2024
Unraveling 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 veteransWhat 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
Clinical 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 modelsAmygdala 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 ResearchConceptsPost-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 markersComparative 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 dataUnderlying Hippocampal Mechanism of Posttraumatic Stress Disorder Treatment Outcome: Evidence From Two Clinical Trials
Zilcha-Mano S, Duek O, Suarez-Jimenez B, Zhu X, Lazarov A, Helpman L, Korem N, Malka M, Harpaz-Rotem I, Neria Y. Underlying Hippocampal Mechanism of Posttraumatic Stress Disorder Treatment Outcome: Evidence From Two Clinical Trials. Biological Psychiatry Global Open Science 2023, 3: 867-874. PMID: 37881552, PMCID: PMC10593870, DOI: 10.1016/j.bpsgos.2023.01.005.Peer-Reviewed Original ResearchPosttraumatic stress disorderRight hippocampal volumeHippocampal volumeSymptom reductionPosttreatment magnetic resonance imagingPosttraumatic stress disorder treatment outcomeLarger hippocampal volumesDisorder treatment outcomesPTSD symptom reductionMagnetic resonance imagingGreater PTSD symptom reductionBetter prognosisClinical trialsTreatment outcomesDepressive symptomsTherapeutic outcomesPTSD treatmentResonance imagingTreatment studiesClinical targetsStress disorderPTSD symptomsSmall sample sizeHippocampal mechanismsTreatment
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 trajectories
2021
Binge drinking following residential treatment for posttraumatic stress disorder among veterans with and without alcohol use disorder
Meshberg-Cohen S, Gross GM, Kachadourian LK, Harpaz-Rotem I. Binge drinking following residential treatment for posttraumatic stress disorder among veterans with and without alcohol use disorder. Journal Of Psychiatric Research 2021, 143: 202-208. PMID: 34500350, DOI: 10.1016/j.jpsychires.2021.09.024.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderMilitary sexual traumaAlcohol use disorderPTSD symptom improvementResidential treatmentBinge drinkingStress disorderPTSD symptom changeResidential PTSD treatmentPTSD symptom decreaseUse disordersBinge drinking daysAlcohol-related variablesPTSD treatmentTrauma typesSexual traumaProblematic drinkingCombat exposureDrinking outcomesSymptom changeGreater likelihoodSymptom improvementBingeSymptom decreaseAlcohol useRacial Disparities in Clinical Outcomes of Veterans Affairs Residential PTSD Treatment Between Black and White Veterans
Gross GM, Smith N, Holliday R, Rozek DC, Hoff R, Harpaz-Rotem I. Racial Disparities in Clinical Outcomes of Veterans Affairs Residential PTSD Treatment Between Black and White Veterans. Psychiatric Services 2021, 73: 126-132. PMID: 34369806, DOI: 10.1176/appi.ps.202000783.Peer-Reviewed Original ResearchConceptsResidential Rehabilitation Treatment ProgramPosttraumatic stress disorderWhite veteransRacial disparitiesClinical outcomesBlack veteransSymptoms of PTSDPoor clinical outcomeRehabilitation treatment programRecurrence 4 monthsPoor treatment outcomesMental health treatmentPublic health issuePTSD symptom reductionResidential PTSD treatmentMental health researchTreatment outcomesPrevalence ratesSymptom reductionHealth treatmentHealth outcomesPTSD treatmentDemographic dataSymptom changeTreatment programA preliminary investigation of VA PTSD residential treatment for veterans admitted from unstable housing or incarceration
Holliday R, Gross G, Desai A, Smith N, Harpaz-Rotem I. A preliminary investigation of VA PTSD residential treatment for veterans admitted from unstable housing or incarceration. Journal Of Social Distress And The Homeless 2021, 31: 238-243. DOI: 10.1080/10530789.2021.1926750.Peer-Reviewed Original ResearchResidential Rehabilitation Treatment ProgramDepressive symptomsUnstable housingPTSD symptomsJustice-involved veteransPost-discharge careRehabilitation treatment programPrison/jailSymptom recurrenceJail/prisonPTSD treatmentSymptomsTreatment programFour monthsVeteransResidential treatmentAdmissionRecurrenceExperienced reductionsSignificant changesTreatmentUnderstanding of factors
2020
Courses of suicidal ideation among military veterans in residential treatment for posttraumatic stress disorder
Smith NB, Sippel LM, Rozek DC, Spangler PT, Traber D, Straud CL, Hoff R, Harpaz‐Rotem I. Courses of suicidal ideation among military veterans in residential treatment for posttraumatic stress disorder. Depression And Anxiety 2020, 37: 273-284. PMID: 31951318, PMCID: PMC7054126, DOI: 10.1002/da.22993.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderBaseline posttraumatic stress disorderPTSD treatmentResidential PTSD treatmentPhysical functioningSuicidal thoughtsStress disorderPTSD symptomsSubstance useVeterans Affairs medical facilitiesWorse physical functioningLength of stayPTSD symptom improvementTrauma-focused psychotherapySpecific treatment interventionsPTSD symptom changeSeverity of suicidalSI onsetRace/ethnicitySymptom improvementPTSD improvementBaseline depressionMultinomial logistic regressionTreatment interventionsSuicidal ideation
2019
Comparing the effectiveness of VA residential PTSD treatment for veterans who do and do not report a history of MST: A national investigation
Holliday R, Smith NB, Holder N, Gross GM, Monteith LL, Maguen S, Hoff RA, Harpaz-Rotem I. Comparing the effectiveness of VA residential PTSD treatment for veterans who do and do not report a history of MST: A national investigation. Journal Of Psychiatric Research 2019, 122: 42-47. PMID: 31923834, DOI: 10.1016/j.jpsychires.2019.12.012.Peer-Reviewed Original ResearchConceptsResidential Rehabilitation Treatment ProgramMilitary sexual traumaPosttraumatic stress disorderPTSD symptomsMST survivorsPTSD treatmentVeterans AffairsProgram completionRehabilitation treatment programSymptom severity scoresEffects of MSTExperience of MSTHistory of MSTPTSD symptom severity scoresPost-treatment gainsRace/ethnicityImpact of MSTSevere PTSD symptomsResidential PTSD treatmentAdjunctive servicesPsychiatric comorbiditySeverity scoreHealth sequelaeIncrease riskWomen veteransHeterogeneity 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 treatmentPredictors of Dropout From Residential Treatment for Posttraumatic Stress Disorder Among Military Veterans
Smith NB, Sippel LM, Rozek DC, Hoff RA, Harpaz-Rotem I. Predictors of Dropout From Residential Treatment for Posttraumatic Stress Disorder Among Military Veterans. Frontiers In Psychology 2019, 10: 362. PMID: 30873081, PMCID: PMC6401625, DOI: 10.3389/fpsyg.2019.00362.Peer-Reviewed Original ResearchPosttraumatic stress disorderTreatment dropoutResidential treatmentStress disorderSymptomatic patient populationResidential PTSD programsType of treatmentTrauma-focused psychotherapyVeterans Affairs programsTrauma-focused therapyResidential programsResidential PTSD treatmentPredictors of dropoutPatient populationSuccessful treatmentPhysical functioningSymptomatic individualsPsychiatric symptomsHigh riskPTSD treatmentReduced likelihoodFiscal year 2015PTSD programGreater PTSD symptomsGreater symptomsExamining 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 resources
2011
Serving Those Who Served: Retention of Newly Returning Veterans From Iraq and Afghanistan in Mental Health Treatment
Harpaz-Rotem I, Rosenheck RA. Serving Those Who Served: Retention of Newly Returning Veterans From Iraq and Afghanistan in Mental Health Treatment. Psychiatric Services 2011, 62: 22-27. PMID: 21209295, DOI: 10.1176/ps.62.1.pss6201_0022.Peer-Reviewed Original ResearchMeSH KeywordsAfghan Campaign 2001-Case-Control StudiesComorbidityFemaleHealth Services AccessibilityHumansIraq War, 2003-2011MaleMental DisordersMental Health ServicesMiddle AgedMultivariate AnalysisPatient Acceptance of Health CarePatient DropoutsProportional Hazards ModelsStress Disorders, Post-TraumaticSurvival AnalysisUnited StatesVeteransConceptsMental health visitsMental health treatmentPosttraumatic stress disorderVietnam-era veteransHealth visitsHealth treatmentPTSD treatmentMental health statusMental health servicesComorbid conditionsInitial diagnosisNumber of visitsNew diagnosisPsychiatric treatmentComorbid diagnosesHealth statusPoisson regressionSurvival analysisFunction of ageHealth servicesMultivariate analysisMore visitsVeterans AffairsStress disorder