Leading the Vanguard: Julia Sheffield

Julia Sheffield headshot

VKC Member Julia Sheffield, Ph.D., is an assistant professor of Psychiatry & Behavioral Sciences and Jack Martin, M.D., research professor in Psychopharmacology. She is a licensed clinical psychologist specializing in psychotherapy for individuals with psychosis, using a cognitive-behavioral therapy approach. Her research focuses on identifying cognitive mechanisms underlying psychotic experiences using neuroimaging, behavioral, and clinical trials approaches.

In the interview below, Sheffield shares how she became interested in disability research, describes her current work investigating psychotic disorders (e.g. schizophrenia), and how becoming a member of the VKC enhances the work she does.

How did your become interested in developmental disabilities research?

For as long as I can remember, I wanted to be a mental health professional, and that road was paved with many formative experiences with individuals with developmental disabilities. My first contact with a clinical environment was volunteering at Misericordia in Chicago – a community for individuals with mild to profound developmental disabilities. This experience had a very meaningful impact on me, as it allowed me to observe the joy and resilience that comes from connecting with others. I ultimately found my clinical “home” in working with individuals with psychotic disorders, such as schizophrenia. Although it is typically diagnosed in early adulthood, schizophrenia is increasingly recognized as a developmental disorder, as cognitive and psychiatric difficulties often manifest before the more pronounced psychotic symptoms, sometimes in very early childhood. I am extremely interested in helping individuals with psychosis live full lives in the context of whatever symptoms they experience, to view themselves as important members of their communities, and to reduce the stigma associated with psychosis.

What are your current research interests/projects?

My current research focuses on understanding and treating delusional thinking, particularly persecutory delusions, which are a severe form of paranoia. I just completed a randomized clinical trial to examine the impact of cognitive behavioral therapy for psychosis on the cognitive and neural mechanisms that are believed to underlie persecutory delusions. I have received funding from the National Institute of Mental Health (NIMH) to continue this work in a larger trial, which will soon be underway.  I am very interested in a particular cognitive process – belief updating – which involves updating one’s beliefs about the world in the face of new information. I want to understand whether expecting more change (i.e. volatility) in one’s environment contributes to paranoia and can be treated with psychotherapy. In addition to this line of research, my graduate student, Drew Kittleson, and I are also beginning to investigate interoception, which is the ability to notice and understand one’s own internal bodily sensations. Alterations in interoception are common in autism and may also help explain some of the perceptual abnormalities and altered inferences observed in schizophrenia. I want to understand how interoception is altered in schizophrenia and might contribute to the development of delusions.

How do you think this research might have an impact in the lives of people with disabilities and their families?

Delusions are profoundly distressing to both individuals with lived experiences and their families. They are often the reason why families are initially aware that their loved one is suffering, because they begin talking about their unusual beliefs or behaving in odd ways as a result of their delusions. Persecutory delusions and paranoia are the most common type of delusions in psychotic disorders and are also experienced across a wide spectrum of severity in the broader population. At its core, paranoia is disconnecting – it engenders mistrust in others and isolates the individual. I believe that understanding the processes that contribute to paranoia may lead to improved treatments, which will help with reconnection and building a happier and more fulfilling life.

What are your reasons for becoming a Vanderbilt Kennedy Center (VKC) Member? How does the VKC enhance the work you do?

I became a VKC Member because of its incredible integration of research with clinical efforts and community engagement. Scientifically, it offers a wonderful community for me to be a part of that opens up potential collaborations. For instance, schizophrenia and autism have many overlapping features; collaborations within the VKC could help elucidate those similarities and differences, guiding treatment advancement. I am also inspired by the outreach done by the VKC and its connection with the community – I hope to learn from other VKC Members about how to integrate that into my own research and clinical work.

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