HERSHEY, Pa. — Penn State Clinical and Translational Science Institute (CTSI) provides a unique opportunity for clinicians and scientists to move research discoveries into practical use. Not only does the Institute improve the health of its neighbors by integrating new findings into health care, it also promotes collaboration within research by providing opportunities for junior researchers to gain skills and knowledge through mentorship.

CTSI’s Early-Stage Investigator Training Program (KL2) is an institutional research and career development program. The KL2 program provides a supportive interdisciplinary environment for junior faculty scholars to gain skills and experience to become successful, independent clinical and translational scientists. This is accomplished through coursework, mentored research and career development programs.

KL2 funding covers dedicated, protected time for research, funds for research supplies, tuition support for up to three courses per semester and travel costs.

The KL2 Training Program selects candidates who, with proper career development and clinical and/or translational research training, will eventually earn independent funding and become successful and ethical clinical and translational investigators.

Steffany Fredman, associate professor of human development and family studies and psychology, received a KL2 award. The publication of her recent article “PTSD Symptom Cluster Severity Predicts Momentary Emotion Dynamics During Couple Conversations” in Behavior Therapy was the culmination of research she began with the support of the 2018 KL2 award. Here, we asked her to offer her insight as a scholar in the program.

Tell us a little bit about your experience in the KL2 program.

I’m a clinical psychologist and came to Penn State in 2014 with a background in developing and testing treatments for Post-Traumatic Stress Disorder (PTSD). I had also done work to understand how PTSD affects relationships and vice-versa. One of the things that was very exciting to me about coming to Penn State and being part of the Department of Human Development and Family Studies (HDFS) was the opportunity to think about intra-individual variability and change and how those processes can differ across individuals and couples. To properly study these processes, however, required that I learn new methodological approaches and statistical techniques.

The KL2 award gave me the time and resources to do this “back to the drawing board” kind of work. I was able to push the bounds of my knowledge as well as identify what would advance the larger disciplinary field. With answers to these new questions about people with PTSD and their partners, we could make our treatments more targeted and more effective. At the time, I was mid-way on the tenure track, and I needed the dedicated, protected time to learn this new methodology with mentorship.

For instance, Dr. Melanie Fischer, now at the University of Marburg, and Dr. Donald Baucom at UNC-Chapel Hill introduced me to using a voice-stress paradigm to investigate patterns of emotional responding among couples in which one partner experiences a psychological disorder. My colleagues Sy-Miin Chow, from Penn State HDFS and Nilam Ram, now at Stanford, provided mentorship regarding the analysis of the intensive emotional arousal data that we mined from laboratory-based couple conversations using the voice stress paradigm. These conversations were from an archival sample of trauma-exposed couples who had been recruited for a study of relationships and stress originally conducted by my colleague Amy Marshall, from Penn State Psychology, who served as another KL2 mentor.

By applying these advanced methodological and data analytic techniques to study emotion dynamics among couples with PTSD while they were discussing their relationships, we can better understand why these couples tend to have difficulties in both managing conflict and in experiencing emotional closeness. Better understanding of these short timescale dynamics will allow us to make our treatments for PTSD more targeted.

For example, our findings indicated that, at higher levels of PTSD symptoms, individuals responded to their own emotional arousal and the arousal communicated through their partner’s voice in a manner consistent with that arousal’s serving as a trauma cue. Helping patients and their partners understand why these difficulties are occurring can decrease self and partner blame and increase motivation to persist in treatments that involve learning to approach and become more comfortable in situations that involve interacting with other people as part of relearning a sense of safety. As trauma survivors’ well-being improves, these positive changes have the potential to cascade outward to others in their social networks, which can then reinforce the gains that the individual has made as part of a virtuous cycle.

Tell us about your own background as a researcher. What drove you to study PTSD and couples?

When I was in grad school, I studied the couple/family context of individual mental health and medical difficulties. When one member of a couple or family has a difficulty, that often becomes a couple- or family-level issue. Mental health and physical health issues are commonly experienced interpersonally, and then what is happening IN the family affects the person’s ability to recover or improve. I was especially interested in understanding how what’s going on in the family might facilitate (or impede) the individual’s making lifestyle changes to treat their conditions. For instance, how do partners of people with anxiety disorders encourage them to approach, rather than avoid, situations that they’re afraid of, which we know is a key ingredient for recovery from fear-based disorders?

During my postdoc at the National Center for PTSD, I worked with Dr. Candice Monson to develop and test cognitive-behavioral couple therapy for those with PTSD and was the project director for an NIH grant to test this therapy in a sample of community couples. That work culminated in the publication of Cognitive-Behavioral Conjoint Therapy for PTSD: Harnessing the Healing Power of Relationships, which is now used nationally by the Veterans Administration.

What do you think others can gain from this program?

The grant writing support and feedback and training are extremely helpful. I was able to secure a $3 million grant from the Department of Defense to test an adapted version of our couple therapy for PTSD. The skills I learned in the KL2 were directly relevant to securing that funding.

What has been the most rewarding part of being a part of the KL2 program?

Understanding that my work is worthy of investment. The University, department head, dean, and all the parties involved in my participation in the KL2 were invested in my success.

More importantly, though, my increased knowledge of grants, grant-writing, new research methodology, advanced statistical techniques, and funding has been something I can pass on to my students. Three of my current and former students have been direct beneficiaries of this investment, publishing papers in high-impact journals because I was better equipped to mentor them. One of my students was awarded an NIH-funded fellowship, and another earned an NSF fellowship. Two of my students are now in academic positions and another will begin a research postdoc in a few months. My participation in the KL2 Training Program has made me a more effective mentor to my own students.

For program information, the selection process, and scholar and mentor expectations, visit the Early-Stage Investigator (KL2) webpage on the Penn State CTSI website.