2024
Barriers to Mental Health Care in US Military Veterans
Lewis C, Fischer I, Tsai J, Harpaz-Rotem I, Pietrzak R. Barriers to Mental Health Care in US Military Veterans. Psychiatric Quarterly 2024, 95: 367-383. PMID: 38940875, DOI: 10.1007/s11126-024-10078-7.Peer-Reviewed Original ResearchMental health careMental health treatmentHealth careHealth treatmentReduce barriersUS veteransNegative beliefsInstrumental barriersNational Health and ResiliencePromote engagementMental health servicesPopulation-based effortsUS military veteransNationally representative dataMultivariate logistic regressionPerceived stigmaHealth servicesSocial supportPsychiatric needsVeterans StudyPractical barriersLow purposeConclusionsNearly halfMilitary veteransCareFunctional correlates of a novel 8-factor 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. Functional correlates of a novel 8-factor model of PTSD in U.S. military veterans: Results from the National Health and Resilience in Veterans Study. Journal Of Psychiatric Research 2024, 171: 69-74. PMID: 38244335, DOI: 10.1016/j.jpsychires.2024.01.017.Peer-Reviewed Original ResearchConceptsModels of posttraumatic stress disorderPosttraumatic stress disorderNational Health and ResilienceU.S. military veteransArousal symptomsSuicidal ideationVeterans StudyCurrent depressionSymptom clustersMilitary veteransPosttraumatic stress disorder symptom clustersPosttraumatic stress disorder symptomsPosttraumatic Stress Disorder ChecklistAnxious arousal symptomsDysphoric arousal symptomsIntrusive symptom clustersOdds of suicidal ideationFunctional correlatesMulti-faceted disorderExternalizing behavioral symptomsAssociated with lower oddsAssociated with higher oddsSymptom structureAvoidance symptomsDSM-5
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 researchNot 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 eventsSeverityCorrelates 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 approachConscientiousnessFirearm 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 effectPurpose in life and physical health in older U.S. military veterans: Cross-sectional results from the National Health and Resilience in Veterans Study
Fischer I, Feldman D, Tsai J, Harpaz-Rotem I, McCutcheon V, Schulenberg S, Pietrzak R. Purpose in life and physical health in older U.S. military veterans: Cross-sectional results from the National Health and Resilience in Veterans Study. Preventive Medicine 2023, 170: 107495. PMID: 37001606, DOI: 10.1016/j.ypmed.2023.107495.Peer-Reviewed Original ResearchConceptsPhysical health conditionsPhysical healthNational HealthDaily livingVeterans StudyHealth conditionsHigher bodily painPhysical role limitationsGeneral population studiesOverall self-reported healthPhysical health difficultiesHigher PILSelf-reported healthOlder U.S. veteransU.S. military veteransBodily painRole limitationsPhysical functioningSleep disordersInstrumental activitiesSelf-report assessmentsCurrent prevalenceCross-sectional resultsU.S. veteransMost veteransRacial and ethnic mental health disparities in U.S. Military Veterans: Results from the National Health and Resilience in Veterans Study
Merians A, Gross G, Spoont M, Bellamy C, Harpaz-Rotem I, Pietrzak R. Racial and ethnic mental health disparities in U.S. Military Veterans: Results from the National Health and Resilience in Veterans Study. Journal Of Psychiatric Research 2023, 161: 71-76. PMID: 36905842, DOI: 10.1016/j.jpsychires.2023.03.005.Peer-Reviewed Original ResearchConceptsPsychiatric disordersWhite veteransNational HealthHispanic veteransMilitary veteransBlack veteransVeterans StudyLifetime major depressive disorderLifetime posttraumatic stress disorderHigh-risk subgroupsPopulation-based studyCurrent psychiatric disorderDrug use disordersMajor depressive disorderCommon psychiatric disordersEthnic differencesPopulation-based sampleCertain psychiatric disordersPopulation-based researchLower household incomeCurrent suicidal ideationPosttraumatic stress disorderRace/ethnicityU.S. military veteransMental health disparitiesIdentifying 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 sampleMental Health Burden in Enlisted and Commissioned U.S. Military Veterans: Importance of Indirect Trauma Exposure in Commissioned Veterans
Merians AN, Na PJ, Tsai J, Harpaz-Rotem I, Pietrzak RH. Mental Health Burden in Enlisted and Commissioned U.S. Military Veterans: Importance of Indirect Trauma Exposure in Commissioned Veterans. Psychiatry 2022, 85: 418-432. PMID: 35532217, DOI: 10.1080/00332747.2022.2068301.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderMajor depressive disorderU.S. military veteransSuicidal ideationMilitary veteransTrauma exposureMost mental health outcomesMental health burdenPast-year suicidal ideationDrug use disordersU.S. veteran populationMental health historyHigh exposureMental health outcomesMultivariable analysisDepressive disorderNational HealthHealth burdenPost-stratification weightsUse disordersVeteran populationHealth historyHealth outcomesIndirect trauma exposureVeterans Study
2021
Mental Health Care Use Among U.S. Military Veterans: Results From the 2019–2020 National Health and Resilience in Veterans Study
Kline AC, Panza KE, Nichter B, Tsai J, Harpaz-Rotem I, Norman SB, Pietrzak RH. Mental Health Care Use Among U.S. Military Veterans: Results From the 2019–2020 National Health and Resilience in Veterans Study. Psychiatric Services 2021, 73: 628-635. PMID: 34775790, DOI: 10.1176/appi.ps.202100112.Peer-Reviewed Original ResearchConceptsMental health careMental health care utilizationHealth care utilizationSubstance use disordersCare utilizationU.S. military veteransMental dysfunctionNational HealthUse disordersHealth careVeterans StudyMental health care usePrimary health care providersHealth care useMilitary veteransHealth care providersUse of careHierarchical logistic regressionCare usePosttraumatic stress disorder (PTSD) symptom severitySleep disordersCare providersDisorder symptom severityU.S. veteransNeed factorsMental health and suicidal ideation in US military veterans with histories of COVID-19 infection
Na P, Tsai J, Harpaz-Rotem I, Pietrzak R. Mental health and suicidal ideation in US military veterans with histories of COVID-19 infection. BMJ Military Health 2021, 168: 15-19. PMID: 34035155, PMCID: PMC8154290, DOI: 10.1136/bmjmilitary-2021-001846.Peer-Reviewed Original ResearchConceptsStrong independent predictorUS military veteransSuicidal ideationIndependent predictorsCOVID-19COVID-related stressorsInternalising disordersPsychiatric conditionsProtective factorsMilitary veteransCOVID-19 infectionLogistic regression analysisPsychiatric symptom severityLower household incomeCurrent suicidal ideationSubstance use problemsProspective cohortMultivariable analysisTrauma burdenPositive screenUS veteransNational HealthPsychiatric symptomsPsychiatric disordersVeterans StudyMindfulness as a Mediator Between Trauma Exposure and Mental Health Outcomes: Results From the National Health and Resilience in Veterans Study
Kachadourian LK, Harpaz-Rotem I, Tsai J, Southwick S, Pietrzak RH. Mindfulness as a Mediator Between Trauma Exposure and Mental Health Outcomes: Results From the National Health and Resilience in Veterans Study. Psychological Trauma Theory Research Practice And Policy 2021, 13: 223-230. PMID: 33475404, PMCID: PMC8500672, DOI: 10.1037/tra0000995.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderAlcohol use disorderLifetime traumaTrauma-related negative affectPresent momentVeterans StudyU.S. veteransTrauma-related experiencesSuicidal ideationTraumatic life eventsLifetime trauma burdenMental health outcomesQuality of lifeMental health problemsTrauma remindersNegative affectMindful attentionTrauma exposurePTSD symptomsMental health issuesTraumatic eventsCumulative traumaStress disorderNoncombat veteransLife eventsCannabinoid 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
The National Health and Resilience in Veterans Study: A Narrative Review and Future Directions
Fogle BM, Tsai J, Mota N, Harpaz-Rotem I, Krystal JH, Southwick SM, Pietrzak RH. The National Health and Resilience in Veterans Study: A Narrative Review and Future Directions. Frontiers In Psychiatry 2020, 11: 538218. PMID: 33362593, PMCID: PMC7755975, DOI: 10.3389/fpsyt.2020.538218.Peer-Reviewed Original ResearchNational HealthVeterans StudyMental disordersNarrative reviewVeterans Affairs Healthcare SystemPopulation-based dataUnique health needsUnited States veteransPost-traumatic stress disorderNon-veteran counterpartsPost-traumatic growthProtective psychosocial characteristicsProspective studyStates veteransIndependent cohortHealth outcomesHealth needsU.S. veteransCare deliveryClinical implicationsLongitudinal changesPsychosocial characteristicsProtective factorsStress disorderTreatment effortsDissociative 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 disorder
2019
Posttraumatic stress symptom courses in U.S. military veterans: A seven-year, nationally representative, prospective cohort study
Mota NP, Cook JM, Smith NB, Tsai J, Harpaz-Rotem I, Krystal JH, Southwick SM, Pietrzak RH. Posttraumatic stress symptom courses in U.S. military veterans: A seven-year, nationally representative, prospective cohort study. Journal Of Psychiatric Research 2019, 119: 23-31. PMID: 31546045, DOI: 10.1016/j.jpsychires.2019.09.005.Peer-Reviewed Original ResearchConceptsPTSD symptom courseSymptom courseU.S. military veteransLatent growth mixture modelingProspective cohort studyMilitary veteransLifetime psychiatric historyMental health treatmentPhysical health difficultiesLifetime traumatic eventsTrauma-exposed veteransProtective psychosocial characteristicsCohort studyProspective cohortModerate symptomsModifiable correlatesNational HealthSymptomatic coursePsychiatric historyHealth treatmentU.S. veteransVeterans StudyPsychosocial characteristicsHigher symptomsHealth difficultiesApolipoprotein E gene polymorphism, posttraumatic stress disorder, and cognitive function in older U.S. veterans: Results from the National Health and Resilience in Veterans Study
Averill LA, Abdallah CG, Levey DF, Han S, Harpaz‐Rotem I, Kranzler HR, Southwick SM, Krystal JH, Gelernter J, Pietrzak RH. Apolipoprotein E gene polymorphism, posttraumatic stress disorder, and cognitive function in older U.S. veterans: Results from the National Health and Resilience in Veterans Study. Depression And Anxiety 2019, 36: 834-845. PMID: 31385647, DOI: 10.1002/da.22912.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderExecutive functionCognitive functioningStress disorderΕ4 carrier statusΕ4 carriersVeterans StudyCognitive dysfunctionAttention/concentrationGreater cognitive difficultiesLower cognitive functioningOlder U.S. veteransΕ4 allele carrier statusPerseverative errorsCognitive difficultiesReplication sampleCarrier statusCognitive functionImportance of assessingNational HealthCognitive declinePredictive effectApolipoprotein E gene polymorphismE gene polymorphismΕ4 allele carriers
2018
Protective correlates of suicidality among veterans with histories of posttraumatic stress disorder and major depressive disorder: Results from the National Health and Resilience in Veterans Study
Kachadourian LK, Tsai J, Harpaz-Rotem I, Southwick SM, Pietrzak RH. Protective correlates of suicidality among veterans with histories of posttraumatic stress disorder and major depressive disorder: Results from the National Health and Resilience in Veterans Study. Journal Of Affective Disorders 2018, 246: 731-737. PMID: 30616162, DOI: 10.1016/j.jad.2018.12.058.Peer-Reviewed Original ResearchMeSH KeywordsAdultCross-Sectional StudiesDepressive Disorder, MajorFemaleHumansLogistic ModelsMaleMiddle AgedMultivariate AnalysisOptimismPrevalenceProtective FactorsResilience, PsychologicalRisk FactorsStress Disorders, Post-TraumaticSuicidal IdeationSuicideSuicide, AttemptedSurveys and QuestionnairesUnited StatesVeteransYoung AdultConceptsMajor depressive disorderPosttraumatic stress disorderProtective correlatesSuicidal ideationSuicide attemptsProtective factorsDepressive disorderNational HealthVeterans StudyMultivariable logistic regression analysisSuicidal behaviorStress disorderHistory of PTSDLogistic regression analysisSample of veteransAssessment of suicidalityLifetime suicide attemptsRisk factorsHigh-risk sampleTreatment approachesU.S. veteransWeb-based surveyCross-sectional natureSuicide riskSelf-report items