2024
Unraveling PTSD: Symptom Cluster Change During and 1 Year After Veterans’ Residential PTSD Treatment
Gross G, Spiller T, Ben-Zion Z, Rubenstein A, Pietrzak R, Duek O, Hoff R, Harpaz-Rotem I. Unraveling PTSD: Symptom Cluster Change During and 1 Year After Veterans’ Residential PTSD Treatment. Psychological Trauma Theory Research Practice And Policy 2024 PMID: 38990694, DOI: 10.1037/tra0001734.Peer-Reviewed Original ResearchPosttraumatic stress disorderPosttraumatic stress disorder symptom clustersPosttraumatic stress disorder clustersSymptom clustersIntrusive symptomsResidential treatmentTreatment of posttraumatic stress disorderPosttraumatic stress disorder symptomsResidential PTSD treatmentPTSD symptom clustersNovel treatment interventionsDifferential treatment responseReduce symptom severityDifferential patterns of changeAvoidance symptomsPTSD treatmentTreatment gainsStress disorderVeterans AffairsSymptom severityCluster CTreatment interventionsCluster BIndividual symptomsCohort of veteransAssociations of Posttraumatic Stress Disorder Symptom Clusters and Pain Interference in Post-9/11 Veterans: Exploring Sleep Impairment and Physical Activity as Underlying Mechanisms
Emrich M, Gnall K, Garnsey C, George J, Park C, Mazure C, Hoff R. Associations of Posttraumatic Stress Disorder Symptom Clusters and Pain Interference in Post-9/11 Veterans: Exploring Sleep Impairment and Physical Activity as Underlying Mechanisms. International Journal Of Behavioral Medicine 2024, 32: 371-384. PMID: 38438749, DOI: 10.1007/s12529-024-10268-4.Peer-Reviewed Original ResearchPost-9/11 veteransPain interferencePhysical activityPTSD symptomsAssociated with pain interferenceModifiable health factorsSleep impairmentSymptom clustersPosttraumatic stress disorder symptom clustersWorsening pain interferencePTSD symptom clustersRe-experiencing symptomsBackgroundPosttraumatic stress disorderHealth factorsSecondary analysisTargeting sleepMethodsThe present studyVeteransHyperarousal symptomsRe-experiencingStress disorderStudy variablesPTSDPainAssociated with changes
2023
Ecological investigation of the co-occurrence of posttraumatic stress disorder symptoms and cannabis use among community women experiencing intimate partner violence
Newberger N, Forkus S, Thomas E, Goldstein S, Ferguson J, Sullivan T, Weiss N. Ecological investigation of the co-occurrence of posttraumatic stress disorder symptoms and cannabis use among community women experiencing intimate partner violence. Drug And Alcohol Dependence 2023, 250: 110905. PMID: 37515827, PMCID: PMC10530157, DOI: 10.1016/j.drugalcdep.2023.110905.Peer-Reviewed Original ResearchConceptsPTSD symptom clustersPosttraumatic stress disorder (PTSD) symptomsSymptom clustersIntimate partner violenceCannabis useCommunity womenDisorder symptomsAcute effectsHazardous patternsPartner violencePTSD symptomsSymptomsWomenCannabisIntervention effortsDaysExternalizing behaviorsSurvey period
2022
A significant U-shaped association between physical activity level and posttraumatic stress disorder in U.S. military Veterans: Results from the 2019–2020 National Health and Resilience in Veterans Study
Adams T, Fenlon E, Penn C, Hubert T, Pietrzak R. A significant U-shaped association between physical activity level and posttraumatic stress disorder in U.S. military Veterans: Results from the 2019–2020 National Health and Resilience in Veterans Study. Mental Health And Physical Activity 2022, 23: 100460. DOI: 10.1016/j.mhpa.2022.100460.Peer-Reviewed Original ResearchPhysical activity levelsU.S. military veteransActivity levelsNational HealthVeterans StudyModerate activity levelsLogistic regressionModerate physical activity levelsLower likelihoodMilitary veteransPositive PTSD screenPublic health guidelinesSpecific PTSD symptomsPTSD symptom dimensionsPosttraumatic stress disorderSelf-report measuresPTSD screenPost-stratification weightsPTSD symptom clustersMultinomial logistic regressionPhysical activityHealth guidelinesClinical implicationsSymptom clustersStress disorderAssociations among Intimate Partner Violence, Posttraumatic Stress Disorder Symptoms, and Disordered Eating among Women Intimate Partner Violence Survivors Residing in Shelter
Holmes SC, King KC, Gonzalez A, Norton MK, Silver KE, Sullivan TP, Johnson DM. Associations among Intimate Partner Violence, Posttraumatic Stress Disorder Symptoms, and Disordered Eating among Women Intimate Partner Violence Survivors Residing in Shelter. Journal Of Interpersonal Violence 2022, 38: 2135-2158. PMID: 35536767, PMCID: PMC9993353, DOI: 10.1177/08862605221098968.Peer-Reviewed Original ResearchConceptsPTSD symptom clustersPosttraumatic stress disorder (PTSD) symptomsWeight/shape concernsPTSD symptomsSymptom clustersShape concernsDisorder symptomsIndirect effectsSpecific PTSD symptom clustersIntimate partner violenceEscape theoryProbable eating disorderSignificant total effectProbable PTSDIntimate partner violence survivorsPsychological distressEating DisordersNegative alterationsCompensatory behaviorsPotential indirect effectsDifferential associationsComorbid diagnosesPartner violenceCurrent sampleViolence survivorsRisk for PTSD symptom worsening during new PTSD treatment episode in a nationally representative sample of treatment-seeking U.S. veterans with subthreshold PTSD
Gross GM, Pietrzak RH, Hoff RA, Katz IR, Harpaz-Rotem I. Risk for PTSD symptom worsening during new PTSD treatment episode in a nationally representative sample of treatment-seeking U.S. veterans with subthreshold PTSD. Journal Of Psychiatric Research 2022, 151: 304-310. PMID: 35526446, DOI: 10.1016/j.jpsychires.2022.04.040.Peer-Reviewed Original ResearchConceptsSymptom worseningRisk factorsSubthreshold PTSDPTSD symptom clustersSymptom clustersPTSD symptomsHealth care utilizationPTSD specialty clinicPoor treatment outcomesUnited States veteransBinary logistic regressionAdjusted analysisCare utilizationTreatment episodesRepresentative sampleSpecialty clinicSignificant symptomsTreatment outcomesSignificant worseningStates veteransSubthreshold symptomsEligible veteransNew episodesOutcome assessmentDiagnostic threshold
2021
Sudden Unexpected Death as a Traumatic Stressor: The Impact of the DSM–5 Revision of Criterion A for Posttraumatic Stress Disorder
Domino J, Whiteman S, Davis M, Witte T, Weathers F. Sudden Unexpected Death as a Traumatic Stressor: The Impact of the DSM–5 Revision of Criterion A for Posttraumatic Stress Disorder. Traumatology An International Journal 2021, 27: 168-176. DOI: 10.1037/trm0000272.Peer-Reviewed Original ResearchDSM-5 definitionPosttraumatic stress disorderUnexpected deathCriterion AStress disorderPTSD symptomsIndirect exposureSevere motor vehicle accidentSudden unexpected deathMotor vehicle accidentsDSM-IV criteriaIndividual PTSD symptomsDSM-5 criteriaDSM-IV definitionOrdinal logistic regressionTrauma groupPTSD symptom clustersDSM-5 criterion ASymptom profilesVehicle accidentsMental disordersSymptom clustersDSM-IVLogistic regressionTrauma-exposed college studentsCannabinoid Receptor 1 rs1049353 Variant, Childhood Abuse, and the Heterogeneity of PTSD Symptoms: Results From the National Health and Resilience in Veterans Study
Korem N, Duek O, Xu K, Harpaz-Rotem I, Pietrzak RH. Cannabinoid Receptor 1 rs1049353 Variant, Childhood Abuse, and the Heterogeneity of PTSD Symptoms: Results From the National Health and Resilience in Veterans Study. Chronic Stress 2021, 5: 24705470211011075. PMID: 33997583, PMCID: PMC8107935, DOI: 10.1177/24705470211011075.Peer-Reviewed Original ResearchPosttraumatic stress disorderOverall PTSD symptomsAnxious arousal symptomsPTSD symptomsNational HealthChildhood abuseVeterans StudySymptom clustersArousal symptomsAllele carrier statusArousal symptom clustersMultivariable analysisEndocannabinoid systemAllele carriersPTSD symptom clustersGene-environment studiesGreater severityG homozygotesU.S. veteransSymptomsStress disorderCarrier statusReceptor geneDisordersSignificant main effect
2019
Heterogeneity of posttraumatic stress symptomatology and social connectedness in treatment-seeking military veterans: a longitudinal examination
Sippel LM, Watkins LE, Pietrzak RH, Hoff R, Harpaz-Rotem I. Heterogeneity of posttraumatic stress symptomatology and social connectedness in treatment-seeking military veterans: a longitudinal examination. European Journal Of Psychotraumatology 2019, 10: 1646091. PMID: 31489133, PMCID: PMC6713134, DOI: 10.1080/20008198.2019.1646091.Peer-Reviewed Original ResearchDysphoric arousal symptomsSocial connectednessPTSD symptomsArousal symptomsTreatment-seeking military veteransGreater PTSD symptom severityCross-lagged panel modelMaintenance of PTSDMilitary veteransPosttraumatic stress symptomatologyPTSD symptom clustersOverall PTSD symptomsPTSD symptom severityPoor social connectednessSocial causation modelIrritability/angerLong-term PTSDTwo-wave cross-lagged panel modelFive-factor modelMost extant researchU.S. military veteransNumbing symptomsSymptom-level analysesStress symptomatologyPTSD treatment
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 correlatesThe Unique Roles of Emotional Numbing and Arousal Symptoms in Relation to Social Connectedness Among Military Veterans in Residential Treatment for PTSD
Sippel LM, Watkins LE, Pietrzak RH, Hoff R, Harpaz-Rotem I. The Unique Roles of Emotional Numbing and Arousal Symptoms in Relation to Social Connectedness Among Military Veterans in Residential Treatment for PTSD. Psychiatry 2018, 81: 271-282. PMID: 30015602, DOI: 10.1080/00332747.2017.1395313.Peer-Reviewed Original ResearchConceptsPTSD symptom clustersDysphoric arousal symptomsPoor social connectednessArousal symptomsEmotional numbingSocial connectednessResidential treatmentPosttraumatic stress disorder (PTSD) symptomsSymptom clustersEmotional numbing symptomsMilitary veteransAnxious arousal symptomsFive-factor modelU.S. military veteransAnxious arousalDysphoric arousalNumbing symptomsInterpersonal functioningTrauma recoveryDisorder symptomsCase conceptualizationGreater distressMore distressPTSDSupportive people
2017
Correlates of Nonimprovement to Pharmacotherapy for Chronic, Antidepressant-Resistant, Military Service–Related Posttraumatic Stress Disorder
Byrne SP, Krystal JH, Rosenheck RA, Vessicchio J, Pietrzak RH. Correlates of Nonimprovement to Pharmacotherapy for Chronic, Antidepressant-Resistant, Military Service–Related Posttraumatic Stress Disorder. Journal Of Clinical Psychopharmacology 2017, 37: 717-721. PMID: 28945664, DOI: 10.1097/jcp.0000000000000777.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAntidepressive AgentsAntipsychotic AgentsDrug Therapy, CombinationFemaleHumansMaleMiddle AgedOutcome Assessment, Health CareRandomized Controlled Trials as TopicRisperidoneSeverity of Illness IndexStress Disorders, Post-TraumaticUnited StatesUnited States Department of Veterans AffairsVeteransConceptsPosttraumatic stress disorderAdjunctive risperidoneTreatment-resistant posttraumatic stress disorderClinician-Administered PTSD Scale scoresSymptom clustersStress disorderOriginal treatment regimenFirst-line pharmacotherapySpecific symptom clustersSpecific PTSD symptom clustersVeterans RANDTreatment regimenPharmacotherapeutic effectsHealth SurveyRole functioningPTSD symptom clustersTreat conditionScale scoreGreater severityVariable improvementRisperidoneTargeted pharmacotherapyPlaceboNonimprovementPharmacotherapyPhysical health conditions associated with full and subthreshold PTSD in U.S. military veterans: Results from the National Health and Resilience in Veterans Study
El-Gabalawy R, Blaney C, Tsai J, Sumner JA, Pietrzak RH. Physical health conditions associated with full and subthreshold PTSD in U.S. military veterans: Results from the National Health and Resilience in Veterans Study. Journal Of Affective Disorders 2017, 227: 849-853. PMID: 29689700, PMCID: PMC6269149, DOI: 10.1016/j.jad.2017.11.058.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultArousalBone Diseases, MetabolicChronic DiseaseComorbidityCorrelation of DataDiabetes MellitusDiagnostic and Statistical Manual of Mental DisordersFemaleHumansMaleMiddle AgedOsteoporosisResilience, PsychologicalRespiratory Tract DiseasesSleep Wake DisordersStress Disorders, Post-TraumaticUnited StatesVeteransYoung AdultConceptsSubthreshold posttraumatic stress disorderPosttraumatic stress disorderFull posttraumatic stress disorderU.S. military veteransNational HealthMilitary veteransVeterans StudyContemporary population-based dataMultiple logistic regression analysisHealth conditionsOdds of osteoporosisOdds of diabetesPopulation-based dataDSM-IV diagnostic criteriaLogistic regression analysisDysphoric arousal symptomsPopulation-based samplePhysical health conditionsSleep disordersPTSD symptom clustersSleep difficultiesRespiratory conditionsDiagnostic criteriaSymptom clustersAnger/irritabilityDifferential predictive value of PTSD symptom clusters for mental health care among Iraq and Afghanistan veterans following PTSD diagnosis
Smith NB, Tsai J, Pietrzak RH, Cook JM, Hoff R, Harpaz-Rotem I. Differential predictive value of PTSD symptom clusters for mental health care among Iraq and Afghanistan veterans following PTSD diagnosis. Psychiatry Research 2017, 256: 32-39. PMID: 28622572, DOI: 10.1016/j.psychres.2017.06.005.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderAfghanistan veteransPTSD symptom clustersNational VA administrative dataVeterans AffairsSymptom clustersMental health service utilizationTreatment-related variablesHealth service utilizationVA administrative dataSelection of treatmentMental health carePTSD symptom cluster severitySymptom cluster severityTrauma-exposed veteransInitial diagnosisClinical variablesPsychotherapy visitsAdequate doseService utilizationDifferential predictive valueLarge cohortCombination treatmentPsychotherapy initiationTreatment approachesPosttraumatic Stress Disorder Symptom Clusters and Acquired Capability for Suicide: A Reexamination Using DSM‐5 Criteria
Spitzer EG, Zuromski KL, Davis MT, Witte TK, Weathers F. Posttraumatic Stress Disorder Symptom Clusters and Acquired Capability for Suicide: A Reexamination Using DSM‐5 Criteria. Suicide And Life-Threatening Behavior 2017, 48: 105-115. PMID: 28261858, DOI: 10.1111/sltb.12341.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorder (PTSD) symptom clustersPTSD symptom clustersSymptom clustersSpecific PTSD symptom clustersSix-factor Anhedonia modelTrauma-exposed undergraduatesInterpersonal-psychological theoryDSM-5 criteriaAcquired CapabilitySuppressor variableCommonality analysisAnhedonia modelBivariate correlationsSuicideComplex relationshipAnhedoniaFacetsUndergraduatesRelationshipStructure coefficientsFindingsTheoryThe Association of PTSD Symptom Severity With Localized Hippocampus and Amygdala Abnormalities
Akiki TJ, Averill CL, Wrocklage KM, Schweinsburg B, Scott JC, Martini B, Averill LA, Southwick SM, Krystal JH, Abdallah CG. The Association of PTSD Symptom Severity With Localized Hippocampus and Amygdala Abnormalities. Chronic Stress 2017, 1: 2470547017724069. PMID: 28825050, PMCID: PMC5562232, DOI: 10.1177/2470547017724069.Peer-Reviewed Original ResearchPosttraumatic stress disorderUS veteransAmygdala abnormalitiesVertex-wise shape analysisPTSD symptomsClinician-Administered PTSD ScaleCross-sectional studyHigh-resolution magnetic resonanceStructural neuroimaging studiesSevere PTSD symptomsHippocampal abnormalitiesPTSD symptom severitySubtle morphometric changesRe-experiencing symptomsRight hippocampusCentromedial amygdalaPTSD symptom clustersRight amygdalaPTSD ScaleAnterior hippocampusHippocampusStructural abnormalitiesDSM-IVSymptom clustersSymptom severityTrauma Exposure, PTSD Symptoms, and Presenting Clinical Problems Among Male Perpetrators of Intimate Partner Violence
Semiatin J, Torres S, LaMotte A, Portnoy G, Murphy C. Trauma Exposure, PTSD Symptoms, and Presenting Clinical Problems Among Male Perpetrators of Intimate Partner Violence. Psychology Of Violence 2017, 7: 91-100. DOI: 10.1037/vio0000041.Peer-Reviewed Original ResearchTrauma exposurePTSD symptomsPosttraumatic stress disorder (PTSD) symptomsAlcohol problemsImplications of traumaPTSD symptom levelsTraumatic event exposurePTSD symptom clustersMultiple trauma exposuresCurrent PTSD symptomsTrauma-informed interventionsIntimate partner violence perpetratorsPartner-violent menGeneral violencePartner violence perpetratorsDrug usePsychological aggressionMale intimate partner violence perpetratorsRelationship maladjustmentEvent exposureDisorder symptomsRelationship dysfunctionRelationship abuseRelationship problemsUnique association
2016
Co-occurring aggression and suicide attempt among veterans entering residential treatment for PTSD: The role of PTSD symptom clusters and alcohol misuse
Watkins LE, Sippel LM, Pietrzak RH, Hoff R, Harpaz-Rotem I. Co-occurring aggression and suicide attempt among veterans entering residential treatment for PTSD: The role of PTSD symptom clusters and alcohol misuse. Journal Of Psychiatric Research 2016, 87: 8-14. PMID: 27984702, DOI: 10.1016/j.jpsychires.2016.12.009.Peer-Reviewed Original ResearchConceptsSuicide attemptsAlcohol misuseU.S. veteransSymptom clustersPTSD symptom clustersVeterans Health Administration sitesSerious public health concernPTSD re-experiencing symptomsResidential treatmentDysphoric arousal symptomsPublic health concernCo-occurring aggressionLogistic regression modelsMultinomial logistic regression modelsPosttraumatic stress disorder (PTSD) symptom clustersRisk factorsRe-experiencing symptomsCorrelates of aggressionAdministration siteHealth concernMisuse symptomsSymptomsArousal symptomsTreatment planningVeteransInitiation of pharmacotherapy for post-traumatic stress disorder among veterans from Iraq and Afghanistan: a dimensional, symptom cluster approach
Harpaz-Rotem I, Rosenheck R, Mohamed S, Pietrzak R, Hoff R. Initiation of pharmacotherapy for post-traumatic stress disorder among veterans from Iraq and Afghanistan: a dimensional, symptom cluster approach. BJPsych Open 2016, 2: 286-293. PMID: 27703791, PMCID: PMC5016711, DOI: 10.1192/bjpo.bp.115.002451.Peer-Reviewed Original ResearchPost-traumatic stress disorderAnxiolytics/sedatives/hypnoticsPTSD diagnosisUS Veterans Health AdministrationPhenotypic presentationInitiation of pharmacotherapyPrescription of antidepressantsSedative/hypnoticsVeterans Health AdministrationHeterogeneous phenotypic presentationsMilitary-related post-traumatic stress disorderHypnotic prescriptionsMedication classesPrescribing patternsFirst prescriptionMultivariable analysisPharmacological treatmentClinical guidelinesInitial episodeUS veteransPTSD symptom clustersRe-experiencing symptomsSleep difficultiesHealth AdministrationSymptom clustersPast year non-medical opioid use and abuse and PTSD diagnosis: Interactions with sex and associations with symptom clusters
Smith KZ, Smith PH, Cercone SA, McKee SA, Homish GG. Past year non-medical opioid use and abuse and PTSD diagnosis: Interactions with sex and associations with symptom clusters. Addictive Behaviors 2016, 58: 167-174. PMID: 26946448, PMCID: PMC4808454, DOI: 10.1016/j.addbeh.2016.02.019.Peer-Reviewed Original ResearchConceptsOpioid use disorder diagnosisNon-medical opioid usePosttraumatic stress disorderHigher oddsSymptom clustersPTSD diagnosisDisorder diagnosisOpioid useAvoidance symptom clustersAverage monthly frequencyNon-institutionalized adultsNational Epidemiologic SurveyIndividual symptom clustersHigh rateSex differencesSpecific symptom clustersImportant sex differencesPTSD symptom clustersReactivity clustersAdjusted modelGeneral U.S.Epidemiologic SurveyRelated conditionsStress disorderDiagnosis
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