1:S16-23. PMID: 17623391

Althoff RR, Copeland WE, Stanger C, Derks EM, Todd RD, Neuman RJ, Van Beijsterveldt CEM, Boomsma DI, Hudziak JJ. (2006). The Latent Class Structure of ADHD is Stable Across Informants.  Twin Res Hum Genet., 9(4):507-522. PMID: 16899158

Althoff RR, Rettew DC, Faraone SV, Boomsma DI, Hudziak JJ. (2006). Latent Class Analysis Shows Strong Heritability of the Child Behavior Checklist-Juvenile Bipolar Phenotype.  Biol Psychiatry. 60(9):903-11. PMID: 16650832 .

Boomsma DI, Rebollo I, Derks EM, Beijsterveldt TC, Althoff RR, Rettew DC, Hudziak JJ.  (2006). Longitudinal Stability of the CBCL-Juvenile Bipolar Disorder Phenotype: A Study in Dutch Twins.  Biol Psychiatry, 60(9):912-20. PMID: 16735031

Hudziak JJ, Althoff RR, Stanger CS, van Beijsterveldt CEM, Nelson EC, Hanna GL, Boomsma DI, Todd R. (2006). The Obsessive Compulsive Scale of the Child Behavior Checklist Predicts Obsessive-Compulsive Disorder: A Receiver Operating Characteristic Curve Analysis.  J Child Psychol Psychiatry, 47(2):160-166. PMID: 16423147

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