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: 1101-1107. 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 frequenciesPrevalence, 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 ResearchUnraveling PTSD: Symptom Cluster Change During and 1 Year After Veterans’ Residential PTSD Treatment
Gross G, Spiller T, Ben-Zion Z, Rubenstein A, Pietrzak R, Duek O, Hoff R, Harpaz-Rotem I. Unraveling PTSD: Symptom Cluster Change During and 1 Year After Veterans’ Residential PTSD Treatment. Psychological Trauma Theory Research Practice And Policy 2024 PMID: 38990694, DOI: 10.1037/tra0001734.Peer-Reviewed Original ResearchPosttraumatic stress disorderPosttraumatic stress disorder symptom clustersPosttraumatic stress disorder clustersSymptom clustersIntrusive symptomsResidential treatmentTreatment of posttraumatic stress disorderPosttraumatic stress disorder symptomsResidential PTSD treatmentPTSD symptom clustersNovel treatment interventionsDifferential treatment responseReduce symptom severityDifferential patterns of changeAvoidance symptomsPTSD treatmentTreatment gainsStress disorderVeterans AffairsSymptom severityCluster CTreatment interventionsCluster BIndividual symptomsCohort of veteransSome Closure on Exposure—Realigning the Perspective on Trauma Treatment and Finding a Pathway Forward: Reply to Brown (2024) and Najavits (2024)
Rubenstein A, Doran J, Duek O, Harpaz-Rotem I. Some Closure on Exposure—Realigning the Perspective on Trauma Treatment and Finding a Pathway Forward: Reply to Brown (2024) and Najavits (2024). American Psychologist 2024, 79: 350-351. PMID: 38635198, DOI: 10.1037/amp0001314.Peer-Reviewed Original ResearchTo 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 researchEmotional 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 transitionSymptomsParticipantsDisordersFunctional 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-5What 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
Examining the association between posttraumatic stress disorder and disruptions in cortical networks identified using data-driven methods
Yang J, Huggins A, Sun D, Baird C, Haswell C, Frijling J, Olff M, van Zuiden M, Koch S, Nawijn L, Veltman D, Suarez-Jimenez B, Zhu X, Neria Y, Hudson A, Mueller S, Baker J, Lebois L, Kaufman M, Qi R, Lu G, Říha P, Rektor I, Dennis E, Ching C, Thomopoulos S, Salminen L, Jahanshad N, Thompson P, Stein D, Koopowitz S, Ipser J, Seedat S, du Plessis S, van den Heuvel L, Wang L, Zhu Y, Li G, Sierk A, Manthey A, Walter H, Daniels J, Schmahl C, Herzog J, Liberzon I, King A, Angstadt M, Davenport N, Sponheim S, Disner S, Straube T, Hofmann D, Grupe D, Nitschke J, Davidson R, Larson C, deRoon-Cassini T, Blackford J, Olatunji B, Gordon E, May G, Nelson S, Abdallah C, Levy I, Harpaz-Rotem I, Krystal J, Morey R, Sotiras A. Examining the association between posttraumatic stress disorder and disruptions in cortical networks identified using data-driven methods. Neuropsychopharmacology 2023, 49: 609-619. PMID: 38017161, PMCID: PMC10789873, DOI: 10.1038/s41386-023-01763-5.Peer-Reviewed Original ResearchPosttraumatic stress disorderStructural covariance networksCortical thicknessPTSD diagnosisInsular cortexPTSD patientsCingulate cortexSymptom severityBilateral superior frontal cortexStress disorderGreater cortical thicknessLower cortical thicknessChildhood trauma severitySuperior frontal cortexRegression analysisAnterior cingulate cortexTrauma-exposed controlsPosterior cingulate cortexPrefrontal regulatory regionsPTSD symptom severityComorbid depressionMotor cortexHealthy controlsFrontal cortexAlcohol abuseClinical 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 modelsEffects of a dissociative drug on fronto-limbic resting-state functional connectivity in individuals with posttraumatic stress disorder: a randomized controlled pilot study
Danböck S, Duek O, Ben-Zion Z, Korem N, Amen S, Kelmendi B, Wilhelm F, Levy I, Harpaz-Rotem I. Effects of a dissociative drug on fronto-limbic resting-state functional connectivity in individuals with posttraumatic stress disorder: a randomized controlled pilot study. Psychopharmacology 2023, 241: 243-252. PMID: 37872291, PMCID: PMC10806226, DOI: 10.1007/s00213-023-06479-4.Peer-Reviewed Original ResearchResting-state functional connectivityPosttraumatic stress disorderFunctional magnetic resonance imagingMedial prefrontal cortexMPFC subregionsAnterior medial PFCFunctional connectivityStress disorderAspartate glutamate receptor antagonistPilot studyNon-competitive N-methylGlutamate receptor antagonistsEffects of ketamineDissociative drugsMagnetic resonance imagingIntravenous drug infusionReceptor antagonistSubanesthetic doseDrug infusionCorrelative findingsKetamineResonance imagingTransient decreaseDrug midazolamAmygdalaChanges 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 eventsSeverityPurpose in life protects against the development of suicidal thoughts and behaviors in U.S. veterans without a history of suicidality: A 10-year, nationally representative, longitudinal study
Fischer I, Nichter B, Feldman D, Na P, Tsai J, Harpaz-Rotem I, Schulenberg S, Pietrzak R. Purpose in life protects against the development of suicidal thoughts and behaviors in U.S. veterans without a history of suicidality: A 10-year, nationally representative, longitudinal study. Journal Of Affective Disorders 2023, 340: 551-554. PMID: 37557988, DOI: 10.1016/j.jad.2023.08.040.Peer-Reviewed Original ResearchConceptsIncident suicidal ideationAlcohol use disorderIncident suicide attemptsCurrent alcohol use disorderHistory of STBSuicidal ideationSuicide attemptsBaseline predictorsDaily livingPopulation-based prospective cohort studySuicidal thoughtsLow purposeCurrent posttraumatic stress disorderProspective cohort studyTraditional risk factorsLower annual household incomeMultivariable regression analysisEvidence-based interventionsUS military veteransPosttraumatic stress disorderAnnual household incomeCohort studyTrauma burdenRisk factorsNational HealthStructural Neuroimaging of Hippocampus and Amygdala Subregions in Posttraumatic Stress Disorder: A Scoping Review
Ben-Zion Z, Korem N, Fine N, Katz S, Siddhanta M, Funaro M, Duek O, Spiller T, Danböck S, Levy I, Harpaz-Rotem I. Structural Neuroimaging of Hippocampus and Amygdala Subregions in Posttraumatic Stress Disorder: A Scoping Review. Biological Psychiatry Global Open Science 2023, 4: 120-134. PMID: 38298789, PMCID: PMC10829655, DOI: 10.1016/j.bpsgos.2023.07.001.Peer-Reviewed Original ResearchPost-traumatic stress disorderAmygdala subregionsStress disorderKey limbic regionsEtiology of PTSDPosttraumatic stress disorderDentate gyrusLimbic regionsSubiculum volumeSubregion volumesHippocampal subregionsDisorder pathogenesisStructural neuroimagingAutomatic segmentation softwareAmygdalar subregionsHippocampusNucleus volumeScoping ReviewPathogenesisCurrent literatureDisordersSegmentation softwareMethodological limitationsPost-traumatic psychopathologyReviewCorrelates 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 approachConscientiousnessNeural valuation of rewards and punishments in posttraumatic stress disorder: a computational approach
Jia R, Ruderman L, Pietrzak R, Gordon C, Ehrlich D, Horvath M, Mirchandani S, DeFontes C, Southwick S, Krystal J, Harpaz-Rotem I, Levy I. Neural valuation of rewards and punishments in posttraumatic stress disorder: a computational approach. Translational Psychiatry 2023, 13: 101. PMID: 36977676, PMCID: PMC10050320, DOI: 10.1038/s41398-023-02388-4.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderValuation systemStress disorderCombat veteransMaintenance of PTSDSubjective valueBrain valuation systemNeural valuation systemVentromedial prefrontal cortexFunctional MRI studyFunction of symptomsMale combat veteransNeural valuationSeries of choicesFear learningPunishment processingPosttrauma symptomsPTSD symptomsNeural encodingNeural mechanismsUncertain optionsPrefrontal cortexSubjective valuationVentral striatumMonetary gainsComparative effectiveness of evidence-based psychotherapies for PTSD delivered in VA residential PTSD treatment
Sippel L, Gross G, Spiller T, Duek O, Smith N, Hoff R, Harpaz-Rotem I. Comparative effectiveness of evidence-based psychotherapies for PTSD delivered in VA residential PTSD treatment. Psychological Medicine 2023, 53: 6859-6866. PMID: 36971021, DOI: 10.1017/s0033291723000375.Peer-Reviewed Original ResearchResidential Rehabilitation Treatment ProgramPosttraumatic stress disorderCognitive processing therapyComparative effectivenessProlonged exposureFirst-line treatmentSevere posttraumatic stress disorderRehabilitation treatment programSelf-reported posttraumatic stress disorderDepressive symptom outcomesDepressive symptom severityEvidence-based psychotherapiesElectronic medical recordsResidential PTSD treatmentSymptomatic patientsComorbid conditionsMedical recordsPE groupSymptom outcomesIndividual cognitive processing therapyDepressive symptomsPTSD treatmentSymptom severityTreatment programProgram evaluation dataRacial 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 disparities