2025
Prevalence of Moral Injury in Nationally Representative Samples of Combat Veterans, Healthcare Workers, and First Responders
Maguen S, Griffin B, Pietrzak R, McLean C, Hamblen J, Norman S. Prevalence of Moral Injury in Nationally Representative Samples of Combat Veterans, Healthcare Workers, and First Responders. Journal Of General Internal Medicine 2025, 1-7. PMID: 39881119, DOI: 10.1007/s11606-024-09337-x.Peer-Reviewed Original ResearchNationally Representative SampleHealthcare workersRepresentative sampleMoral injuryDesignCross-sectional surveyPrevalence of moral injuryFirst respondersExposure to PMIEsMoral injury symptomsCombat veteransHigh-risk populationHigh-risk groupInjury eventsInjury exposureHealthcareVeteransWell-beingOccupational differencesRespondentsPMIEsPrevalenceWorkersComplex decisionsClinicInjury
2024
Health and psychiatric impairment associated with moral injury, military sexual trauma, and their co-occurrence in U.S. combat veterans
Nichter B, Hill M, Maguen S, Norman S, Fischer I, Pietrzak R. Health and psychiatric impairment associated with moral injury, military sexual trauma, and their co-occurrence in U.S. combat veterans. Journal Of Psychosomatic Research 2024, 179: 111617. PMID: 38394711, DOI: 10.1016/j.jpsychores.2024.111617.Peer-Reviewed Original ResearchMilitary sexual traumaExposure to military sexual traumaU.S. combat veteransCombat veteransMoral injurySexual traumaNational Health and ResilienceSeverity of posttraumatic stressPast-year suicidal ideationPrevalence of military sexual traumaPhysical health comorbiditiesCo-occurrenceChronic medical conditionsGeneralized anxietyPopulation-based studyPosttraumatic stressSuicidal ideationVeterans StudySomatic complaintsPsychosocial functioningInsomnia symptomsMilitary veteransLifetime prevalencePMIEsHealth comorbidities
2023
Neural valuation of rewards and punishments in posttraumatic stress disorder: a computational approach
Jia R, Ruderman L, Pietrzak R, Gordon C, Ehrlich D, Horvath M, Mirchandani S, DeFontes C, Southwick S, Krystal J, Harpaz-Rotem I, Levy I. Neural valuation of rewards and punishments in posttraumatic stress disorder: a computational approach. Translational Psychiatry 2023, 13: 101. PMID: 36977676, PMCID: PMC10050320, DOI: 10.1038/s41398-023-02388-4.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderValuation systemStress disorderCombat veteransMaintenance of PTSDSubjective valueBrain valuation systemNeural valuation systemVentromedial prefrontal cortexFunctional MRI studyFunction of symptomsMale combat veteransNeural valuationSeries of choicesFear learningPunishment processingPosttrauma symptomsPTSD symptomsNeural encodingNeural mechanismsUncertain optionsPrefrontal cortexSubjective valuationVentral striatumMonetary gains
2022
Mental health of U.S. combat veterans by war era: Results from the National health and Resilience in veterans study
Na P, Schnurr P, Pietrzak R. Mental health of U.S. combat veterans by war era: Results from the National health and Resilience in veterans study. Journal Of Psychiatric Research 2022, 158: 36-40. PMID: 36565542, PMCID: PMC11929138, DOI: 10.1016/j.jpsychires.2022.12.019.Peer-Reviewed Original ResearchConceptsIraq/Afghanistan war veteransAfghanistan war veteransPosttraumatic stress disorderUS combat veteransNational HealthUse disordersWar veteransCurrent drug use disordersCombat veteransCurrent major depressive disorderCombat exposure severityCurrent alcohol use disorderEra veteransLifetime posttraumatic stress disorderAdverse psychiatric outcomesDrug use disordersMajor depressive disorderGulf War veteransCurrent suicidal thoughtsMental health factorsAlcohol use disorderCurrent suicidal ideationTrauma burdenDepressive disorderERA groupHomelessness and Contact with the Criminal Legal System among U.S. Combat Veterans: An Exploration of Potential Mediating Factors
Orak U, Kelton K, Vaughn M, Tsai J, Pietrzak R. Homelessness and Contact with the Criminal Legal System among U.S. Combat Veterans: An Exploration of Potential Mediating Factors. Criminal Justice And Behavior 2022, 50: 392-409. DOI: 10.1177/00938548221140352.Peer-Reviewed Original ResearchCombat veteransUse disordersCLS involvementU.S. combat veteransDrug use disordersAlcohol use disorderPotential mediating factorsRisk factorsNational HealthModifiable mechanismsHistory of homelessnessVeterans StudyDescriptive studyPrevention effortsPotential mechanismsNotable proportionVeteransInvolvementDisordersAssociationMoral injuryMediating factorsIndirect associationsLarge proportionModeling gene × environment interactions in PTSD using human neurons reveals diagnosis-specific glucocorticoid-induced gene expression
Seah C, Breen M, Rusielewicz T, Bader H, Xu C, Hunter C, McCarthy B, Deans P, Chattopadhyay M, Goldberg J, Dobariya S, Desarnaud F, Makotkine I, Flory J, Bierer L, Staniskyte M, Noggle S, Huckins L, Paull D, Brennand K, Yehuda R. Modeling gene × environment interactions in PTSD using human neurons reveals diagnosis-specific glucocorticoid-induced gene expression. Nature Neuroscience 2022, 25: 1434-1445. PMID: 36266471, PMCID: PMC9630117, DOI: 10.1038/s41593-022-01161-y.Peer-Reviewed Original ResearchConceptsPost-traumatic stress disorderPeripheral blood mononuclear cellsGlucocorticoid-induced changesGlucocorticoid-induced gene expressionBlood mononuclear cellsIndividual clinical outcomesEnvironmental risk factorsHuman postmortem brainGlucocorticoid hypersensitivityClinical outcomesGlutamatergic neuronsMononuclear cellsRisk factorsHydrocortisone exposureSevere traumaPostmortem brainsHuman neuronsGlucocorticoid responseInduced neuronsStress disorderNeuronsNew therapeuticsGene expressionGene × environment interactionsCombat veteransMoral injury among U.S. combat veterans with and without PTSD and depression
Norman SB, Nichter B, Maguen S, Na PJ, Schnurr PP, Pietrzak RH. Moral injury among U.S. combat veterans with and without PTSD and depression. Journal Of Psychiatric Research 2022, 154: 190-197. PMID: 35947898, DOI: 10.1016/j.jpsychires.2022.07.033.Peer-Reviewed Original ResearchConceptsProbable posttraumatic stress disorderPosttraumatic stress disorderCombat veteransInjurious eventsU.S. combat veteransProbable depressionFunctional impairmentMost veteransStress disorderDepressionVeteransPrevalenceDisordersRepresentative studyRepresentative sampleMoral injuryPMIEsParticipants
2021
Drinking to Cope with Posttraumatic Stress: A Nationally Representative Study of Men with and without Military Combat Experience
Blakey SM, Tsai J, Elbogen EB. Drinking to Cope with Posttraumatic Stress: A Nationally Representative Study of Men with and without Military Combat Experience. Journal Of Dual Diagnosis 2021, 17: 101-112. PMID: 33730991, DOI: 10.1080/15504263.2021.1891360.Peer-Reviewed Original ResearchConceptsMilitary combat experiencePosttraumatic stress disorderMilitary combat veteransPTSD symptomsPTSD symptom countCombat experienceHazardous alcohol useAlcohol abuse/dependenceTrauma survivorsAbuse/dependencePTSD diagnosisCombat veteransAlcohol useLifetime trauma exposureSymptom countsTrauma-exposed menLifetime PTSD severityLifetime alcohol abuse/dependenceLifetime PTSD diagnosisLifetime traumatic experiencesFace interview studyMultivariate analysisPosttraumatic stressTrauma exposurePTSD severity
2019
Randomized Controlled Trial of Imagery Rehearsal for Posttraumatic Nightmares in Combat Veterans.
Harb GC, Cook JM, Phelps AJ, Gehrman PR, Forbes D, Localio R, Harpaz-Rotem I, Gur RC, Ross RJ. Randomized Controlled Trial of Imagery Rehearsal for Posttraumatic Nightmares in Combat Veterans. Journal Of Clinical Sleep Medicine 2019, 15: 757-767. PMID: 31053215, PMCID: PMC6510682, DOI: 10.5664/jcsm.7770.Peer-Reviewed Original ResearchConceptsCognitive behavioral therapyPosttraumatic stress disorderNightmare Distress QuestionnaireNightmare Frequency QuestionnaireBehavioral therapySevere posttraumatic stress disorderUnited States veteransOperation Enduring Freedom/Operation Iraqi Freedom veteransImagery rehearsalOperation Iraqi Freedom veteransSubgroups of veteransIraqi Freedom veteransFrequency questionnaireControlled TrialsPrimary outcomeLikelihood ratio chi-squareStates veteransDistress QuestionnaireStress disorderChi-squareRecurrent nightmaresConfidence intervalsMilitary veteransVeteransCombat veteransNeural computations of threat in the aftermath of combat trauma
Homan P, Levy I, Feltham E, Gordon C, Hu J, Li J, Pietrzak RH, Southwick S, Krystal JH, Harpaz-Rotem I, Schiller D. Neural computations of threat in the aftermath of combat trauma. Nature Neuroscience 2019, 22: 470-476. PMID: 30664770, PMCID: PMC6829910, DOI: 10.1038/s41593-018-0315-x.Peer-Reviewed Original ResearchConceptsPTSD symptomsPost-traumatic stress disorder symptomsHigher PTSD symptom severityThreat-predictive cuesPTSD symptom severityAssociative threatPredictive cuesNeural trackingDisorder symptomsPrediction errorCombat veteransDynamic learning rateNegative outcomesCombat traumaSmaller amygdala volumesNeural computationLatent markersSymptomatic veteransSymptom severityAmygdala volumeAssociabilityCuesLearning rateVeteransSymptoms
2018
Locus of control in US combat veterans: Unique associations with posttraumatic stress disorder 5-factor model symptom clusters
Smith NB, Sippel LM, Presseau C, Rozek D, Mota N, Gordon C, Horvath M, Harpaz-Rotem I. Locus of control in US combat veterans: Unique associations with posttraumatic stress disorder 5-factor model symptom clusters. Psychiatry Research 2018, 268: 152-156. PMID: 30029062, DOI: 10.1016/j.psychres.2018.07.015.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderLocus of controlPTSD symptom clustersOverall PTSD symptomsAvoidance symptomsPTSD symptomsSymptom clustersStress disorderCombat veteransExternal locusCombat exposureCorrelates of PTSDSpecific PTSD symptom clustersTrauma-focused treatmentSelf-report measuresUS combat veteransIntervention effortsUnique associationUS military veteransExtreme scoresPotential correlatesMilitary veteransBivariate correlationsOnly avoidanceSignificant correlates
2017
Gender-Specific Risk Factors for Psychopathology and Reduced Functioning in a Post-9/11 Veteran Sample
Scoglio AAJ, Shirk SD, Hoff RA, Potenza MN, Mazure CM, Park CL, McKee SA, Porter EA, Kraus SW. Gender-Specific Risk Factors for Psychopathology and Reduced Functioning in a Post-9/11 Veteran Sample. Journal Of Interpersonal Violence 2017, 36: np1359-1374np. PMID: 29295023, PMCID: PMC6461523, DOI: 10.1177/0886260517746182.Peer-Reviewed Original ResearchConceptsCombat veteransGender-related differencesSexual traumaFemale veteransU.S. combat veteransGender-specific risk factorsMental health problemsSubstance use disordersSocial functioningTrauma historyVeteran sampleFemale combat veteransRisk factorsGeneral populationMale veteransWomen veteransHealth problemsImpulsivitySecondary analysisVeteran reintegrationPsychopathologyMale counterpartsVeteransCivilian lifeAdditional investigationMental and Physical Health Conditions in US Combat Veterans: Results From the National Health and Resilience in Veterans Study.
Thomas MM, Harpaz-Rotem I, Tsai J, Southwick SM, Pietrzak RH. Mental and Physical Health Conditions in US Combat Veterans: Results From the National Health and Resilience in Veterans Study. The Primary Care Companion For CNS Disorders 2017, 19 PMID: 28657698, DOI: 10.4088/pcc.17m02118.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge FactorsCardiovascular DiseasesCross-Sectional StudiesFemaleHealth StatusHumansMaleMental DisordersMental HealthMiddle AgedMigraine DisordersResilience, PsychologicalSex FactorsSocioeconomic FactorsSubstance-Related DisordersSuicideUnited StatesVeteransWar ExposureYoung AdultConceptsPhysical health conditionsPosttraumatic stress disorderOlder combat veteransCurrent posttraumatic stress disorderGreater oddsHealth conditionsChronic painHeart diseaseUS veteransNational HealthMigraine headacheCombat veteransSuicidal ideationVeterans StudyCurrent generalized anxiety disorderHeart attackVeterans Affairs Healthcare SystemLifetime posttraumatic stress disorderUS veteran populationElevated ratesPopulation-based burdenCurrent psychiatric disorderDrug use disordersMental health factorsGeneralized anxiety disorderNeuroeconomic approach to trauma related psychopathology: A version to ambiguous losses in PTSD
Harpaz-Rotem I, Jia R, Ruderman L, Pietrzak R, Levy I. Neuroeconomic approach to trauma related psychopathology: A version to ambiguous losses in PTSD. European Psychiatry 2017, 41: s358. DOI: 10.1016/j.eurpsy.2017.02.349.Peer-Reviewed Original ResearchAnxious arousal symptomsArousal symptomsAmbiguity attitudesCombat exposureTrauma-related symptomatologyTrauma-related psychopathologyTrauma-related symptomsWhole-brain analysisBehavioral economics techniquesSeverity of PTSDDisclosure of interestNeuroeconomic approachNeural underpinningsTraditional diagnostic categoriesSpecific brain areasCombat veteransRelated psychopathologyAmbiguous optionBehavioral outcomesFMRI dataBrain analysisPTSDLoss domainAmbiguous lossBrain areasMoral injury in U.S. combat veterans: Results from the national health and resilience in veterans study
Wisco BE, Marx BP, May CL, Martini B, Krystal JH, Southwick SM, Pietrzak RH. Moral injury in U.S. combat veterans: Results from the national health and resilience in veterans study. Depression And Anxiety 2017, 34: 340-347. PMID: 28370818, DOI: 10.1002/da.22614.Peer-Reviewed Original ResearchMental disordersNational HealthCombat veteransU.S. combat veteransCurrent mental disorderPast psychiatric disordersPopulation-based sampleCombat severityMental health problemsMoral Injury Events ScaleFunctional outcomeMoral injuryWhite racePsychiatric disordersHealth problemsU.S. veteransSuicidal ideationVeterans StudySuicide attemptsInjurious eventsCombat exposureSociodemographic variablesDisordersExposure historyVeterans
2016
Caring for the Geriatric Combat Veteran at the Veteran Affairs Hospital
Bhattacharya B, Pei K, Lui F, Rosenthal R, Davis K. Caring for the Geriatric Combat Veteran at the Veteran Affairs Hospital. Current Trauma Reports 2016, 3: 62-68. DOI: 10.1007/s40719-016-0068-5.ChaptersReal-Time fMRI Neurofeedback with War Veterans with Chronic PTSD: A Feasibility Study
Gerin MI, Fichtenholtz H, Roy A, Walsh CJ, Krystal JH, Southwick S, Hampson M. Real-Time fMRI Neurofeedback with War Veterans with Chronic PTSD: A Feasibility Study. Frontiers In Psychiatry 2016, 7: 111. PMID: 27445868, PMCID: PMC4914513, DOI: 10.3389/fpsyt.2016.00111.Peer-Reviewed Original ResearchPost-traumatic stress disorderChronic post-traumatic stress disorderResting-state functional connectivity patternsReal-time functional magnetic resonanceStudy of efficacyReal-time fMRI neurofeedbackWar veteransFunctional connectivity patternsFunctional magnetic resonanceClinical improvementAvailable treatmentsTrauma scriptsSymptom reductionMeaningful improvementsNovel interventionsNF trainingStress disorderBrain connectivityNeurofeedback interventionAmygdala activityFMRI neurofeedbackCombat veteransInterventionVeteransFeasibility studyPOSTTRAUMATIC STRESS SYMPTOMS AND AVERSION TO AMBIGUOUS LOSSES IN COMBAT VETERANS
Ruderman L, Ehrlich DB, Roy A, Pietrzak RH, Harpaz-Rotem I, Levy I. POSTTRAUMATIC STRESS SYMPTOMS AND AVERSION TO AMBIGUOUS LOSSES IN COMBAT VETERANS. Depression And Anxiety 2016, 33: 606-613. PMID: 27000639, PMCID: PMC5247796, DOI: 10.1002/da.22494.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderCombat veteransAmbiguity attitudesCombat exposureDecision-making taskTrauma-related symptomsAnxious arousal symptomsBehavioral economics techniquesUncertainty attitudesAnxious arousalNeural underpinningsTraditional diagnostic categoriesArousal symptomsStress disorderBehavioral levelBehavioral outcomesParticipants' choicesLoss domainBehavioral economicsPsychiatric symptomsVeteransAttitudesPsychiatric disordersUncertain outcomesUncertain gains
2014
Combat Exposure Factors Associated With the Likelihood of Behavioral and Psychiatric Issues
Gallaway M, Mitchell M, Fink D, Forys-Donahue K, Pecko J, Bell M, Millikan A. Combat Exposure Factors Associated With the Likelihood of Behavioral and Psychiatric Issues. Journal Of Military Social Work And Behavioral Health Services 2014, 2: 138-146. DOI: 10.1080/21635781.2014.897205.Peer-Reviewed Original Research
2012
Factors Associated With Physical Aggression Among US Army Soldiers
Gallaway M, Fink D, Millikan A, Bell M. Factors Associated With Physical Aggression Among US Army Soldiers. Aggressive Behavior 2012, 38: 357-367. PMID: 22898873, DOI: 10.1002/ab.21436.Peer-Reviewed Original ResearchConceptsOvert aggressive behaviorPhysical aggressionUS Army soldiersMisuse of alcoholCombat exposureArmy soldiersSample of US Army soldiersAggressive behaviorSelf-reported physical aggressionLevels of physical aggressionActive duty US Army soldiersPosttraumatic stress disorderIncreased physical aggressionIncreased combat exposureLevels of combatOvert physical aggressionRevised Conflict Tactics ScaleConflict Tactics ScaleLevels of aggressionTraumatic brain injuryCombat veteransStress disorderCombat intensityCombat deploymentTactics Scale
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