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 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 Research
2023
Evaluating 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 ResearchConceptsPosttraumatic 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
Longitudinal volumetric evaluation of hippocampus and amygdala subregions in recent trauma survivors
Ben-Zion Z, Korem N, Spiller TR, Duek O, Keynan JN, Admon R, Harpaz-Rotem I, Liberzon I, Shalev AY, Hendler T. Longitudinal volumetric evaluation of hippocampus and amygdala subregions in recent trauma survivors. Molecular Psychiatry 2022, 28: 657-667. PMID: 36280750, PMCID: PMC9918676, DOI: 10.1038/s41380-022-01842-x.Peer-Reviewed Original ResearchConceptsEmergency departmentAmygdala subregionsPTSD diagnosisGeneral hospital emergency departmentLeft amygdala volumeHospital emergency departmentRight hippocampus volumeCA1 hippocampal subregionRecent trauma survivorsTrauma survivorsCivilian trauma survivorsED admissionEligible participantsHippocampus volumeAmygdala volumeHippocampal subregionsVulnerability traitsDisorder pathogenesisClinical InterviewModerate evidenceHippocampus subregionsTrauma exposureStructural MRIRobust evidenceLower initial volumeComparative 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 reductionA comparison of methods to harmonize cortical thickness measurements across scanners and sites
Sun D, Rakesh G, Haswell CC, Logue M, Baird CL, O'Leary EN, Cotton AS, Xie H, Tamburrino M, Chen T, Dennis EL, Jahanshad N, Salminen LE, Thomopoulos SI, Rashid F, Ching CRK, Koch SBJ, Frijling JL, Nawijn L, van Zuiden M, Zhu X, Suarez-Jimenez B, Sierk A, Walter H, Manthey A, Stevens JS, Fani N, van Rooij SJH, Stein M, Bomyea J, Koerte IK, Choi K, van der Werff SJA, Vermeiren RRJM, Herzog J, Lebois LAM, Baker JT, Olson EA, Straube T, Korgaonkar MS, Andrew E, Zhu Y, Li G, Ipser J, Hudson AR, Peverill M, Sambrook K, Gordon E, Baugh L, Forster G, Simons RM, Simons JS, Magnotta V, Maron-Katz A, du Plessis S, Disner SG, Davenport N, Grupe DW, Nitschke JB, deRoon-Cassini TA, Fitzgerald JM, Krystal JH, Levy I, Olff M, Veltman DJ, Wang L, Neria Y, De Bellis MD, Jovanovic T, Daniels JK, Shenton M, van de Wee NJA, Schmahl C, Kaufman ML, Rosso IM, Sponheim SR, Hofmann DB, Bryant RA, Fercho KA, Stein DJ, Mueller SC, Hosseini B, Phan KL, McLaughlin KA, Davidson RJ, Larson CL, May G, Nelson SM, Abdallah CG, Gomaa H, Etkin A, Seedat S, Harpaz-Rotem I, Liberzon I, van Erp TGM, Quidé Y, Wang X, Thompson PM, Morey RA. A comparison of methods to harmonize cortical thickness measurements across scanners and sites. NeuroImage 2022, 261: 119509. PMID: 35917919, PMCID: PMC9648725, DOI: 10.1016/j.neuroimage.2022.119509.Peer-Reviewed Original ResearchRemodeling of the Cortical Structural Connectome in Posttraumatic Stress Disorder: Results From the ENIGMA-PGC Posttraumatic Stress Disorder Consortium
Sun D, Rakesh G, Clarke-Rubright EK, Haswell CC, Logue MW, O'Leary EN, Cotton AS, Xie H, Dennis EL, Jahanshad N, Salminen LE, Thomopoulos SI, Rashid FM, Ching CRK, Koch SBJ, Frijling JL, Nawijn L, van Zuiden M, Zhu X, Suarez-Jimenez B, Sierk A, Walter H, Manthey A, Stevens JS, Fani N, van Rooij SJH, Stein MB, Bomyea J, Koerte I, Choi K, van der Werff SJA, Vermeiren RRJM, Herzog JI, Lebois LAM, Baker JT, Ressler KJ, Olson EA, Straube T, Korgaonkar MS, Andrew E, Zhu Y, Li G, Ipser J, Hudson AR, Peverill M, Sambrook K, Gordon E, Baugh LA, Forster G, Simons RM, Simons JS, Magnotta VA, Maron-Katz A, du Plessis S, Disner SG, Davenport ND, Grupe D, Nitschke JB, deRoon-Cassini TA, Fitzgerald J, Krystal JH, Levy I, Olff M, Veltman DJ, Wang L, Neria Y, De Bellis MD, Jovanovic T, Daniels JK, Shenton ME, van de Wee NJA, Schmahl C, Kaufman ML, Rosso IM, Sponheim SR, Hofmann DB, Bryant RA, Fercho KA, Stein DJ, Mueller SC, Phan KL, McLaughlin KA, Davidson RJ, Larson C, May G, Nelson SM, Abdallah CG, Gomaa H, Etkin A, Seedat S, Harpaz-Rotem I, Liberzon I, Wang X, Thompson PM, Morey RA. Remodeling of the Cortical Structural Connectome in Posttraumatic Stress Disorder: Results From the ENIGMA-PGC Posttraumatic Stress Disorder Consortium. Biological Psychiatry Cognitive Neuroscience And Neuroimaging 2022, 7: 935-948. PMID: 35307575, PMCID: PMC9835553, DOI: 10.1016/j.bpsc.2022.02.008.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderCortical thicknessStructural covarianceComorbid depressionControl subjectsLarge effect sizesStress disorderEffect sizeTrauma-exposed control subjectsCase-control differencesCortical surface areaInflammatory processClinical dataResting-state functional connectivity networksPositive pairwise correlationsCortical differencesCortical regionsCortical neuroanatomyStress hormonesFunctional connectivity networksPTSD casesSmall effect sizesGroup differencesStructural networkStructural connectome
2021
Mindfulness 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 events
2020
Sex Differences in Associations Between Depression and Posttraumatic Stress Disorder Symptoms and Tobacco Use Among Veterans of Recent Conflicts
Gross GM, Bastian LA, Smith NB, Harpaz-Rotem I, Hoff R. Sex Differences in Associations Between Depression and Posttraumatic Stress Disorder Symptoms and Tobacco Use Among Veterans of Recent Conflicts. Journal Of Women's Health 2020, 29: 677-685. PMID: 31934813, DOI: 10.1089/jwh.2019.8082.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderTobacco usePTSD symptomsFemale veteransSex differencesAssociation of depressionTobacco use cessationBaseline interview dataCross-sectional associationsMental health conditionsLogistic regression modelsPosttraumatic stress disorder (PTSD) symptomsBinary logistic regression modelSex-specific barriersTobacco usersSymptomsStress disorderAlcohol useHealth conditionsDepressionDisorder symptomsVeteran sampleMH conditionsIntervention strategiesEffects of demographics
2019
Randomized 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 veteransAdoption by VA Residential Programs of Two Evidence-Based Psychotherapies for PTSD: Effect on Patient Outcomes
Cook JM, Schnurr PP, Simiola V, Thompson R, Hoff R, Harpaz-Rotem I. Adoption by VA Residential Programs of Two Evidence-Based Psychotherapies for PTSD: Effect on Patient Outcomes. Psychiatric Services 2019, 70: 553-560. PMID: 30966944, PMCID: PMC6690369, DOI: 10.1176/appi.ps.201800338.Peer-Reviewed Original ResearchMeSH KeywordsAdultCognitive Behavioral TherapyComorbidityDepressionFemaleHumansImplosive TherapyMaleMiddle AgedOutcome and Process Assessment, Health CarePsychological DistressResidential TreatmentStress Disorders, Post-TraumaticSubstance-Related DisordersUnited StatesUnited States Department of Veterans AffairsVeteransConceptsPosttraumatic stress disorderCognitive processing therapyEvidence-based psychotherapiesVeterans Affairs residential treatment programsAdoption groupsAlcohol useResidential treatment programSample of veteransGroup × time interactionPTSD symptomsStress disorderGroup formatProgram intakeResidential programs× time interactionDepression symptomsTreatment programPsychotherapyBasis of responsesPatient outcomesTime interactionProgram dischargeQualitative interviewsMonths postdischargeVeteransExamining the nonresponse phenomenon: Factors associated with treatment response in a national sample of veterans undergoing residential PTSD treatment
Sripada RK, Blow FC, Rauch SAM, Ganoczy D, Hoff R, Harpaz-Rotem I, Bohnert KM. Examining the nonresponse phenomenon: Factors associated with treatment response in a national sample of veterans undergoing residential PTSD treatment. Journal Of Anxiety Disorders 2019, 63: 18-25. PMID: 30785007, DOI: 10.1016/j.janxdis.2019.02.001.Peer-Reviewed Original ResearchConceptsResidential PTSD treatmentPTSD treatmentPTSD symptom changeTreatment-seeking veteransContextual protective factorsPhysical health resourcesNational sampleLarge national samplePsychological stateIndividual-level factorsLife eventsMultilevel modelingSymptom changeTreatment entryPoor treatment responseProtective factorsWorse treatment responsePersonality disorderPTSDBetter treatment responseTreatment responseCurrent studyGreater pain severityVeteransTheory of resourcesNeural computations of threat in the aftermath of combat trauma
Homan P, Levy I, Feltham E, Gordon C, Hu J, Li J, Pietrzak RH, Southwick S, Krystal JH, Harpaz-Rotem I, Schiller D. Neural computations of threat in the aftermath of combat trauma. Nature Neuroscience 2019, 22: 470-476. PMID: 30664770, PMCID: PMC6829910, DOI: 10.1038/s41593-018-0315-x.Peer-Reviewed Original ResearchConceptsPTSD symptomsPost-traumatic stress disorder symptomsHigher PTSD symptom severityThreat-predictive cuesPTSD symptom severityAssociative threatPredictive cuesNeural trackingDisorder symptomsPrediction errorCombat veteransDynamic learning rateNegative outcomesCombat traumaSmaller amygdala volumesNeural computationLatent markersSymptomatic veteransSymptom severityAmygdala volumeAssociabilityCuesLearning rateVeteransSymptoms
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 itemsLatent typologies of DSM-5 PTSD symptoms in U.S. military veterans
Byrne SP, Harpaz-Rotem I, Tsai J, Southwick SM, Pietrzak RH. Latent typologies of DSM-5 PTSD symptoms in U.S. military veterans. Psychiatry Research 2018, 273: 266-273. PMID: 30658212, DOI: 10.1016/j.psychres.2018.12.094.Peer-Reviewed Original ResearchConceptsHigh symptom classPosttraumatic stress disorderSymptom classUse disordersLifetime historyDSM-5 PTSD symptomsPTSD symptomsLatent class analysisDrug use disordersNicotine use disorderDSM-5 posttraumatic stress disorderDSM-5 criteriaU.S. military veteransMajor depressiveCognitive impairmentU.S. veteransSymptomsPersonalized approachHigher symptomsStress disorderGeneralized anxietyMilitary veteransThree-class solutionDisordersVeteransContrasting contributions of anhedonia to obsessive-compulsive, hoarding, and post-traumatic stress disorders
Pushkarskaya H, Sobowale K, Henick D, Tolin DF, Anticevic A, Pearlson GD, Levy I, Harpaz-Rotem I, Pittenger C. Contrasting contributions of anhedonia to obsessive-compulsive, hoarding, and post-traumatic stress disorders. Journal Of Psychiatric Research 2018, 109: 202-213. PMID: 30572276, PMCID: PMC8549853, DOI: 10.1016/j.jpsychires.2018.11.029.Peer-Reviewed Original ResearchConceptsPost-traumatic stress disorderObsessive-compulsive disorderValue-based choiceGambling TaskStress disorderSelf-reported risk takingBehavior-based measuresRisk perceptionAspects of anhedoniaRole of anhedoniaEffect of anhedoniaRisk-taking propensitySymptoms of depressionTransdiagnostic constructCompulsive disorderBehavioral outcomesGeneral depressionIndex of difficultyAnhedoniaRisk takingUnique contributionIndividual risk aversionPsychotic disordersPerceptionTaskIn Their Own Words: Clinician Experiences and Challenges in Administering Evidence-Based Treatments for PTSD in the Veterans Health Administration
Doran JM, O’Shea M, Harpaz-Rotem I. In Their Own Words: Clinician Experiences and Challenges in Administering Evidence-Based Treatments for PTSD in the Veterans Health Administration. Psychiatric Quarterly 2018, 90: 11-27. PMID: 30209719, DOI: 10.1007/s11126-018-9604-5.Peer-Reviewed Original ResearchConceptsVeterans Affairs Healthcare SystemEvidence-based psychotherapiesClinician experienceVeteran populationVeterans Health AdministrationOutpatient PTSD clinicClinicians' perceptionsPTSD clinicClinical practiceHealth AdministrationTreatment effectivenessHealthcare systemPTSDTreatmentOne-hour focus groupsCliniciansRepresentative quotesPresent studyFocus groupsActive ingredientsChange/improvementClinicPopulationLocus of control in US combat veterans: Unique associations with posttraumatic stress disorder 5-factor model symptom clusters
Smith NB, Sippel LM, Presseau C, Rozek D, Mota N, Gordon C, Horvath M, Harpaz-Rotem I. Locus of control in US combat veterans: Unique associations with posttraumatic stress disorder 5-factor model symptom clusters. Psychiatry Research 2018, 268: 152-156. PMID: 30029062, DOI: 10.1016/j.psychres.2018.07.015.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderLocus of controlPTSD symptom clustersOverall PTSD symptomsAvoidance symptomsPTSD symptomsSymptom clustersStress disorderCombat veteransExternal locusCombat exposureCorrelates of PTSDSpecific PTSD symptom clustersTrauma-focused treatmentSelf-report measuresUS combat veteransIntervention effortsUnique associationUS military veteransExtreme scoresPotential correlatesMilitary veteransBivariate correlationsOnly avoidanceSignificant correlatesThe Unique Roles of Emotional Numbing and Arousal Symptoms in Relation to Social Connectedness Among Military Veterans in Residential Treatment for PTSD
Sippel LM, Watkins LE, Pietrzak RH, Hoff R, Harpaz-Rotem I. The Unique Roles of Emotional Numbing and Arousal Symptoms in Relation to Social Connectedness Among Military Veterans in Residential Treatment for PTSD. Psychiatry 2018, 81: 271-282. PMID: 30015602, DOI: 10.1080/00332747.2017.1395313.Peer-Reviewed Original ResearchConceptsPTSD symptom clustersDysphoric arousal symptomsPoor social connectednessArousal symptomsEmotional numbingSocial connectednessResidential treatmentPosttraumatic stress disorder (PTSD) symptomsSymptom clustersEmotional numbing symptomsMilitary veteransAnxious arousal symptomsFive-factor modelU.S. military veteransAnxious arousalDysphoric arousalNumbing symptomsInterpersonal functioningTrauma recoveryDisorder symptomsCase conceptualizationGreater distressMore distressPTSDSupportive peopleClinically Significant Change in Posttraumatic Stress Disorder Symptoms Is Associated With Lower Levels of Aggression After Residential Treatment Discharge
Watkins LE, Sippel LM, Pietrzak RH, Hoff R, Harpaz‐Rotem I. Clinically Significant Change in Posttraumatic Stress Disorder Symptoms Is Associated With Lower Levels of Aggression After Residential Treatment Discharge. Journal Of Traumatic Stress 2018, 31: 265-272. PMID: 29603388, DOI: 10.1002/jts.22275.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderPTSD symptomsPTSD changeResidential treatmentPosttraumatic stress disorder (PTSD) symptomsLess aggressionPTSD symptom changePTSD symptom reductionCurrent studyDisorder symptomsStress disorderContextual effectsSymptom reductionSymptom changeAggressionMultilevel modelsPrevious researchTreatment dischargeLow levelsVeterans Health Administration sitesVeteransSignificant changesTreatment sitesFindingsSymptoms