2024
Post-treatment alterations in white matter integrity in PTSD: Effects on symptoms and functional connectivity a secondary analysis of an RCT
Korem N, Duek O, Ben-Zion Z, Spiller T, Gordon C, Amen S, Levy I, Harpaz-Rotem I. Post-treatment alterations in white matter integrity in PTSD: Effects on symptoms and functional connectivity a secondary analysis of an RCT. Psychiatry Research Neuroimaging 2024, 343: 111864. PMID: 39111111, DOI: 10.1016/j.pscychresns.2024.111864.Peer-Reviewed Original ResearchReduced resting-state functional connectivityPost-traumatic stress disorderPost-traumatic stress disorder symptomsFunctional connectivityPost-treatment changesReducing PTSD symptom severityFollow-up changesResting-state functional connectivityIntensive exposure therapyExposure-based psychotherapyVentromedial prefrontal cortexPTSD symptom severityReduced structural connectivityFunctional connectivity patternsPost-treatmentWhite matter integrityPrefrontal cortexExposure therapyPTSD symptomsStress disorderSymptom severityUncinate fasciculusLimbic systemSecondary analysisAssociated with sustained changes
2023
Evaluating a novel 8-factor dimensional model of PTSD in U.S. military veterans: Results from the National Health and Resilience in Veterans Study
Stiltner B, Fischer I, Duek O, Polimanti R, Harpaz-Rotem I, Pietrzak R. Evaluating a novel 8-factor dimensional model of PTSD in U.S. military veterans: Results from the National Health and Resilience in Veterans Study. Journal Of Affective Disorders 2023, 346: 303-307. PMID: 37979626, DOI: 10.1016/j.jad.2023.11.041.Peer-Reviewed Original ResearchConceptsIndex traumaPTSD symptomsNational HealthPosttraumatic stress disorder (PTSD) symptomsVeterans StudyMilitary veteransTrauma-exposed populationsClinician-administered interviewU.S. military veteransConfirmatory factor analysisDSM-5 modelStrong significant associationTrauma exposureIntrusive symptomsDisorder symptomsCombat exposureHigh riskU.S. veteransDSM-5Significant associationSymptomsInterpersonal violenceFactor analysisPTSDScarce researchClinical Outcomes of Veterans Affairs Residential PTSD Treatment for PTSD and Depressive Symptoms: 1-Year Follow-Up Outcomes and Gender Differences
Gross G, Spiller T, Carretta R, Sippel L, Smith N, Harpaz-Rotem I. Clinical Outcomes of Veterans Affairs Residential PTSD Treatment for PTSD and Depressive Symptoms: 1-Year Follow-Up Outcomes and Gender Differences. Psychological Trauma Theory Research Practice And Policy 2023, 15: 1406-1415. PMID: 37199985, DOI: 10.1037/tra0001494.Peer-Reviewed Original ResearchPosttraumatic stress disorderResidential Rehabilitation Treatment ProgramDepressive symptomsWomen veteransTime pointsTreatment gainsRehabilitation treatment programResidential treatmentDepressive symptom severityGreater symptom reductionFirst national investigationLong-term effectivenessResidential PTSD treatmentClinical outcomesYear postdischargeUp OutcomesSymptom reductionPTSD treatmentSymptom changeSymptom severitySymptomsTreatment programStress disorderPTSD symptomsLinear mixed modelsChanges in mental health among U.S. military veterans during the COVID-19 pandemic: A network analysis
Spiller T, Na P, Merians A, Duek O, Ben-Zion Z, Tsai J, von Känel R, Harpaz-Rotem I, Pietrzak R. Changes in mental health among U.S. military veterans during the COVID-19 pandemic: A network analysis. Journal Of Psychiatric Research 2023, 165: 352-359. PMID: 37595331, DOI: 10.1016/j.jpsychires.2023.08.003.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderSymptoms of PTSDTraumatic eventsPosttraumatic growthU.S. military veteransPTSD symptomsSuicidal ideationMental healthMilitary veteransIncrease of symptomsPopulation-based sampleCOVID-19 pandemicFirst yearStress disorderMost veteransSymptomsFirst monthPsychopathological symptomsGeneral resilienceGroup levelAnxietyVeteransIndividual reactionsDepressionSubtle increaseNot all traumas are created equal: Phenotypic heterogeneity of PTSD symptoms in relation to index traumas in U.S. military veterans
Kachadourian L, Duek O, Tsai J, Harpaz-Rotem I, Pietrzak R. Not all traumas are created equal: Phenotypic heterogeneity of PTSD symptoms in relation to index traumas in U.S. military veterans. Journal Of Affective Disorders 2023, 340: 728-731. PMID: 37572698, PMCID: PMC10754253, DOI: 10.1016/j.jad.2023.08.012.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderU.S. military veteransMilitary veteransIndex traumaPTSD symptomsDysphoric arousal symptomsIllness/injuryGreater overall severityIndex traumatic eventClinical presentationNational HealthDiagnostic criteriaTreatment approachesGreater severityOverall severityVeterans StudyInterpersonal violenceStress disorderTraumaArousal symptomsSymptomsVeteransPhenotypic heterogeneityTraumatic eventsSeverityAmygdala downregulation training using fMRI neurofeedback in post-traumatic stress disorder: a randomized, double-blind trial
Zhao Z, Duek O, Seidemann R, Gordon C, Walsh C, Romaker E, Koller W, Horvath M, Awasthi J, Wang Y, O’Brien E, Fichtenholtz H, Hampson M, Harpaz-Rotem I. Amygdala downregulation training using fMRI neurofeedback in post-traumatic stress disorder: a randomized, double-blind trial. Translational Psychiatry 2023, 13: 177. PMID: 37230984, PMCID: PMC10209552, DOI: 10.1038/s41398-023-02467-6.Peer-Reviewed Original ResearchConceptsPost-traumatic stress disorderControl groupAmygdala activityPTSD treatmentDouble-blind clinical trialStress disorderDouble-blind trialSecondary outcome measurementsTrauma recallNeurofeedback trainingGreater improvementAmygdala controlsPotential clinical applicationsSymptom scoresActive groupClinical trialsTreatment successOutcome measurementsTrauma scriptsSymptom reductionNeurofeedback interventionPTSD symptomsFMRI neurofeedbackAmygdalaNeural markersNeural 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 gainsClinical significance of novel 8-factor model of DSM-5 PTSD in national VA PTSD residential treatment data: Internally- v. externally-cued intrusions
Gross G, Spiller T, Duek O, Pietrzak R, Harpaz-Rotem I. Clinical significance of novel 8-factor model of DSM-5 PTSD in national VA PTSD residential treatment data: Internally- v. externally-cued intrusions. Journal Of Affective Disorders 2023, 328: 255-260. PMID: 36806596, DOI: 10.1016/j.jad.2023.02.046.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderPTSD symptomsDysphoric arousalDSM-5 posttraumatic stress disorderDSM-5 PTSD symptomsDistinct underlying processesSelf-report measuresGeneralized anxiety symptomsSuperior model fitPhysical health functioningCore defining featuresStructural equation modelingWorse emotional functioningAnxious arousalSymptoms of depressionNegative affectIntrusion symptomsGreater avoidanceEmotional functioningStress disorderAnxiety symptomsPTSD ChecklistIntrusion factorCross-sectional designGeneralized anxietyUnderlying Hippocampal Mechanism of Posttraumatic Stress Disorder Treatment Outcome: Evidence From Two Clinical Trials
Zilcha-Mano S, Duek O, Suarez-Jimenez B, Zhu X, Lazarov A, Helpman L, Korem N, Malka M, Harpaz-Rotem I, Neria Y. Underlying Hippocampal Mechanism of Posttraumatic Stress Disorder Treatment Outcome: Evidence From Two Clinical Trials. Biological Psychiatry Global Open Science 2023, 3: 867-874. PMID: 37881552, PMCID: PMC10593870, DOI: 10.1016/j.bpsgos.2023.01.005.Peer-Reviewed Original ResearchPosttraumatic stress disorderRight hippocampal volumeHippocampal volumeSymptom reductionPosttreatment magnetic resonance imagingPosttraumatic stress disorder treatment outcomeLarger hippocampal volumesDisorder treatment outcomesPTSD symptom reductionMagnetic resonance imagingGreater PTSD symptom reductionBetter prognosisClinical trialsTreatment outcomesDepressive symptomsTherapeutic outcomesPTSD treatmentResonance imagingTreatment studiesClinical targetsStress disorderPTSD symptomsSmall sample sizeHippocampal mechanismsTreatment
2022
Distinguishing emotional numbing symptoms of posttraumatic stress disorder from major depressive disorder
Duek O, Seidemann R, Pietrzak R, Harpaz-Rotem I. Distinguishing emotional numbing symptoms of posttraumatic stress disorder from major depressive disorder. Journal Of Affective Disorders 2022, 324: 294-299. PMID: 36586605, DOI: 10.1016/j.jad.2022.12.105.Peer-Reviewed Original ResearchConceptsEmotional numbing symptomsPosttraumatic stress disorderNumbing symptomsEmotional numbingStress disorderSymptom clustersTrauma-exposed individualsGreater PTSD severityMajor depressive disorderContext of traumaUnique variancePTSD symptomsPTSD phenotypePTSD severityDifferent symptom clustersWorse treatment outcomesDepressive disorderCore aspectsNumbingDistinct contributionsMDD symptomsDSM-IIIFunctional impairmentDisordersTreatment outcomesRisk 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
A preliminary investigation of VA PTSD residential treatment for veterans admitted from unstable housing or incarceration
Holliday R, Gross G, Desai A, Smith N, Harpaz-Rotem I. A preliminary investigation of VA PTSD residential treatment for veterans admitted from unstable housing or incarceration. Journal Of Social Distress And The Homeless 2021, 31: 238-243. DOI: 10.1080/10530789.2021.1926750.Peer-Reviewed Original ResearchResidential Rehabilitation Treatment ProgramDepressive symptomsUnstable housingPTSD symptomsJustice-involved veteransPost-discharge careRehabilitation treatment programPrison/jailSymptom recurrenceJail/prisonPTSD treatmentSymptomsTreatment programFour monthsVeteransResidential treatmentAdmissionRecurrenceExperienced reductionsSignificant changesTreatmentUnderstanding of factorsMindfulness as a Mediator Between Trauma Exposure and Mental Health Outcomes: Results From the National Health and Resilience in Veterans Study
Kachadourian LK, Harpaz-Rotem I, Tsai J, Southwick S, Pietrzak RH. Mindfulness as a Mediator Between Trauma Exposure and Mental Health Outcomes: Results From the National Health and Resilience in Veterans Study. Psychological Trauma Theory Research Practice And Policy 2021, 13: 223-230. PMID: 33475404, PMCID: PMC8500672, DOI: 10.1037/tra0000995.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderAlcohol use disorderLifetime traumaTrauma-related negative affectPresent momentVeterans StudyU.S. veteransTrauma-related experiencesSuicidal ideationTraumatic life eventsLifetime trauma burdenMental health outcomesQuality of lifeMental health problemsTrauma remindersNegative affectMindful attentionTrauma exposurePTSD symptomsMental health issuesTraumatic eventsCumulative traumaStress disorderNoncombat veteransLife eventsCannabinoid 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
2020
Courses of suicidal ideation among military veterans in residential treatment for posttraumatic stress disorder
Smith NB, Sippel LM, Rozek DC, Spangler PT, Traber D, Straud CL, Hoff R, Harpaz‐Rotem I. Courses of suicidal ideation among military veterans in residential treatment for posttraumatic stress disorder. Depression And Anxiety 2020, 37: 273-284. PMID: 31951318, PMCID: PMC7054126, DOI: 10.1002/da.22993.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderBaseline posttraumatic stress disorderPTSD treatmentResidential PTSD treatmentPhysical functioningSuicidal thoughtsStress disorderPTSD symptomsSubstance useVeterans Affairs medical facilitiesWorse physical functioningLength of stayPTSD symptom improvementTrauma-focused psychotherapySpecific treatment interventionsPTSD symptom changeSeverity of suicidalSI onsetRace/ethnicitySymptom improvementPTSD improvementBaseline depressionMultinomial logistic regressionTreatment interventionsSuicidal ideationSex Differences in Associations Between Depression and Posttraumatic Stress Disorder Symptoms and Tobacco Use Among Veterans of Recent Conflicts
Gross GM, Bastian LA, Smith NB, Harpaz-Rotem I, Hoff R. Sex Differences in Associations Between Depression and Posttraumatic Stress Disorder Symptoms and Tobacco Use Among Veterans of Recent Conflicts. Journal Of Women's Health 2020, 29: 677-685. PMID: 31934813, DOI: 10.1089/jwh.2019.8082.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderTobacco usePTSD symptomsFemale veteransSex differencesAssociation of depressionTobacco use cessationBaseline interview dataCross-sectional associationsMental health conditionsLogistic regression modelsPosttraumatic stress disorder (PTSD) symptomsBinary logistic regression modelSex-specific barriersTobacco usersSymptomsStress disorderAlcohol useHealth conditionsDepressionDisorder symptomsVeteran sampleMH conditionsIntervention strategiesEffects of demographics
2019
Comparing the effectiveness of VA residential PTSD treatment for veterans who do and do not report a history of MST: A national investigation
Holliday R, Smith NB, Holder N, Gross GM, Monteith LL, Maguen S, Hoff RA, Harpaz-Rotem I. Comparing the effectiveness of VA residential PTSD treatment for veterans who do and do not report a history of MST: A national investigation. Journal Of Psychiatric Research 2019, 122: 42-47. PMID: 31923834, DOI: 10.1016/j.jpsychires.2019.12.012.Peer-Reviewed Original ResearchConceptsResidential Rehabilitation Treatment ProgramMilitary sexual traumaPosttraumatic stress disorderPTSD symptomsMST survivorsPTSD treatmentVeterans AffairsProgram completionRehabilitation treatment programSymptom severity scoresEffects of MSTExperience of MSTHistory of MSTPTSD symptom severity scoresPost-treatment gainsRace/ethnicityImpact of MSTSevere PTSD symptomsResidential PTSD treatmentAdjunctive servicesPsychiatric comorbiditySeverity scoreHealth sequelaeIncrease riskWomen veteransHeterogeneity 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 treatmentPosttraumatic Stress Disorder Symptoms, Functioning, and Suicidal Ideation in US Military Veterans: A Symptomics Approach.
Kachadourian LK, Harpaz-Rotem I, Tsai J, Southwick SM, Pietrzak RH. Posttraumatic Stress Disorder Symptoms, Functioning, and Suicidal Ideation in US Military Veterans: A Symptomics Approach. The Primary Care Companion For CNS Disorders 2019, 21 PMID: 31050228, DOI: 10.4088/pcc.18m02402.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderPositive affectMeasures of functioningCognitive functioningNegative thoughtsPTSD symptomsConcentration difficultiesSleep difficultiesTreatment of PTSDUS military veteransSeverity of PTSDPosttraumatic stress disorder (PTSD) symptomsSuicidal ideationDSM-5 PTSD symptomsMilitary veteransLifetime trauma burdenIrritability/aggressionHyperarousal symptomsDisorder symptomsStress disorderPsychogenic amnesiaPTSD diagnosisQuality of lifeMental functioningMost varianceAdoption by VA Residential Programs of Two Evidence-Based Psychotherapies for PTSD: Effect on Patient Outcomes
Cook JM, Schnurr PP, Simiola V, Thompson R, Hoff R, Harpaz-Rotem I. Adoption by VA Residential Programs of Two Evidence-Based Psychotherapies for PTSD: Effect on Patient Outcomes. Psychiatric Services 2019, 70: 553-560. PMID: 30966944, PMCID: PMC6690369, DOI: 10.1176/appi.ps.201800338.Peer-Reviewed Original ResearchMeSH KeywordsAdultCognitive Behavioral TherapyComorbidityDepressionFemaleHumansImplosive TherapyMaleMiddle AgedOutcome and Process Assessment, Health CarePsychological DistressResidential TreatmentStress Disorders, Post-TraumaticSubstance-Related DisordersUnited StatesUnited States Department of Veterans AffairsVeteransConceptsPosttraumatic stress disorderCognitive processing therapyEvidence-based psychotherapiesVeterans Affairs residential treatment programsAdoption groupsAlcohol useResidential treatment programSample of veteransGroup × time interactionPTSD symptomsStress disorderGroup formatProgram intakeResidential programs× time interactionDepression symptomsTreatment programPsychotherapyBasis of responsesPatient outcomesTime interactionProgram dischargeQualitative interviewsMonths postdischargeVeterans