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 ResearchMeSH KeywordsAdultAgedComorbidityCost of IllnessDepressive Disorder, MajorFemaleHumansMaleMiddle AgedPrevalenceStress Disorders, Post-TraumaticUnited StatesVeteransYoung AdultConceptsSubthreshold 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 ResearchMeSH KeywordsAdultAmygdalaEmotionsFemaleHumansMagnetic Resonance ImagingMalePainReceptor, Cannabinoid, CB1Stress Disorders, Post-TraumaticYoung AdultSome 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 researchFunctional 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 ResearchMeSH KeywordsHumansLogistic ModelsOdds RatioPatient DischargeResidential TreatmentStress Disorders, Post-TraumaticConceptsMaintenance 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
Neural patterns differentiate traumatic from sad autobiographical memories in PTSD
Perl O, Duek O, Kulkarni K, Gordon C, Krystal J, Levy I, Harpaz-Rotem I, Schiller D. Neural patterns differentiate traumatic from sad autobiographical memories in PTSD. Nature Neuroscience 2023, 26: 2226-2236. PMID: 38036701, DOI: 10.1038/s41593-023-01483-5.Peer-Reviewed Original ResearchConceptsPost-traumatic stress disorderTraumatic memoriesAutobiographical memoryNeural patternsIntersubject representational similarity analysisSimilar neural representationsRepresentational similarity analysisPosterior cingulate cortexTrauma memoriesMnemonic featuresNegative memoriesMultivoxel patternsNeural representationCognitive stateHippocampal representationsCognitive entitiesStress disorderCingulate cortexNeural activityTraumatic narrativesIndividual symptom severitySemantic representationMemory typesOwn memoryMemoryEvaluating 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 ResearchMeSH KeywordsDiagnostic and Statistical Manual of Mental DisordersEmotionsFactor Analysis, StatisticalHumansStress Disorders, Post-TraumaticVeteransConceptsIndex 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 eventsSeverityPost-traumatic stress disorder: rethinking diagnosis
Fischer I, Pietrzak R, Maercker A, Shalev A, Katz I, Harpaz-Rotem I. Post-traumatic stress disorder: rethinking diagnosis. The Lancet Psychiatry 2023, 10: 741-742. PMID: 37499676, DOI: 10.1016/s2215-0366(23)00227-4.Peer-Reviewed Original ResearchCorrelates 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 ResearchMeSH KeywordsAdaptation, PsychologicalEmotionsHumansRisk FactorsStress Disorders, Post-TraumaticVeteransConceptsPosttraumatic 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 approachConscientiousnessLong term structural and functional neural changes following a single infusion of Ketamine in PTSD
Duek O, Korem N, Li Y, Kelmendi B, Amen S, Gordon C, Milne M, Krystal J, Levy I, Harpaz-Rotem I. Long term structural and functional neural changes following a single infusion of Ketamine in PTSD. Neuropsychopharmacology 2023, 48: 1648-1658. PMID: 37270621, PMCID: PMC10517133, DOI: 10.1038/s41386-023-01606-3.Peer-Reviewed Original ResearchMeSH KeywordsExtinction, PsychologicalHumansKetamineMidazolamPilot ProjectsPsychotherapyStress Disorders, Post-TraumaticConceptsKetamine recipientsSingle infusionMain study outcomeTiming of administrationEnd of treatmentNMDA receptor antagonistFunctional neural changesFrequency of administrationSignificant clinical implicationsTrauma-focused psychotherapyBrief exposure therapyAmygdala-vmPFC connectivityPost-retrieval extinctionKetamine doseKetamine administrationReceptor antagonistTrauma scriptsNeural changesClinical implicationsDecreased connectivityExposure therapyKetamineTrauma memoriesStudy outcomesUncinate fasciculusAmygdala downregulation training using fMRI neurofeedback in post-traumatic stress disorder: a randomized, double-blind trial
Zhao Z, Duek O, Seidemann R, Gordon C, Walsh C, Romaker E, Koller W, Horvath M, Awasthi J, Wang Y, O’Brien E, Fichtenholtz H, Hampson M, Harpaz-Rotem I. Amygdala downregulation training using fMRI neurofeedback in post-traumatic stress disorder: a randomized, double-blind trial. Translational Psychiatry 2023, 13: 177. PMID: 37230984, PMCID: PMC10209552, DOI: 10.1038/s41398-023-02467-6.Peer-Reviewed Original ResearchMeSH KeywordsAmygdalaDown-RegulationHumansMagnetic Resonance ImagingNeurofeedbackStress Disorders, Post-TraumaticConceptsPost-traumatic stress disorderControl groupAmygdala activityPTSD treatmentDouble-blind clinical trialStress disorderDouble-blind trialSecondary outcome measurementsTrauma recallNeurofeedback trainingGreater improvementAmygdala controlsPotential clinical applicationsSymptom scoresActive groupClinical trialsTreatment successOutcome measurementsTrauma scriptsSymptom reductionNeurofeedback interventionPTSD symptomsFMRI neurofeedbackAmygdalaNeural markersPurpose 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 ResearchMeSH KeywordsActivities of Daily LivingAgedCross-Sectional StudiesDisabled PersonsHumansSelf ReportStress Disorders, Post-TraumaticVeteransConceptsPhysical 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 veteransNeural 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 ResearchMeSH KeywordsBrain MappingFearHumansMagnetic Resonance ImagingMalePrefrontal CortexPunishmentRewardStress Disorders, Post-TraumaticConceptsPosttraumatic 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 gainsClinical significance of novel 8-factor model of DSM-5 PTSD in national VA PTSD residential treatment data: Internally- v. externally-cued intrusions
Gross G, Spiller T, Duek O, Pietrzak R, Harpaz-Rotem I. Clinical significance of novel 8-factor model of DSM-5 PTSD in national VA PTSD residential treatment data: Internally- v. externally-cued intrusions. Journal Of Affective Disorders 2023, 328: 255-260. PMID: 36806596, DOI: 10.1016/j.jad.2023.02.046.Peer-Reviewed Original ResearchMeSH KeywordsClinical RelevanceCross-Sectional StudiesCuesDiagnostic and Statistical Manual of Mental DisordersHumansResidential TreatmentStress Disorders, Post-TraumaticUnited StatesConceptsPosttraumatic stress disorderPTSD symptomsDysphoric arousalDSM-5 posttraumatic stress disorderDSM-5 PTSD symptomsDistinct underlying processesSelf-report measuresGeneralized anxiety symptomsSuperior model fitPhysical health functioningCore defining featuresStructural equation modelingWorse emotional functioningAnxious arousalSymptoms of depressionNegative affectIntrusion symptomsGreater avoidanceEmotional functioningStress disorderAnxiety symptomsPTSD ChecklistIntrusion factorCross-sectional designGeneralized anxietyUnderstanding 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 ResearchMeSH KeywordsAmbulatory CareFemaleHumansMaleMiddle AgedOutpatientsStress Disorders, Post-TraumaticUnited StatesUnited States Department of Veterans AffairsVeteransConceptsSpecialty 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 sampleIdentifying 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 ResearchMeSH KeywordsAgedAgingCross-Sectional StudiesHumansResilience, PsychologicalStress Disorders, Post-TraumaticSurveys and QuestionnairesVeteransConceptsUS 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 correlatesHealthCorrelatesEvaluating the Evidence for Brain-Based Biotypes of Psychiatric Vulnerability in the Acute Aftermath of Trauma
Ben-Zion Z, Spiller T, Keynan J, Admon R, Levy I, Liberzon I, Shalev A, Hendler T, Harpaz-Rotem I. Evaluating the Evidence for Brain-Based Biotypes of Psychiatric Vulnerability in the Acute Aftermath of Trauma. American Journal Of Psychiatry 2023, 180: 146-154. PMID: 36628514, PMCID: PMC9898083, DOI: 10.1176/appi.ajp.20220271.Peer-Reviewed Original ResearchMeSH KeywordsAdultBrainFemaleHumansLongitudinal StudiesMaleNeuroimagingProspective StudiesStress Disorders, Post-TraumaticConceptsPosttraumatic psychopathologyPsychiatric vulnerabilityGeneral hospital emergency departmentHospital emergency departmentRecent trauma survivorsAdditional replication studiesEmergency departmentObjective neural markersDifferent longitudinal patternsProspective symptomsMonths posttraumaAcute aftermathPsychiatric disordersEffective personalized treatmentTrauma exposureFunctional MRIPersonalized treatmentConsistent subgroupTreatment implicationsNeural activityAssessment 1Neural markersLongitudinal studyNeurobiological indicesDiagnostic methods
2022
Distinguishing emotional numbing symptoms of posttraumatic stress disorder from major depressive disorder
Duek O, Seidemann R, Pietrzak R, Harpaz-Rotem I. Distinguishing emotional numbing symptoms of posttraumatic stress disorder from major depressive disorder. Journal Of Affective Disorders 2022, 324: 294-299. PMID: 36586605, DOI: 10.1016/j.jad.2022.12.105.Peer-Reviewed Original ResearchMeSH KeywordsAffectCognitionDepressive Disorder, MajorEmotionsHumansStress Disorders, Post-TraumaticConceptsEmotional numbing symptomsPosttraumatic stress disorderNumbing symptomsEmotional numbingStress disorderSymptom clustersTrauma-exposed individualsGreater PTSD severityMajor depressive disorderContext of traumaUnique variancePTSD symptomsPTSD phenotypePTSD severityDifferent symptom clustersWorse treatment outcomesDepressive disorderCore aspectsNumbingDistinct contributionsMDD symptomsDSM-IIIFunctional impairmentDisordersTreatment outcomes