Marc Rosen, MD
Professor of PsychiatryCards
Appointments
Contact Info
Psychiatry
Department of Psychiatry, 116-A4
West Haven, CT 06516
United States
About
Titles
Professor of Psychiatry
Biography
Dr. Rosen has been at Yale since beginning his psychiatry residency in 1987. He directs the Addictions programs at VA Connecticut. His research focuses on health service use among people with addiction and comorbid conditions, with an emphasis on financial considerations. His group's research materials are available at http://www.behaviorchange.yale.edu/
Appointments
Psychiatry
ProfessorPrimary
Other Departments & Organizations
Education & Training
- MD
- University of Pennsylvania (1986)
- BA
- Columbia (1982)
Research
Overview
We develop and test the efficacy of behavioral interventions for clients with comorbid psychiatric and substance abuse.
One line of research considers whether interventions targeting spending decisions by dually diagnosed clients might reduce their substance use. This question has been approached with surveys, analysis of data from quasi-experimental designs, and clinical trials. Our research has demonstrated that a high proportion of VA inpatients need money management assistance, and that expenditures for illicit drugs are not increased after benefits have been awarded. In several surveys, we have described generally high client ratings of satisfaction with a variety of involuntary payee arrangements.
In clinical trials, we have tested the efficacy of a money management-based intervention called ATM (Advisor Teller Money Manager). ATM involves a positive conception of the power of money to help clients achieve their goals and their ability to learn to manage their own affairs, as well as dampening the temptation to spend loose cash on illicit drugs and alcohol. In a recently-completed 36-week clinical trial of ATM, ATM participants had less cocaine use, reduced preference for immediate rewards (as measured by the Delayed Discounting Questionnaire), and greater likelihood of being assigned a payee compared to participants assigned to the Control intervention.
A second line of research considers interventions targeting medication non-adherence. A difficulty in counseling clients concerning the need to take prescribed medication is the difficulty in knowing when the medications were taken. In a series of studies, our group has tested the efficacy of counseling in which clients are provided electronically-generated feedback and review the dates and times medications were taken as prescribed and when they were missed. In clinical trials, we have found this counseling to be effective among clients prescribed medication for diabetes but ineffective among clients prescribed antiretroviral medication. However, review of feedback has been effective when coupled with material reinforcement, contingent on on-time bottle openings.
A third line of research examines the processes involved in applying for Compensation and Pension examinations. One multi-site study involves comparing a semi-structured method of conducting the Compensation and Pension evaluation of veterans being evaluated for PTSD to assessment as usual. A second study is comparing the effect of four sessions of Benefits Counseling to a control condition on engagement in work among veterans presenting for evaluation of psychiatric disabilities.
- Clinical trial of abstinence-linked money management in people with comorbid psychiatric disorders and cocaine use.
- Clinical trial of benefits counseling for veterans presenting for Compensation and Pension evaluations.
- E3 study comparing two methods of conducting Compensation and Pension evaluations of veterans presenting for psychiatric evaluations.
- Multisite Adherence evaluation of pooled data concerning adherence, viral loads and substance use among people with HIV
Medical Subject Headings (MeSH)
Research at a Glance
Yale Co-Authors
Publications Timeline
Research Interests
Anne C. Black, PhD
Christina Lazar, MPH
Patrick G. O'Connor, MD, MPH, MACP
Robert Rosenheck, MD
Christopher van Dyck, MD
Elina A. Stefanovics, PhD
Substance-Related Disorders
Mental Disorders
Publications
2024
Initial Development of a Self-Report Survey on Use of Nonpharmacological and Self-Care Approaches for Pain Management (NSCAP)
Edmond S, Kerns R, Geda M, Luther S, Edwards R, Taylor S, Rosen M, Fritz J, Goertz C, Zeliadt S, Seal K. Initial Development of a Self-Report Survey on Use of Nonpharmacological and Self-Care Approaches for Pain Management (NSCAP). Pain Medicine 2024, pnae082. PMID: 39163504, DOI: 10.1093/pm/pnae082.Peer-Reviewed Original ResearchAltmetricM41 Do People With Substance Misuse (SM) Use Distinct Pain Treatment Modalities?
Rosen M, Gilstad-Hayden K, Sellinger J, Lazar C, Martino S. M41 Do People With Substance Misuse (SM) Use Distinct Pain Treatment Modalities? Drug And Alcohol Dependence 2024, 260: 110321. DOI: 10.1016/j.drugalcdep.2023.110321.Peer-Reviewed Original ResearchSensitivity, specificity, and discordance with self-report of nail sample testing for alcohol and cannabis
Morie K, Gilstad-Hayden K, Martino S, Lazar C, Rosen M. Sensitivity, specificity, and discordance with self-report of nail sample testing for alcohol and cannabis. Drug And Alcohol Dependence 2024, 261: 111358. PMID: 38943713, DOI: 10.1016/j.drugalcdep.2024.111358.Peer-Reviewed Original ResearchAltmetricConceptsDelta 9-THCAlcohol-related problemsRisky alcohol useSelf-reportAlcohol useEthyl glucuronideAUDIT-CAlcohol use patternsSelf-reported alcoholInaccurate self-reportsSubstance use patternsFactors associated with discordanceSubstance-related harmsMarijuana problemsNail clippingsCannabis metabolitesNon-Hispanic ethnicityStandard cut-offsMarijuana useClinical trialsCannabisAlcohol metabolitesWhite raceTelephone questionnaireHighest specificityDo veterans with risky substance use (RSU) use distinct pain treatment modalities?
Meshberg‐Cohen S, Gilstad‐Hayden K, Martino S, Lazar C, Sellinger J, Rosen M. Do veterans with risky substance use (RSU) use distinct pain treatment modalities? American Journal On Addictions 2024 PMID: 38849976, DOI: 10.1111/ajad.13620.Peer-Reviewed Original ResearchAltmetricConceptsRisky substance usePain treatment modalitiesTreatment modalitiesPain treatmentPrescribed opioidsPain treatment utilizationSubstance Involvement TestNonopioid pain treatmentPain treatment outcomesSubstance useOver-the-counter medicationsNumerical rating scalePrimary careMusculoskeletal conditionsAssociated with numberPain serviceNonopioid treatmentsPrescription medicationsOpioid medicationsChronic painOpioid prescriptionsOver-the-counterVeteransDisability claimsOpioidMilitary sexual trauma-related posttraumatic stress disorder service-connection: Characteristics of claimants and award denial across gender, race, and compared to combat trauma
Webermann A, Gianoli M, Rosen M, Portnoy G, Runels T, Black A. Military sexual trauma-related posttraumatic stress disorder service-connection: Characteristics of claimants and award denial across gender, race, and compared to combat trauma. PLOS ONE 2024, 19: e0280708. PMID: 38206995, PMCID: PMC10783784, DOI: 10.1371/journal.pone.0280708.Peer-Reviewed Original ResearchAltmetricMeSH Keywords and ConceptsConceptsMilitary sexual traumaSexual traumaBlack veteransVeterans Benefits AdministrationVeterans' claimsPosttraumatic stress disorderBenefits administrationWomen veteransWhite veteransSystemic barriersService-connectedStress disorderMen veteransCharacteristics of claimantsStressor typeGenderCombat traumaClaimsRaceArmy veteransDenialEffect sizeUnderserved backgroundsVeteransHigher odds
2023
Military Sexual Trauma and its Association with Mental Health Among Sexual Minority and Heterosexual Veterans in the United States
Webermann A, Merians A, Gross G, Portnoy G, Rosen M, Pietrzak R. Military Sexual Trauma and its Association with Mental Health Among Sexual Minority and Heterosexual Veterans in the United States. LGBT Health 2023, 10: s61-s69. PMID: 37754922, DOI: 10.1089/lgbt.2023.0074.Peer-Reviewed Original ResearchCitationsAltmetricMeSH Keywords and ConceptsConceptsMental health symptomsMilitary sexual traumaHealth symptomsHeterosexual veteransCurrent drug use disordersCurrent mental health symptomsCurrent posttraumatic stress disorderMultivariable logistic regressionDrug use disordersPrevalence of MSTMilitary characteristicsSexual traumaPosttraumatic stress disorderRepresentative web-based surveyHigh prevalenceUse disordersU.S. veteransWeb-based surveySociodemographic characteristicsSymptomsBivariate analysisLogistic regressionStress disorderMental healthPrevalenceAdherence to Antiretrovirals and HIV Viral Suppression Under COVID-19 Pandemic Interruption – Findings from a Randomized Clinical Trial Using Ingestible Sensors to Monitor Adherence
Wang Y, Daar E, Huang Y, Xiong D, Shen J, Zhou L, Siqueiros L, Guerrero M, Rosen M, Liu H. Adherence to Antiretrovirals and HIV Viral Suppression Under COVID-19 Pandemic Interruption – Findings from a Randomized Clinical Trial Using Ingestible Sensors to Monitor Adherence. AIDS And Behavior 2023, 27: 4041-4051. PMID: 37401993, PMCID: PMC10598162, DOI: 10.1007/s10461-023-04118-9.Peer-Reviewed Original ResearchMeSH Keywords and ConceptsConceptsLog viral loadViral loadClinical trialsHIV RNA viral loadUsual care groupHIV viral suppressionRNA viral loadRandomized clinical trialsSelf-reported adherenceLongitudinal mixed effects modelsViral suppressionClinical outcomesCare groupWeek 28Week 16Intervention groupAntiretroviralsIntervention effectsVulnerable populationsAdherenceMixed effects modelsRandom interceptRetention rateCOVID-19 pandemicIngestible sensorCompensation and Pension Exams for Military Sexual Trauma–Related Posttraumatic Stress Disorder: Examiner Perspectives, Clinical Impacts on Veterans, and Strategies
Webermann A, Nester M, Gianoli M, Black A, Rosen M, Mattocks K, Portnoy G. Compensation and Pension Exams for Military Sexual Trauma–Related Posttraumatic Stress Disorder: Examiner Perspectives, Clinical Impacts on Veterans, and Strategies. Women's Health Issues 2023, 33: 428-434. PMID: 37003918, DOI: 10.1016/j.whi.2023.02.002.Peer-Reviewed Original ResearchCitationsAltmetricMeSH Keywords and ConceptsConceptsVHA mental health careMental health carePosttraumatic stress disorderMilitary sexual traumaVeterans Benefits AdministrationClinical impactHealth careWomen veteransStress disorderSexual traumaPotential clinical impactCurrent psychosocial functioningThousands of veteransPsychotherapy referralsDiagnostic evaluationPsychosocial functioningDisability claimsPTSD symptomsVeteransCareTraumaExaminersExamDisordersExaminers’ responses
2022
Proposed Changes to the Department of Veterans Affairs Disability Rating Rubric for Mental Disorders
Gianoli M, Meisler A, Rosen M. Proposed Changes to the Department of Veterans Affairs Disability Rating Rubric for Mental Disorders. Psychiatric Services 2022, 74: 628-635. PMID: 36510762, DOI: 10.1176/appi.ps.20220377.Peer-Reviewed Original ResearchAltmetricMeSH Keywords and ConceptsConceptsMental disordersVeterans AffairsFunctional impairmentSymptom-based algorithmMental health conditionsPosttraumatic stress disorderRating schedulePsychiatric symptomsCurrent standard practiceStress disorderHealth conditionsDisordersDomains of functionDisability systemDisability benefitsExamination proceduresDisability determinationImpairmentStudy dataSignificant changesVeteransReal-world functioningStandard practiceRating rubricAward amountIngestible sensor system for measuring, monitoring and enhancing adherence to antiretroviral therapy: An open-label, usual care-controlled, randomised trial
Liu H, Wang Y, Huang Y, Xiong D, Shen J, Siqueiros L, Bala V, Savage G, Guerrero M, Corado K, Rosen M, Fletcher C, Daar E. Ingestible sensor system for measuring, monitoring and enhancing adherence to antiretroviral therapy: An open-label, usual care-controlled, randomised trial. EBioMedicine 2022, 86: 104330. PMID: 36372731, PMCID: PMC9782816, DOI: 10.1016/j.ebiom.2022.104330.Peer-Reviewed Original ResearchCitationsAltmetricMeSH Keywords and ConceptsConceptsHIV RNA viral loadRNA viral loadViral loadARV concentrationsUC groupIngestible sensorUsual care groupIngestible Sensor SystemOverall satisfaction rateInstitute of HealthGroup-based trajectory modelsAdvancing Translational SciencesAntiretroviral therapyHIV clinicCare groupText remindersIS groupImproved adherenceMeasure scoresSatisfaction rateStudy participantsAntiretroviralsMental healthAdherenceNational Institute
Clinical Trials
Current Trials
Engaging Veterans Seeking Service-Connection Payments in Pain Treatment (PragmaticSBIRT)
HIC ID2000022664RolePrincipal InvestigatorPrimary Completion Date09/30/2023Recruiting ParticipantsGenderBothAge18 years - 100 years
News & Links
News
- January 16, 2024
Military Sexual Trauma-related Posttraumatic Stress Disorder Service-connection: Characteristics of Claimants and Award Denial Across Gender, Race, and Compared to Combat Trauma
- February 06, 2019
Study: Veterans with recent substance use problems don’t jeopardize their VA disability claims
- January 14, 2019
Yale study tracks association between PTSD treatment utilization and compensation exams
- May 01, 2015
Yale research on financial capability of social security beneficiaries presented to Institute of Medicine committee
Related Links
Get In Touch
Contacts
Psychiatry
Department of Psychiatry, 116-A4
West Haven, CT 06516
United States
Locations
VA Connecticut Healthcare
Academic Office
950 Campbell Avenue, Ste 116-A4
West Haven, CT 06516