2024
Prevalence, Correlates, and Burden of Subthreshold PTSD in US Veterans.
Fischer I, Na P, Harpaz-Rotem I, Marx B, Pietrzak R. Prevalence, Correlates, and Burden of Subthreshold PTSD in US Veterans. The Journal Of Clinical Psychiatry 2024, 85 PMID: 39480145, DOI: 10.4088/jcp.24m15465.Peer-Reviewed Original ResearchConceptsSubthreshold posttraumatic stress disorderPosttraumatic stress disorderPosttraumatic stress disorder symptom clustersLifetime psychiatric disordersUS veteransUS military veteransSymptom-related distressStress disorderPsychiatric disordersSymptom clustersTreating veteransCriterion AMilitary veteransTraumatic eventsCognitive functionWorking case definitionMental healthCriterion FFunctional impairmentVeteransNationally representative sampleFunctional correlatesDisordersElevated oddsGreater oddsAmygdala Cannabinoid 1 Receptor, Pain Response, and Emotional Numbing in Trauma-Exposed Individuals
Korem N, Hillmer A, D’Souza D, Nia A, Levy I, Pietrzak R, Harpaz-Rotem I. Amygdala Cannabinoid 1 Receptor, Pain Response, and Emotional Numbing in Trauma-Exposed Individuals. JAMA Network Open 2024, 7: e2432387. PMID: 39250156, PMCID: PMC11385051, DOI: 10.1001/jamanetworkopen.2024.32387.Peer-Reviewed Original ResearchWhat Happens Next? Maintenance of Gains After Discharge From VA Residential PTSD Treatment
Grau P, Harpaz-Rotem I, Ilgen M, Ganoczy D, Sripada R. What Happens Next? Maintenance of Gains After Discharge From VA Residential PTSD Treatment. The Journal Of Nervous And Mental Disease 2024, 212: 197-204. PMID: 38536046, DOI: 10.1097/nmd.0000000000001749.Peer-Reviewed Original ResearchConceptsMaintenance of gainsResidential PTSD treatmentPosttraumatic stress disorderPTSD treatmentStress disorderResidential treatmentSymptom reboundDepartment of Veterans AffairsCohort of veteransSignificant respondersTreatment responseNational cohort of veteransVeteransAssociated with maintenanceResponse profilesPain severityVeterans AffairsGreater pain severitySessionsAssociated with decreased oddsPsychotherapyAssociated with increased oddsSeverityDisordersRespondents
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 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 eventsSeverityFirearm Ownership Among a Nationally Representative Sample of U.S. Veterans
Fischer I, Aunon F, Nichter B, Hill M, Panza K, Kline A, Na P, Tsai J, Harpaz-Rotem I, Pietrzak R. Firearm Ownership Among a Nationally Representative Sample of U.S. Veterans. American Journal Of Preventive Medicine 2023, 65: 1129-1133. PMID: 37354925, DOI: 10.1016/j.amepre.2023.06.013.Peer-Reviewed Original ResearchConceptsU.S. veteransMultivariable logistic regression analysisLogistic regression analysisAlcohol use disorderSuicide prevention effortsU.S. military veteransNationally Representative SampleMale sexTrauma burdenNational HealthRepresentative sampleFirearm ownershipChi-square analysisUse disordersFirearm safetyIndependent sample t-testLifetime historyVeterans StudyPrevention effortsPsychiatric variablesMilitary veteransVeteransRegression analysisT-testSignificant main effectUnderstanding veteran barriers to specialty outpatient PTSD clinical care
Rozek D, Steigerwald V, Baker S, Gross G, Maieritsch K, Hoff R, Harpaz-Rotem I, Smith N. Understanding veteran barriers to specialty outpatient PTSD clinical care. Journal Of Anxiety Disorders 2023, 95: 102675. PMID: 36854224, DOI: 10.1016/j.janxdis.2023.102675.Peer-Reviewed Original ResearchConceptsSpecialty outpatient clinicsPosttraumatic stress disorderOutpatient clinicPTSD specialty clinicClinical characteristicsMale sexPTSD symptom severitySpecialty clinicWhite raceClinical careClinical concernTreatment engagementSymptom severityStress disorderClinicGreater likelihoodVeteransSignificant minorityTreatmentImpact of demographicsMulti-faceted barriersCareFiscal year 2019DemographicsNational sampleCharacterization of Mental Health in US Veterans Before, During, and 2 Years After the Onset of the COVID-19 Pandemic
Fischer I, Na P, Harpaz-Rotem I, Krystal J, Pietrzak R. Characterization of Mental Health in US Veterans Before, During, and 2 Years After the Onset of the COVID-19 Pandemic. JAMA Network Open 2023, 6: e230463. PMID: 36821116, PMCID: PMC9951035, DOI: 10.1001/jamanetworkopen.2023.0463.Peer-Reviewed Original ResearchIdentifying significant correlates of purpose in life in older US military veterans: results from the national health and resilience in veterans study.
Fischer I, Feldman D, Tsai J, Harpaz-Rotem I, Lucas K, Schulenberg S, Pietrzak R. Identifying significant correlates of purpose in life in older US military veterans: results from the national health and resilience in veterans study. International Psychogeriatrics 2023, 35: 560-565. PMID: 36715004, DOI: 10.1017/s1041610222001223.Peer-Reviewed Original ResearchConceptsUS military veteransNational HealthMilitary veteransSignificant correlatesOlder US veteransAdverse health outcomesModifiable psychosocial factorsAdverse outcomesElastic net analysisUS veteransDepressive symptomsPsychosocial factorsHealth outcomesVeterans StudyPsychosocial variablesTreatment effortsCognitive outcomesCross-sectional dataVeteransOutcomesSocial supportCommunity integrationImportant correlatesHealthCorrelates
2022
Perceived Purpose in Life, Mental Health, and Suicidality in Older U.S. Military Veterans: Results From the National Health and Resilience in Veterans Study
Fischer IC, Tsai J, Harpaz-Rotem I, McCutcheon VE, Schulenberg SE, Pietrzak RH. Perceived Purpose in Life, Mental Health, and Suicidality in Older U.S. Military Veterans: Results From the National Health and Resilience in Veterans Study. American Journal Of Geriatric Psychiatry 2022, 31: 87-93. PMID: 36253289, DOI: 10.1016/j.jagp.2022.09.010.Peer-Reviewed Original ResearchConceptsMental disordersNational HealthU.S. veteransVeterans StudyHigher PILSubstance use disordersOlder U.S. veteransU.S. military veteransMajor depressiveSelf-report assessmentsLower oddsCurrent prevalenceUse disordersMost veteransSuicide attemptsMental healthGeneralized anxietySuicidalityDisordersMilitary veteransVeteransPosttraumatic stressHealthOddsRepresentative sampleComparative effectiveness of group v. individual trauma-focused treatment for posttraumatic stress disorder in veterans
Spiller TR, Duek O, Buta E, Gross G, Smith NB, Harpaz-Rotem I. Comparative effectiveness of group v. individual trauma-focused treatment for posttraumatic stress disorder in veterans. Psychological Medicine 2022, 53: 4561-4568. PMID: 35959560, PMCID: PMC10388318, DOI: 10.1017/s0033291722001441.Peer-Reviewed Original ResearchConceptsGroup cognitive processing therapyCognitive processing therapyPosttraumatic stress disorderIndividual cognitive processing therapyPTSD symptom severitySymptom severityStress disorderReal-world effectivenessComparative effectiveness studiesResidential treatmentEffective treatmentComparative effectivenessVeterans AffairsEffectiveness studiesPTSD ChecklistPTSD severityGroup therapySeverityVeteransTreatmentDSM-5Group V.TherapyDisordersSmall reduction
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 factorsIn Their Own Words: Veteran Experiences with Evidence-Based Treatments for PTSD in the Veterans Health Administration
Doran JM, O’Shea M, Harpaz-Rotem I. In Their Own Words: Veteran Experiences with Evidence-Based Treatments for PTSD in the Veterans Health Administration. Psychiatric Quarterly 2021, 92: 961-980. PMID: 33409926, DOI: 10.1007/s11126-020-09861-z.Peer-Reviewed Original ResearchConceptsVeterans Affairs Healthcare SystemEvidence-based psychotherapiesVeterans Health AdministrationEvidence-based treatmentsOutpatient PTSD clinicVeterans' experiencesTreatment completionTreatment outcomesPTSD clinicTreatment protocolHealth AdministrationHealthcare systemTreatmentPTSDOutcomesVeteransVeterans' perceptionsMultiple barriersTreatment dropAssessment toolPresent study
2019
Randomized Controlled Trial of Imagery Rehearsal for Posttraumatic Nightmares in Combat Veterans.
Harb GC, Cook JM, Phelps AJ, Gehrman PR, Forbes D, Localio R, Harpaz-Rotem I, Gur RC, Ross RJ. Randomized Controlled Trial of Imagery Rehearsal for Posttraumatic Nightmares in Combat Veterans. Journal Of Clinical Sleep Medicine 2019, 15: 757-767. PMID: 31053215, PMCID: PMC6510682, DOI: 10.5664/jcsm.7770.Peer-Reviewed Original ResearchConceptsCognitive behavioral therapyPosttraumatic stress disorderNightmare Distress QuestionnaireNightmare Frequency QuestionnaireBehavioral therapySevere posttraumatic stress disorderUnited States veteransOperation Enduring Freedom/Operation Iraqi Freedom veteransImagery rehearsalOperation Iraqi Freedom veteransSubgroups of veteransIraqi Freedom veteransFrequency questionnaireControlled TrialsPrimary outcomeLikelihood ratio chi-squareStates veteransDistress QuestionnaireStress disorderChi-squareRecurrent nightmaresConfidence intervalsMilitary veteransVeteransCombat veteransAdoption 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 postdischargeVeteransExamining the nonresponse phenomenon: Factors associated with treatment response in a national sample of veterans undergoing residential PTSD treatment
Sripada RK, Blow FC, Rauch SAM, Ganoczy D, Hoff R, Harpaz-Rotem I, Bohnert KM. Examining the nonresponse phenomenon: Factors associated with treatment response in a national sample of veterans undergoing residential PTSD treatment. Journal Of Anxiety Disorders 2019, 63: 18-25. PMID: 30785007, DOI: 10.1016/j.janxdis.2019.02.001.Peer-Reviewed Original ResearchConceptsResidential PTSD treatmentPTSD treatmentPTSD symptom changeTreatment-seeking veteransContextual protective factorsPhysical health resourcesNational sampleLarge national samplePsychological stateIndividual-level factorsLife eventsMultilevel modelingSymptom changeTreatment entryPoor treatment responseProtective factorsWorse treatment responsePersonality disorderPTSDBetter treatment responseTreatment responseCurrent studyGreater pain severityVeteransTheory of resourcesNeural computations of threat in the aftermath of combat trauma
Homan P, Levy I, Feltham E, Gordon C, Hu J, Li J, Pietrzak RH, Southwick S, Krystal JH, Harpaz-Rotem I, Schiller D. Neural computations of threat in the aftermath of combat trauma. Nature Neuroscience 2019, 22: 470-476. PMID: 30664770, PMCID: PMC6829910, DOI: 10.1038/s41593-018-0315-x.Peer-Reviewed Original ResearchConceptsPTSD symptomsPost-traumatic stress disorder symptomsHigher PTSD symptom severityThreat-predictive cuesPTSD symptom severityAssociative threatPredictive cuesNeural trackingDisorder symptomsPrediction errorCombat veteransDynamic learning rateNegative outcomesCombat traumaSmaller amygdala volumesNeural computationLatent markersSymptomatic veteransSymptom severityAmygdala volumeAssociabilityCuesLearning rateVeteransSymptoms
2018
Latent typologies of DSM-5 PTSD symptoms in U.S. military veterans
Byrne SP, Harpaz-Rotem I, Tsai J, Southwick SM, Pietrzak RH. Latent typologies of DSM-5 PTSD symptoms in U.S. military veterans. Psychiatry Research 2018, 273: 266-273. PMID: 30658212, DOI: 10.1016/j.psychres.2018.12.094.Peer-Reviewed Original ResearchConceptsHigh symptom classPosttraumatic stress disorderSymptom classUse disordersLifetime historyDSM-5 PTSD symptomsPTSD symptomsLatent class analysisDrug use disordersNicotine use disorderDSM-5 posttraumatic stress disorderDSM-5 criteriaU.S. military veteransMajor depressiveCognitive impairmentU.S. veteransSymptomsPersonalized approachHigher symptomsStress disorderGeneralized anxietyMilitary veteransThree-class solutionDisordersVeteransClinically Significant Change in Posttraumatic Stress Disorder Symptoms Is Associated With Lower Levels of Aggression After Residential Treatment Discharge
Watkins LE, Sippel LM, Pietrzak RH, Hoff R, Harpaz‐Rotem I. Clinically Significant Change in Posttraumatic Stress Disorder Symptoms Is Associated With Lower Levels of Aggression After Residential Treatment Discharge. Journal Of Traumatic Stress 2018, 31: 265-272. PMID: 29603388, DOI: 10.1002/jts.22275.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderPTSD symptomsPTSD changeResidential treatmentPosttraumatic stress disorder (PTSD) symptomsLess aggressionPTSD symptom changePTSD symptom reductionCurrent studyDisorder symptomsStress disorderContextual effectsSymptom reductionSymptom changeAggressionMultilevel modelsPrevious researchTreatment dischargeLow levelsVeterans Health Administration sitesVeteransSignificant changesTreatment sitesFindingsSymptoms
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 planningVeterans