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 oddsBarriers 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 researchChanges 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 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 effectRacial 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 factorsReligion, spirituality, and risk for incident posttraumatic stress disorder, suicidal ideation, and hazardous drinking in U.S. military veterans: A 7-year, nationally representative, prospective cohort study
Rubenstein A, Koenig HG, Marin DB, Sharma V, Harpaz-Rotem I, Pietrzak RH. Religion, spirituality, and risk for incident posttraumatic stress disorder, suicidal ideation, and hazardous drinking in U.S. military veterans: A 7-year, nationally representative, prospective cohort study. Journal Of Affective Disorders 2021, 295: 1110-1117. PMID: 34706422, DOI: 10.1016/j.jad.2021.08.128.Peer-Reviewed Original ResearchConceptsNon-organizational religious activityProspective cohort studyOrganizational religious activityHazardous drinkingSuicidal ideationMental health outcomesU.S. military veteransCohort studyHealth outcomesMilitary veteransIncident posttraumatic stress disorderMultivariable logistic regression analysisLogistic regression analysisMental health assessmentPosttraumatic stress disorderCross-sectional designPositive mental health outcomesLower incidenceLower riskSociodemographic factorsClinical implicationsGreater riskStress disorderHealth assessmentRegression analysisMental 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 StudyThe hidden burden of social anxiety disorder in U.S. military veterans: Results from the National Health and Resilience in Veterans Study
Byrne SP, Fogle BM, Asch R, Esterlis I, Harpaz-Rotem I, Tsai J, Pietrzak RH. The hidden burden of social anxiety disorder in U.S. military veterans: Results from the National Health and Resilience in Veterans Study. Journal Of Affective Disorders 2021, 291: 9-14. PMID: 34022553, DOI: 10.1016/j.jad.2021.04.088.Peer-Reviewed Original ResearchConceptsU.S. military veteransPsychiatric comorbidityPsychiatric disordersSuicidal ideationU.S. veteransAnxiety disordersComorbid psychiatric disordersMilitary veteransLifetime major depressionImportance of screeningPrevalent mental disordersSocial anxiety disorderMental health functioningCurrent suicidal ideationMeasures of functioningPosttraumatic stress disorderLifetime social anxiety disorderIncremental burdenMultivariable analysisPsychiatric morbidityNational HealthRepresentative sampleMajor depressionFunctional impairmentPsychiatric history
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 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 difficultiesHeterogeneity of posttraumatic stress symptomatology and social connectedness in treatment-seeking military veterans: a longitudinal examination
Sippel LM, Watkins LE, Pietrzak RH, Hoff R, Harpaz-Rotem I. Heterogeneity of posttraumatic stress symptomatology and social connectedness in treatment-seeking military veterans: a longitudinal examination. European Journal Of Psychotraumatology 2019, 10: 1646091. PMID: 31489133, PMCID: PMC6713134, DOI: 10.1080/20008198.2019.1646091.Peer-Reviewed Original ResearchDysphoric arousal symptomsSocial connectednessPTSD symptomsArousal symptomsTreatment-seeking military veteransGreater PTSD symptom severityCross-lagged panel modelMaintenance of PTSDMilitary veteransPosttraumatic stress symptomatologyPTSD symptom clustersOverall PTSD symptomsPTSD symptom severityPoor social connectednessSocial causation modelIrritability/angerLong-term PTSDTwo-wave cross-lagged panel modelFive-factor modelMost extant researchU.S. military veteransNumbing symptomsSymptom-level analysesStress symptomatologyPTSD treatmentRandomized 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 veterans