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THRIVE Laboratory

Patrick Smith
Dr. Patrick J. Smith is a clinical psychologist and biostatistician with expertise in behavioral medicine and neuropsychology. He also directs the THRIVE Laboratory.

THRIVE: Transforming Health and Resilience through Interventions for Vascular Enhancement

The THRIVE Laboratory has ready access to phlebotomy and blood sample processing facilities, laboratory space dedicated to neuropsychological testing, source materials for neuropsychological assessments and normative measures, biobehavioral assessment materials (including actigraphy, physical frailty, and ambulatory cognition assessments) and physical space for behavioral intervention delivery.

Dr. Smith is an Associate Professor of Psychiatry and Neurology at UNC-CH, where he began his current appointment in 2022. Prior to this, he had spent nearly 20 years working and training at Duke University and DUMC, beginning as a research assistant in 2003 and then PhD graduate student in Clinical Health Psychology in 2005. After obtaining his PhD at Duke in 2010, he completed dual-postdoctoral trainings in behavioral medicine and clinical neuropsychology at DUMC. He also completed an MPH in biostatistics at UNC-CH in parallel.

His research is focused on using biobehavioral interventions to improve cognitive function and mental health outcomes among adults with chronic medical conditions, with a particular focus on targeting cardiometabolic treatment mechanisms. He has been continuously funded by the NIH over the past 15 years, including from the NHLBI and NIA, as well as from foundation and industry sponsors. He was previously a standing member of one of the NIH’s primary behavioral medicine study sections: Biobehavioral Medicine and Health Outcomes (BMHO). He also serves as the co-lead for the UNC clinical core on the Duke-UNC Alzheimer’s Disease Research Center and is the sole UNC neuropsychologist.

Publications

Current Studies

Dr. Smith’s current projects include the use of time-restricted eating to improve cognitive functioning, remotely-delivered telehealth interventions to improve physical frailty in solid organ transplant candidates, the use of Acceptance and Commitment Therapy (ACT) telehealth interventions among individuals with chronic medical conditions, precision approaches to enhance prediction of dementia, and examining cardiovascular mechanisms of improved sleep quality using Cognitive Behavioral Therapy for Insomnia (CBT-I).

Affiliated Collabroators

Erik Hanson (UNC)

Lisa Kanser (UNC)

Zev Nakamura (UNC)

Kim Huffman (Duke)

Heather Whitson (Duke)

Virginia O’Hayer (Thomas Jefferson University)

Jonathan Singer (UCSF)

The focus of this study is the use of time restricted eating (TRE) to improve metabolic and cognitive functioning among older adults with mild cognitive impairment (MCI). Our goal is to examine whether individuals with MCI can engage and sustain engagement in a 16:2 intermittent fasting protocol, the preliminary effects of TRE on metabolism, inflammation, and cognitive function, and the associations between changes in metabolic function, inflammation, and cognitive function.

Status: Enrollment Completed (analysis phase)

The focus of this study is the use of a telehealth, exercise-based, prehabilitation intervention to improve physical activity and physical frailty measures among individuals undergoing lung transplantation. This trial, conducted in collaboration with Dr. Jon Singer, examines whether we can develop a remotely delivered behavioral intervention to improve physical frailty as a ‘prehabilitation’ intervention for those that cannot access standard pulmonary rehabilitation.

Status: Ongoing

Dr. Smith is a collaborator on several trials examining the cardiovascular mechanisms of a Cognitive Behavioral Therapy for Insomnia (CBT-I) intervention among individuals with risk factors for cardiovascular disease. These trials, conducted in collaboration with Drs. Andrew Sherwood and Jean Beckham, attempt to examine how enhancing sleep quality may reduce cardiovascular risk.

Status: Enrollment Completed (analysis phase)

Dr. Smith is an active collaborator with Dr. Virginia O’Hayer and other colleagues examining the use of telehealth delivered Acceptance and Commitment Therapy (ACT) to improve coping with chronic medical conditions. Recent trials, including ACT with CF and ACT with NMOSD, have demonstrated that brief telehealth interventions can improve psychological flexibility and psychological functioning among individuals with chronic medical conditions and that these improvements appear to be sustained over subsequent months following intervention completion.

Status: Ongoing

Dr. Smith is one of two neuropsychologists on the Duke-UNC ADRC, serving as a member of the UNC Clinical Core. The Duke-UNC ADRC is focused on identifying modifiable risk factors for Alzheimer’s Disease and Related Dementias (ADRD) that can be treated in order to reduce risk of ADRD later in life. Dr. Smith has led several of the initial publications for the ADRC, focusing on the role of physical frailty and sensory functions as they relate to cognitive function and cerebrospinal fluid ADRD biomarkers.

Status: Ongoing

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