2024
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 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 frequenciesEmotional 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
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 eventsSeverity
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 factorsCannabinoid 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
Dissociative symptoms predict risk for the development of PTSD: Results from the National Health and Resilience in Veterans Study (NHRVS)
Herzog S, Fogle BM, Harpaz-Rotem I, Tsai J, DePierro J, Pietrzak RH. Dissociative symptoms predict risk for the development of PTSD: Results from the National Health and Resilience in Veterans Study (NHRVS). Journal Of Psychiatric Research 2020, 131: 215-219. PMID: 32998083, DOI: 10.1016/j.jpsychires.2020.09.018.Peer-Reviewed Original ResearchConceptsDevelopment of PTSDPosttraumatic stress disorderU.S. military veteransDissociative symptomsRisk factorsDerealization symptomsIncident posttraumatic stress disorderTrauma exposureImmutable risk factorsProspective cohort studyPopulation-based risk factorsMilitary veteransPrediction of PTSDPotential clinical utilityTrauma-related factorsTrauma-exposed veteransCohort studyNational HealthRelative riskClinical utilityU.S. veteransVeterans StudySymptomsTrauma characteristicsStress disorderSex 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
Neural 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 rateVeteransSymptomsEndocannabinoid System Alterations in Posttraumatic Stress Disorder: A Review of Developmental and Accumulative Effects of Trauma
Nia A, Bender R, Harpaz-Rotem I. Endocannabinoid System Alterations in Posttraumatic Stress Disorder: A Review of Developmental and Accumulative Effects of Trauma. Chronic Stress 2019, 3: 2470547019864096. PMID: 31660473, PMCID: PMC6816276, DOI: 10.1177/2470547019864096.Peer-Reviewed Original ResearchEndocannabinoid system alterationsEndocannabinoid systemSystem alterationsEndocannabinoid ligandsProlonged stressPosttraumatic stress disorderImportant sex differencesClinical studiesPsychiatric symptomsCannabinoid receptorsHuman studiesChronic stressStress disorderTraumaDecreased levelsDevelopmental ageSex differencesCurrent literatureReceptorsAlterationsAccumulative effectReviewSymptomsLevels
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 solutionDisordersVeteransBDNF Val66Met polymorphism and posttraumatic stress symptoms in U.S. military veterans: Protective effect of physical exercise
Pitts BL, Whealin JM, Harpaz-Rotem I, Duman RS, Krystal JH, Southwick SM, Pietrzak RH. BDNF Val66Met polymorphism and posttraumatic stress symptoms in U.S. military veterans: Protective effect of physical exercise. Psychoneuroendocrinology 2018, 100: 198-202. PMID: 30388593, DOI: 10.1016/j.psyneuen.2018.10.011.Peer-Reviewed Original ResearchMeSH KeywordsAgedAmino Acid SubstitutionBrain-Derived Neurotrophic FactorCase-Control StudiesExerciseFemaleHumansMaleMethionineMiddle AgedMilitary PersonnelPolymorphism, Single NucleotideProtective FactorsResilience, PsychologicalSeverity of Illness IndexStress Disorders, Post-TraumaticUnited StatesValineVeteransConceptsMet allele carriersBDNF Val66Met polymorphismAllele carriersVal66Met polymorphismPhysical exerciseGreater severityPTSD symptomsU.S. military veteransTrauma burdenBrain-derived neurotrophic factor (BDNF) Val66Met polymorphismPast-month PTSD symptomsNeurotrophic factor Val66Met polymorphismMilitary veteransLifetime trauma burdenHigh trauma burdenVal/ValAdrenal (HPA) axis reactivityPosttraumatic stress disorder (PTSD) symptomsBDNF releaseCurrent PTSD symptomsProtective effectRe-experiencing symptomsAxis reactivityPosttraumatic stress symptomsSymptomsClinically 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
2017
Apolipoprotein E gene polymorphism, trauma burden, and posttraumatic stress symptoms in U.S. military veterans: Results from the National Health and Resilience in Veterans Study
Mota NP, Han S, Harpaz‐Rotem I, Maruff P, Krystal JH, Southwick SM, Gelernter J, Pietrzak RH. Apolipoprotein E gene polymorphism, trauma burden, and posttraumatic stress symptoms in U.S. military veterans: Results from the National Health and Resilience in Veterans Study. Depression And Anxiety 2017, 35: 168-177. PMID: 29172227, PMCID: PMC5794529, DOI: 10.1002/da.22698.Peer-Reviewed Original ResearchConceptsΕ4 allele carriersApolipoprotein E gene polymorphismE gene polymorphismTrauma burdenU.S. military veteransAllele carriersPosttraumatic stress disorderPTSD symptomsNational HealthGreater social supportGene polymorphismsGreater severityMilitary veteransVeterans StudyAPOE ε4 carrier statusSocial supportΕ4 carrier statusAPOE genotypeΕ4 noncarriersPosttraumatic stress symptomsIndependent replication sampleSymptomsPTSD riskStress disorderCarrier statusSynaptic Loss and the Pathophysiology of PTSD: Implications for Ketamine as a Prototype Novel Therapeutic
Krystal JH, Abdallah CG, Averill LA, Kelmendi B, Harpaz-Rotem I, Sanacora G, Southwick SM, Duman RS. Synaptic Loss and the Pathophysiology of PTSD: Implications for Ketamine as a Prototype Novel Therapeutic. Current Psychiatry Reports 2017, 19: 74. PMID: 28844076, PMCID: PMC5904792, DOI: 10.1007/s11920-017-0829-z.Peer-Reviewed Original ResearchConceptsSynaptic connectivityRapid-acting treatmentPathophysiology of PTSDPotential clinical importanceTreatment of PTSDSynaptic lossPurpose of ReviewStudiesDisconnection syndromeClinical importanceNovel pharmacotherapeuticsNovel therapeuticsPTSD symptomsRecent FindingsHerePTSDPathophysiologyKetamineTreatmentDisordersTherapeutic applicationsStress-related lossesSyndromeSymptomsPharmacotherapeutics
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 planningVeteransLate-life exacerbation of PTSD symptoms in US veterans: results from the National Health and Resilience in Veterans Study.
Mota N, Tsai J, Kirwin PD, Harpaz-Rotem I, Krystal JH, Southwick SM, Pietrzak RH. Late-life exacerbation of PTSD symptoms in US veterans: results from the National Health and Resilience in Veterans Study. The Journal Of Clinical Psychiatry 2016, 77: 348-54. PMID: 27046308, DOI: 10.4088/jcp.15m10101.Peer-Reviewed Original ResearchConceptsOlder US veteransPosttraumatic stress disorderUS veteransPTSD symptomsNational HealthVeterans StudyMultivariable logistic regression modelWorst traumaDelayed-onset posttraumatic stress disorderExecutive dysfunctionWave 2Population-based dataUS military veteransLogistic regression modelsWave 1Cohort studySignificant exacerbationGreater severitySymptomsOlder ageStress disorderSelf-reported cognitive difficultiesPotential targetMilitary veteransLater life
2014
Functional significance of a novel 7-factor model of DSM-5 PTSD symptoms: Results from the National Health and Resilience in Veterans Study
Pietrzak RH, Tsai J, Armour C, Mota N, Harpaz-Rotem I, Southwick SM. Functional significance of a novel 7-factor model of DSM-5 PTSD symptoms: Results from the National Health and Resilience in Veterans Study. Journal Of Affective Disorders 2014, 174: 522-526. PMID: 25556669, DOI: 10.1016/j.jad.2014.12.007.Peer-Reviewed Original ResearchConceptsQuality of lifePosttraumatic stress disorderDSM-5 PTSD symptomsPTSD symptomsNational HealthU.S. veteransSuicidal ideationVeterans StudySymptom clustersDysphoric arousal symptomsCross-sectional designFunctional outcomePsychiatric comorbidityClinical significancePTSD symptom clustersCurrent depressionDSM-5 PTSD symptom clustersPTSD phenotypeMental disordersSymptomsComorbid psychopathologyStress disorderFunctional correlatesStatistical ManualTreatment efforts