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 oddsFunctional 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 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 HealthCorrelates 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 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 disparitiesUnderstanding 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 ResearchConceptsSpecialty 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 sampleCharacterization of Mental Health in US Veterans Before, During, and 2 Years After the Onset of the COVID-19 Pandemic
Fischer I, Na P, Harpaz-Rotem I, Krystal J, Pietrzak R. Characterization of Mental Health in US Veterans Before, During, and 2 Years After the Onset of the COVID-19 Pandemic. JAMA Network Open 2023, 6: e230463. PMID: 36821116, PMCID: PMC9951035, DOI: 10.1001/jamanetworkopen.2023.0463.Peer-Reviewed Original ResearchIdentifying 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
Treatment response trajectories in residential PTSD programs for veterans: A national cohort investigation
Grau P, Sripada R, Pietrzak R, Ganoczy D, Harpaz-Rotem I. Treatment response trajectories in residential PTSD programs for veterans: A national cohort investigation. Journal Of Anxiety Disorders 2022, 92: 102645. PMID: 36334317, DOI: 10.1016/j.janxdis.2022.102645.Peer-Reviewed Original ResearchConceptsEvidence-based psychotherapiesThree-group trajectory modelTreatment outcomesTreatment responseTime of admissionPoor treatment outcomesPoor treatment responseNon-white raceResidential PTSD programsSubset of veteransPTSD treatment outcomesResidential PTSD treatmentPain severityCohort investigationPTSD careNational cohortFull cohortPTSD treatmentTherapeutic gainTreatment dropoutSymptom trajectoriesVeterans AffairsPTSD programTreatment response trajectoriesTreatment trajectoriesPerceived 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 sampleComparative effectiveness of group v. individual trauma-focused treatment for posttraumatic stress disorder in veterans
Spiller TR, Duek O, Buta E, Gross G, Smith NB, Harpaz-Rotem I. Comparative effectiveness of group v. individual trauma-focused treatment for posttraumatic stress disorder in veterans. Psychological Medicine 2022, 53: 4561-4568. PMID: 35959560, PMCID: PMC10388318, DOI: 10.1017/s0033291722001441.Peer-Reviewed Original ResearchConceptsGroup cognitive processing therapyCognitive processing therapyPosttraumatic stress disorderIndividual cognitive processing therapyPTSD symptom severitySymptom severityStress disorderReal-world effectivenessComparative effectiveness studiesResidential treatmentEffective treatmentComparative effectivenessVeterans AffairsEffectiveness studiesPTSD ChecklistPTSD severityGroup therapySeverityVeteransTreatmentDSM-5Group V.TherapyDisordersSmall reductionEmotional numbing in PTSD is associated with lower amygdala reactivity to pain
Korem N, Duek O, Ben-Zion Z, Kaczkurkin AN, Lissek S, Orederu T, Schiller D, Harpaz-Rotem I, Levy I. Emotional numbing in PTSD is associated with lower amygdala reactivity to pain. Neuropsychopharmacology 2022, 47: 1913-1921. PMID: 35945274, PMCID: PMC9485255, DOI: 10.1038/s41386-022-01405-2.Peer-Reviewed Original ResearchMeSH KeywordsAmygdalaEmotionsHumansMagnetic Resonance ImagingPainStress Disorders, Post-TraumaticVeteransConceptsPosttraumatic stress disorderAmygdala reactivityLower amygdala reactivityHigher pain responseLower amygdala activationAltered pain perceptionAmygdala activationProcessing of painAmygdala responseEmotional numbingPain correlateMild painPain processingPain thresholdPain responsePain perceptionPainControl groupPTSD groupStress disorderRobust reductionAmygdala activityCombat controlsAmygdalaEmotional numbing symptomsMental 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 StudyRisk for PTSD symptom worsening during new PTSD treatment episode in a nationally representative sample of treatment-seeking U.S. veterans with subthreshold PTSD
Gross GM, Pietrzak RH, Hoff RA, Katz IR, Harpaz-Rotem I. Risk for PTSD symptom worsening during new PTSD treatment episode in a nationally representative sample of treatment-seeking U.S. veterans with subthreshold PTSD. Journal Of Psychiatric Research 2022, 151: 304-310. PMID: 35526446, DOI: 10.1016/j.jpsychires.2022.04.040.Peer-Reviewed Original ResearchConceptsSymptom worseningRisk factorsSubthreshold PTSDPTSD symptom clustersSymptom clustersPTSD symptomsHealth care utilizationPTSD specialty clinicPoor treatment outcomesUnited States veteransBinary logistic regressionAdjusted analysisCare utilizationTreatment episodesRepresentative sampleSpecialty clinicSignificant symptomsTreatment outcomesSignificant worseningStates veteransSubthreshold symptomsEligible veteransNew episodesOutcome assessmentDiagnostic thresholdExploration of a Novel Model of Intrusive Symptoms in Posttraumatic Stress Disorder Among US Veterans
Duek O, Spiller TR, Rubenstein A, Pietrzak RH, Harpaz-Rotem I. Exploration of a Novel Model of Intrusive Symptoms in Posttraumatic Stress Disorder Among US Veterans. JAMA Network Open 2022, 5: e223555. PMID: 35311966, PMCID: PMC8938717, DOI: 10.1001/jamanetworkopen.2022.3555.Peer-Reviewed Original Research