2024
To Expose or Not to Expose: A Comprehensive Perspective on Treatment for Posttraumatic Stress Disorder
Rubenstein A, Duek O, Doran J, Harpaz-Rotem I. To Expose or Not to Expose: A Comprehensive Perspective on Treatment for Posttraumatic Stress Disorder. American Psychologist 2024, 79: 331-343. PMID: 38635195, PMCID: PMC11034887, DOI: 10.1037/amp0001121.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderTreating posttraumatic stress disorderNon-trauma-focused treatmentsExposure therapyStress disorderTreatment of posttraumatic stress disorderNon-trauma-focused therapiesPosttraumatic stress disorder diagnosisSelf-directed exposureTrauma-focused psychotherapyPsychotherapy factorsTrauma memoriesTrauma-focusedBehavioral paradigmsSymptom remissionHigh dropout ratesTherapy processTherapy contextProlonged exposurePsychotherapyDropout ratesIncreased patient autonomyResearch literatureDisordersClinical research
2023
Long term structural and functional neural changes following a single infusion of Ketamine in PTSD
Duek O, Korem N, Li Y, Kelmendi B, Amen S, Gordon C, Milne M, Krystal J, Levy I, Harpaz-Rotem I. Long term structural and functional neural changes following a single infusion of Ketamine in PTSD. Neuropsychopharmacology 2023, 48: 1648-1658. PMID: 37270621, PMCID: PMC10517133, DOI: 10.1038/s41386-023-01606-3.Peer-Reviewed Original ResearchMeSH KeywordsExtinction, PsychologicalHumansKetamineMidazolamPilot ProjectsPsychotherapyStress Disorders, Post-TraumaticConceptsKetamine recipientsSingle infusionMain study outcomeTiming of administrationEnd of treatmentNMDA receptor antagonistFunctional neural changesFrequency of administrationSignificant clinical implicationsTrauma-focused psychotherapyBrief exposure therapyAmygdala-vmPFC connectivityPost-retrieval extinctionKetamine doseKetamine administrationReceptor antagonistTrauma scriptsNeural changesClinical implicationsDecreased connectivityExposure therapyKetamineTrauma memoriesStudy outcomesUncinate fasciculus
2022
Treatment response trajectories in residential PTSD programs for veterans: A national cohort investigation
Grau P, Sripada R, Pietrzak R, Ganoczy D, Harpaz-Rotem I. Treatment response trajectories in residential PTSD programs for veterans: A national cohort investigation. Journal Of Anxiety Disorders 2022, 92: 102645. PMID: 36334317, DOI: 10.1016/j.janxdis.2022.102645.Peer-Reviewed Original ResearchMeSH KeywordsCohort StudiesHumansPsychotherapyResidential TreatmentStress Disorders, Post-TraumaticUnited StatesVeteransConceptsEvidence-based psychotherapiesThree-group trajectory modelTreatment outcomesTreatment responseTime of admissionPoor treatment outcomesPoor treatment responseNon-white raceResidential PTSD programsSubset of veteransPTSD treatment outcomesResidential PTSD treatmentPain severityCohort investigationPTSD careNational cohortFull cohortPTSD treatmentTherapeutic gainTreatment dropoutSymptom trajectoriesVeterans AffairsPTSD programTreatment response trajectoriesTreatment trajectories
2021
Racial Disparities in Clinical Outcomes of Veterans Affairs Residential PTSD Treatment Between Black and White Veterans
Gross GM, Smith N, Holliday R, Rozek DC, Hoff R, Harpaz-Rotem I. Racial Disparities in Clinical Outcomes of Veterans Affairs Residential PTSD Treatment Between Black and White Veterans. Psychiatric Services 2021, 73: 126-132. PMID: 34369806, DOI: 10.1176/appi.ps.202000783.Peer-Reviewed Original ResearchConceptsResidential Rehabilitation Treatment ProgramPosttraumatic stress disorderWhite veteransRacial disparitiesClinical outcomesBlack veteransSymptoms of PTSDPoor clinical outcomeRehabilitation treatment programRecurrence 4 monthsPoor treatment outcomesMental health treatmentPublic health issuePTSD symptom reductionResidential PTSD treatmentMental health researchTreatment outcomesPrevalence ratesSymptom reductionHealth treatmentHealth outcomesPTSD treatmentDemographic dataSymptom changeTreatment program
2020
Early discontinuation of pharmacotherapy in U.S. veterans diagnosed with PTSD and the role of psychotherapy
Duek O, Pietrzak RH, Petrakis I, Hoff R, Harpaz-Rotem I. Early discontinuation of pharmacotherapy in U.S. veterans diagnosed with PTSD and the role of psychotherapy. Journal Of Psychiatric Research 2020, 132: 167-173. PMID: 33126010, DOI: 10.1016/j.jpsychires.2020.10.005.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderRisk factorsEarly discontinuationMedication discontinuationPsychotropic medicationsPoor medication adherenceSimilar risk factorsStrong risk factorDeterminants of discontinuationKey risk factorsRole of psychotherapySingle medicationMedication adherenceMedication treatmentPsychiatric comorbidityAntipsychotic medicationPatient educationDiscontinuationOlder veteransMedicationsAdjunctive psychotherapyYounger veteransEarly interventionU.S. veteransVA treatment
2017
Psychotherapy Utilization and Retention in a National Sample of Veterans With PTSD
Doran JM, Pietrzak RH, Hoff R, Harpaz‐Rotem I. Psychotherapy Utilization and Retention in a National Sample of Veterans With PTSD. Journal Of Clinical Psychology 2017, 73: 1259-1279. PMID: 28186638, DOI: 10.1002/jclp.22445.Peer-Reviewed Original ResearchFear extinction and memory reconsolidation as critical components in behavioral treatment for posttraumatic stress disorder and potential augmentation of these processes
Smith NB, Doran JM, Sippel LM, Harpaz-Rotem I. Fear extinction and memory reconsolidation as critical components in behavioral treatment for posttraumatic stress disorder and potential augmentation of these processes. Neuroscience Letters 2017, 649: 170-175. PMID: 28065842, DOI: 10.1016/j.neulet.2017.01.006.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderReconsolidation processPTSD psychotherapyStress disorderBehavioral treatmentExposure-based treatmentsCritical brain regionsFear extinctionMemory reconsolidationTraumatic memoriesImportant future directionsPTSD populationsPTSD therapyNeurobiological mechanismsPrefrontal cortexReconsolidationBrain regionsPsychotherapyProcess of extinctionMemoryPotential avenuesFuture directionsBehavioral modificationExtinctionDisorders
2015
Mental Health Treatment for Older Veterans Newly Diagnosed with PTSD: A National Investigation
Smith NB, Cook JM, Pietrzak R, Hoff R, Harpaz-Rotem I. Mental Health Treatment for Older Veterans Newly Diagnosed with PTSD: A National Investigation. American Journal Of Geriatric Psychiatry 2015, 24: 201-212. PMID: 25772341, DOI: 10.1016/j.jagp.2015.02.001.Peer-Reviewed Original ResearchConceptsMental health treatmentPosttraumatic stress disorderOlder veteransVA healthcare systemHealth treatmentClinical characteristicsDecreased oddsNational administrative data setVeterans AffairsMental health service utilizationAppropriate mental health treatmentOdds of treatmentMental health visitsHealth service utilizationHealthcare systemPharmacy recordsHealth visitsCox regressionPsychiatric comorbidityPsychotherapy visitsService utilizationLarge cohortMedical appointmentsAdministrative data setsNew diagnosis
2014
Diffusion of Prazosin Treatment for PTSD
Hermes E, Harpaz-Rotem I, Rosenheck R. Diffusion of Prazosin Treatment for PTSD. American Journal Of Psychiatry 2014, 171: 117-117. PMID: 24399430, DOI: 10.1176/appi.ajp.2013.13091259.Peer-Reviewed Original Research
2012
Psychotherapy use in a privately insured population of patients diagnosed with a mental disorder
Harpaz-Rotem I, Libby D, Rosenheck RA. Psychotherapy use in a privately insured population of patients diagnosed with a mental disorder. Social Psychiatry And Psychiatric Epidemiology 2012, 47: 1837-1844. PMID: 22349151, DOI: 10.1007/s00127-012-0486-9.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnxiety DisordersComorbidityDatabases as TopicDepressive Disorder, MajorFemaleHealth Care SurveysHumansInsurance CoverageInsurance, HealthLogistic ModelsMaleMental DisordersMental Health ServicesMiddle AgedPrivate SectorPsychotherapyStress Disorders, Post-TraumaticTreatment OutcomeUnited StatesConceptsMajor depressive disorderUse of psychotherapyPosttraumatic stress disorderReceipt of psychotherapyPsychotherapy visitsDepressive disorderMild depressionBipolar disorderMental disordersStress disorderAlcohol useCorrelates of receiptCurrent Procedural Terminology codesPopulation of patientsLarge claims databaseAlternative drug therapiesProcedural Terminology codesMental health servicesMultivariate binary regressionEffectiveness of psychotherapyPatient characteristicsClaims databasePharmacological treatmentDrug therapyPsychotherapy use