Tobias Spiller, MD
Assistant Professor Adjunct in PsychiatryAbout
Research
Overview
Medical Research Interests
Biological Psychiatry; Emergency Services, Psychiatric; Posttraumatic Growth, Psychological; Stress Disorders, Post-Traumatic
Publications
Featured Publications
Unveiling the Structure in Mental Disorder Presentations
Spiller T, Duek O, Helmer M, Murray J, Fielstein E, Pietrzak R, von Känel R, Harpaz-Rotem I. Unveiling the Structure in Mental Disorder Presentations. JAMA Psychiatry 2024, 81: 1101-1107. PMID: 39110437, PMCID: PMC11307158, DOI: 10.1001/jamapsychiatry.2024.2047.Peer-Reviewed Original ResearchSymptom combinationsNational Institute of Mental Health Data ArchivePosttraumatic stress disorderDiagnostic criteriaHeterogeneity of symptomsSecondary data analysisCross-sectional studyRevision of diagnostic criteriaSymptom-based definitionsDSM criteriaStress disorderSymptom heterogeneityDisorder presentationsClinical populationsMain OutcomesAssess symptomsGroup of individualsParticipantsSymptomsNational InstituteDisordersIndividualsSchizophreniaAnxietyIndividual frequencies
2025
Assessing and alleviating state anxiety in large language models
Ben-Zion Z, Witte K, Jagadish A, Duek O, Harpaz-Rotem I, Khorsandian M, Burrer A, Seifritz E, Homan P, Schulz E, Spiller T. Assessing and alleviating state anxiety in large language models. Npj Digital Medicine 2025, 8: 132. PMID: 40033130, PMCID: PMC11876565, DOI: 10.1038/s41746-025-01512-6.Peer-Reviewed Original Research
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 changesUnraveling 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 veteransEmotional State Transitions in Trauma-Exposed Individuals With and Without Posttraumatic Stress Disorder
Korem N, Duek O, Spiller T, Ben-Zion Z, Levy I, Harpaz-Rotem I. Emotional State Transitions in Trauma-Exposed Individuals With and Without Posttraumatic Stress Disorder. JAMA Network Open 2024, 7: e246813. PMID: 38625701, PMCID: PMC11022112, DOI: 10.1001/jamanetworkopen.2024.6813.Peer-Reviewed Original ResearchPosttraumatic stress disorderTrauma-exposed individualsEmotional numbing symptomsTrauma-exposed controlsNegative emotional statesNumbing symptomsEmotional numbingDSM-5Valence ratingsStress disorderEmotional statesTrauma-exposed control groupPTSD experiencesPosttraumatic stress disorder symptomsPosttraumatic Stress Disorder ChecklistDSM-5 criteriaAge-related associationsStimulus valencePCL-5Emotional responsesEmotional state transitionEmotional transitionSymptomsParticipantsDisorders
2023
Changes 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 increaseStructural Neuroimaging of Hippocampus and Amygdala Subregions in Posttraumatic Stress Disorder: A Scoping Review
Ben-Zion Z, Korem N, Fine N, Katz S, Siddhanta M, Funaro M, Duek O, Spiller T, Danböck S, Levy I, Harpaz-Rotem I. Structural Neuroimaging of Hippocampus and Amygdala Subregions in Posttraumatic Stress Disorder: A Scoping Review. Biological Psychiatry Global Open Science 2023, 4: 120-134. PMID: 38298789, PMCID: PMC10829655, DOI: 10.1016/j.bpsgos.2023.07.001.Peer-Reviewed Original ResearchPost-traumatic stress disorderAmygdala subregionsStress disorderKey limbic regionsEtiology of PTSDPosttraumatic stress disorderDentate gyrusLimbic regionsSubiculum volumeSubregion volumesHippocampal subregionsDisorder pathogenesisStructural neuroimagingAutomatic segmentation softwareAmygdalar subregionsHippocampusNucleus volumeScoping ReviewPathogenesisCurrent literatureDisordersSegmentation softwareMethodological limitationsPost-traumatic psychopathologyReviewCorrelates of avoidance coping in trauma-exposed U.S. military veterans: Results from the National Health and Resilience in Veterans Study
Korem N, Ben-Zion Z, Spiller T, Duek O, Harpaz-Rotem I, Pietrzak R. Correlates of avoidance coping in trauma-exposed U.S. military veterans: Results from the National Health and Resilience in Veterans Study. Journal Of Affective Disorders 2023, 339: 89-97. PMID: 37437721, DOI: 10.1016/j.jad.2023.07.036.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderAvoidance copingTraumatic eventsU.S. military veteransEmotional stabilityNegative affect symptomsEmotional neglectSexual abuseAffect symptomsMilitary veteransAvoidant coping strategiesGreater emotional stabilityPhysical health outcomesPsychosocial risk factorsConsolidated memoryStress disorderCoping strategiesAdverse childhood experiencesStressful experiencesCopingVeterans StudyChildhood experiencesStrong feelingsNetwork analytic approachConscientiousnessComparative effectiveness of evidence-based psychotherapies for PTSD delivered in VA residential PTSD treatment
Sippel L, Gross G, Spiller T, Duek O, Smith N, Hoff R, Harpaz-Rotem I. Comparative effectiveness of evidence-based psychotherapies for PTSD delivered in VA residential PTSD treatment. Psychological Medicine 2023, 53: 6859-6866. PMID: 36971021, DOI: 10.1017/s0033291723000375.Peer-Reviewed Original ResearchResidential Rehabilitation Treatment ProgramPosttraumatic stress disorderCognitive processing therapyComparative effectivenessProlonged exposureFirst-line treatmentSevere posttraumatic stress disorderRehabilitation treatment programSelf-reported posttraumatic stress disorderDepressive symptom outcomesDepressive symptom severityEvidence-based psychotherapiesElectronic medical recordsResidential PTSD treatmentSymptomatic patientsComorbid conditionsMedical recordsPE groupSymptom outcomesIndividual cognitive processing therapyDepressive symptomsPTSD treatmentSymptom severityTreatment programProgram evaluation dataClinical 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 anxiety