Children and Adults; Clinical Neurophysiology; Forensic Psychiatry; Psychiatry
Wearing many hats, my work include administrative, clinical, academic, and research responsibilities. Administratively, I oversee our department’s forensic faculty and staff, forensic programs, and the forensic psychology training program. Clinically, I (or my team) conduct psychological evaluations that address clinical and forensic questions (e.g. emotional problems, cognitive issues, risk, competency, criminal responsibility, etc). Using social-psychological-physiological methods, I help clients overcome psychological and emotional problems and optimize their performance. Academically, I teach and supervise students at all levels, with the ultimate goal of facilitating scholarly thinking and work. All students are encouraged to get involved in my research program, which focuses on the neurobiological, behavioral, and societal factors that underlie human emotions, aggression and impulsivity.
Children and Adults; Psychiatry; Molecular and Cellular Biology; Neuropharmacology; Signal Transduction
Research Interests: Calcium Metabolism in Affective Disorders; Psychopharmacology; Psychosomatic Medicine; Medical Education. Clinical specialties: mood disorders, psychosis, interactions between medical and psychiatric disorders, psychopharmacology, difficult diagnoses, complex clinical entities
Child Neurology; Children and Adults; Developmental Neurology; Neurology; Pediatrics
My research was focused originally on using astrocyte cell cultures to shed light upon processes related to astro-gliosis, the key response of developing and mature brain to injury. The laboratory succeeded in modeling many immunochemical features of gliosis in primary brain cell culture. More recently, I have been involved in the clinical care of, and research regarding, children with leukodystrophies. This includes coordinating several clinical research projects in roles as Clinical Director of the Hunter James Kelly Research Institute (HJKRI), and as President of the New York State Krabbe Disease Consortium. Projects include expansion of the World Wide Registry for Krabbe Disease (WWR), a database maintained at HJKRI that now has clinical and genetic information for over 150 affected patients afflicted with this rare disease, and examining ways to involve the WWR in national data-sharing initiatives promoted by the NIH, including the Newborn Screening Translational Research Network (NBSTRN). HJKRI is also conducting long-term follow-up studies of affected children, in conjunction with the Rare Clinical Disease Research Network (RDCRN) examining neuro-developmental parameters before and after therapeutic transplantation. Additional projects include exploration of the genotype/phenotype relationship in Krabbe, including exome and whole genome analyses with collaborators, and participating in research to uncover new biomarkers and to develop novel therapies. I am also the Director of the Headache and Concussion clinics at Children’s Hospital of Buffalo. These clinical leadership roles in Western New York and New York State can facilitate significant recruitment into multi-center research studies.
Children and Adults; Forensic Psychiatry; Psychiatry
My time is split between the Erie County Forensic Mental Health Service (ECFMH) and the Erie County Medical Center (ECMC). At ECFMH I conduct Article 730 competency evaluations for the courts, along with other requested evaluations from the criminal justice system. I complete clinical rounds on the Constant Observation units (suicide watch) at the Erie County Holding Center (ECHC). At ECHC I oversee a Residential Treatment Unit for inmates who have a serious mental illness and may benefit from a higher level of care. Working within a treatment team consisting of mental health staff, a psychiatrist, a nurse practitioner, a psychologist, and students, staff provide weekly individual counseling, weekly groups, and comprehensive psychiatric care. We conduct psychological assessment with inmates and track clinical outcomes over time. Further, we conduct research from this information on an ongoing basis. I also help to supervise graduate and undergraduate level students. At ECMC I am the Unit Chief of a new, specialized psychiatric inpatient unit--Transitions--for individuals at imminent risk for aggression or recently became aggressive primary to a mental illness. A interdisciplinary team of licensed mental health counselors, nursing, a clinical manager, a psychiatrist, an occupational therapist, and a psychologist work to stabilize patients and prevent incidents of aggression. I provide oversight of clinical programming (individual and group psychotherapy) and assessment activities. In the future we will provide all patients with assessment and track outcomes over time. This unit will also be a training unit for students and will conduct research. My other clinical and evaluation interests include sex offender treatment and risk assessment, work with individuals who have serious mental illness, particularly Schizophrenia, and mood disorders. When I primarily conducted psychotherapy in the past I specialized in working with individuals who had depression and anxiety disorders. I have also specialized in working with domestic violence, both victims and offenders throughout my career. My research interests are varied, but include aggression, violence, well-being, positive psychology topics, countertransference management, sex offender work, therapist effects, and mood disorders.
Children and Adults; General Neurology; Movement Disorders; Neurodegenerative disorders; Neurology; Parkinson's; Tourette's Syndrome
I received my medical degree from the University of Otago Medical School in New Zealand in 1977 and, following further advanced training in general medicine and Neurology was elected to Fellowship of the Royal Australasian College of Physicians in 1984. On completion of a Neurology residency and fellowship in Movement Disorders at the University of Rochester (1988), I joined the faculty of the Department of Neurology at the University at Buffalo. As a Clinical Professor at UB, I am engaged in patient care and the teaching of students, residents and fellows at the VA Medical Center. I also have a focused Movement Disorders clinic at the Brain and Spine Center (Williamsville, NY). My interests include not only disorders of voluntary movement but also the associated cognitive, behavioral and psychiatric dysfunction commonly accompanying such disorders. Accordingly, I conduct clinical studies in Movement Disorders not only with my Neurology and Neuroimaging colleagues at UB, but have also collaborated on clinical studies in Tourette syndrome with colleagues from the UB Department of Psychiatry, where I have a secondary appointment, and with members of the Division of Developmental and Behavioral Neurosciences. My publications include co-editing a textbook on “Frontal-Subcortical Circuits in Psychiatric and Neurological Disorders” (Guilford Press, 2001). I am an active member of the American Academy of Neurology, the Movement Disorders Society, the Tourette Syndrome Association, the American Neuropsychiatric Association, and the Royal Australasian College of Physicians.
Clinical Genetics; Pediatrics; Children and Adults; Dysmorphology; Pediatric Genetics
I specialize in the evaluation of children and adults with birth defects, developmental disability, autism and genetic disorders and/or syndromes. My goal as a clinical geneticist/dymorphologist is to make specific overall diagnoses in order to provide patients and their families with information regarding prognosis and recurrence risks, i.e., the likelihood that a trait or disorder present in one family member will occur again in other family members. In addition, I help coordinate patient care in conjunction with patients’ primary care physicians and other specialists. I also work closely with genetic counselors who evaluate patients for a variety of concerns and help to coordinate genetic diagnostic testing as indicated. As a UBMD physician working at the Women and Children‘s Hospital of Buffalo, I direct the Williams Syndrome Clinic and serve as the clinical director at the Craniofacial Center of Western New York. The Craniofacial Center provides comprehensive, interdisciplinary evaluation and management of individuals from birth through adulthood with congenital and acquired craniofacial abnormalities. Common diagnoses include clefts of the lip and/or palate, craniosynostosis and ear anomalies. We hold monthly conferences that focus both on teaching and communication amongst providers in an effort to optimize patient care. My particular interest in the care of individuals with Williams Syndrome led me to start a multidisciplinary Williams Syndrome clinic in 1994. This is one of only twelve such clinics in the country. The clinic is held monthly, and it is organized by patient age groups; the format allows families to interact and share their experiences. Geneticists, genetic counselors, cardiologists, pediatric psychiatrists and pediatric dentists contribute their expertise at these clinics, and every patient sees a provider from each of these specialties. Additional evaluations for our Williams Syndrome patients are provided by other specialists such as ophthalmologists, nephrologists and neuropsychologists, depending on individual patient needs. I have coordinated a number of research studies in this patient population, and I have published extensively in this field. As a UB faculty member, I also teach residents and medical students during their month-long genetics elective.