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 researchFirearm 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 veterans
2022
Perceived 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 sample
2021
Mental Health Care Use Among U.S. Military Veterans: Results From the 2019–2020 National Health and Resilience in Veterans Study
Kline AC, Panza KE, Nichter B, Tsai J, Harpaz-Rotem I, Norman SB, Pietrzak RH. Mental Health Care Use Among U.S. Military Veterans: Results From the 2019–2020 National Health and Resilience in Veterans Study. Psychiatric Services 2021, 73: 628-635. PMID: 34775790, DOI: 10.1176/appi.ps.202100112.Peer-Reviewed Original ResearchConceptsMental health careMental health care utilizationHealth care utilizationSubstance use disordersCare utilizationU.S. military veteransMental dysfunctionNational HealthUse disordersHealth careVeterans StudyMental health care usePrimary health care providersHealth care useMilitary veteransHealth care providersUse of careHierarchical logistic regressionCare usePosttraumatic stress disorder (PTSD) symptom severitySleep disordersCare providersDisorder symptom severityU.S. veteransNeed factorsThe hidden burden of social anxiety disorder in U.S. military veterans: Results from the National Health and Resilience in Veterans Study
Byrne SP, Fogle BM, Asch R, Esterlis I, Harpaz-Rotem I, Tsai J, Pietrzak RH. The hidden burden of social anxiety disorder in U.S. military veterans: Results from the National Health and Resilience in Veterans Study. Journal Of Affective Disorders 2021, 291: 9-14. PMID: 34022553, DOI: 10.1016/j.jad.2021.04.088.Peer-Reviewed Original ResearchConceptsU.S. military veteransPsychiatric comorbidityPsychiatric disordersSuicidal ideationU.S. veteransAnxiety disordersComorbid psychiatric disordersMilitary veteransLifetime major depressionImportance of screeningPrevalent mental disordersSocial anxiety disorderMental health functioningCurrent suicidal ideationMeasures of functioningPosttraumatic stress disorderLifetime social anxiety disorderIncremental burdenMultivariable analysisPsychiatric morbidityNational HealthRepresentative sampleMajor depressionFunctional impairmentPsychiatric historyLongitudinal courses of suicidal ideation in U.S. military veterans: a 7-year population-based, prospective cohort study
Herzog S, Tsai J, Nichter B, Kachadourian L, Harpaz-Rotem I, Pietrzak RH. Longitudinal courses of suicidal ideation in U.S. military veterans: a 7-year population-based, prospective cohort study. Psychological Medicine 2021, 52: 3570-3579. PMID: 33602367, DOI: 10.1017/s0033291721000301.Peer-Reviewed Original ResearchNew-onset suicidal ideationChronic suicidal ideationPhysical health difficultiesPrior suicide attemptsSuicidal ideationSuicide attemptsProtective factorsSI groupLongitudinal courseHealth difficultiesProspective suicide attemptsProspective cohort studyRecent stressorsHigh ratePosttraumatic stress disorderMental health supportSuicide prevention effortsU.S. military veteransCohort studyNew onsetBaseline riskHigh riskU.S. veteransMost veteransPhysical distressMindfulness 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 eventsCannabinoid Receptor 1 rs1049353 Variant, Childhood Abuse, and the Heterogeneity of PTSD Symptoms: Results From the National Health and Resilience in Veterans Study
Korem N, Duek O, Xu K, Harpaz-Rotem I, Pietrzak RH. Cannabinoid Receptor 1 rs1049353 Variant, Childhood Abuse, and the Heterogeneity of PTSD Symptoms: Results From the National Health and Resilience in Veterans Study. Chronic Stress 2021, 5: 24705470211011075. PMID: 33997583, PMCID: PMC8107935, DOI: 10.1177/24705470211011075.Peer-Reviewed Original ResearchPosttraumatic stress disorderOverall PTSD symptomsAnxious arousal symptomsPTSD symptomsNational HealthChildhood abuseVeterans StudySymptom clustersArousal symptomsAllele carrier statusArousal symptom clustersMultivariable analysisEndocannabinoid systemAllele carriersPTSD symptom clustersGene-environment studiesGreater severityG homozygotesU.S. veteransSymptomsStress disorderCarrier statusReceptor geneDisordersSignificant main effect
2020
The National Health and Resilience in Veterans Study: A Narrative Review and Future Directions
Fogle BM, Tsai J, Mota N, Harpaz-Rotem I, Krystal JH, Southwick SM, Pietrzak RH. The National Health and Resilience in Veterans Study: A Narrative Review and Future Directions. Frontiers In Psychiatry 2020, 11: 538218. PMID: 33362593, PMCID: PMC7755975, DOI: 10.3389/fpsyt.2020.538218.Peer-Reviewed Original ResearchNational HealthVeterans StudyMental disordersNarrative reviewVeterans Affairs Healthcare SystemPopulation-based dataUnique health needsUnited States veteransPost-traumatic stress disorderNon-veteran counterpartsPost-traumatic growthProtective psychosocial characteristicsProspective studyStates veteransIndependent cohortHealth outcomesHealth needsU.S. veteransCare deliveryClinical implicationsLongitudinal changesPsychosocial characteristicsProtective factorsStress disorderTreatment effortsEarly discontinuation of pharmacotherapy in U.S. veterans diagnosed with PTSD and the role of psychotherapy
Duek O, Pietrzak RH, Petrakis I, Hoff R, Harpaz-Rotem I. Early discontinuation of pharmacotherapy in U.S. veterans diagnosed with PTSD and the role of psychotherapy. Journal Of Psychiatric Research 2020, 132: 167-173. PMID: 33126010, DOI: 10.1016/j.jpsychires.2020.10.005.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderRisk factorsEarly discontinuationMedication discontinuationPsychotropic medicationsPoor medication adherenceSimilar risk factorsStrong risk factorDeterminants of discontinuationKey risk factorsRole of psychotherapySingle medicationMedication adherenceMedication treatmentPsychiatric comorbidityAntipsychotic medicationPatient educationDiscontinuationOlder veteransMedicationsAdjunctive psychotherapyYounger veteransEarly interventionU.S. veteransVA treatmentDissociative symptoms predict risk for the development of PTSD: Results from the National Health and Resilience in Veterans Study (NHRVS)
Herzog S, Fogle BM, Harpaz-Rotem I, Tsai J, DePierro J, Pietrzak RH. Dissociative symptoms predict risk for the development of PTSD: Results from the National Health and Resilience in Veterans Study (NHRVS). Journal Of Psychiatric Research 2020, 131: 215-219. PMID: 32998083, DOI: 10.1016/j.jpsychires.2020.09.018.Peer-Reviewed Original ResearchConceptsDevelopment of PTSDPosttraumatic stress disorderU.S. military veteransDissociative symptomsRisk factorsDerealization symptomsIncident posttraumatic stress disorderTrauma exposureImmutable risk factorsProspective cohort studyPopulation-based risk factorsMilitary veteransPrediction of PTSDPotential clinical utilityTrauma-related factorsTrauma-exposed veteransCohort studyNational HealthRelative riskClinical utilityU.S. veteransVeterans StudySymptomsTrauma characteristicsStress disorderDissociative Symptoms in a Nationally Representative Sample of Trauma-Exposed U.S. Military Veterans: Prevalence, Comorbidities, and Suicidality
Herzog S, Fogle BM, Harpaz-Rotem I, Tsai J, Pietrzak RH. Dissociative Symptoms in a Nationally Representative Sample of Trauma-Exposed U.S. Military Veterans: Prevalence, Comorbidities, and Suicidality. Journal Of Affective Disorders 2020, 272: 138-145. PMID: 32379605, DOI: 10.1016/j.jad.2020.03.177.Peer-Reviewed Original ResearchConceptsQuality of lifeU.S. veteransDissociative symptomsPsychiatric comorbidityGreater likelihoodPoor mental health outcomesCurrent suicidal ideationNon-veteran populationsMental health outcomesPTSD diagnostic statusDirectionality of findingsLevel of functioningU.S. military veteransNationally Representative SampleClinical correlatesTrauma-exposed populationsRepresentative sampleRisk factorsSevere dissociative symptomsLifetime suicide attempt historySuicide attempt historyPsychiatric characteristicsComorbiditiesHealth outcomesSuicidal ideation
2019
Posttraumatic stress symptom courses in U.S. military veterans: A seven-year, nationally representative, prospective cohort study
Mota NP, Cook JM, Smith NB, Tsai J, Harpaz-Rotem I, Krystal JH, Southwick SM, Pietrzak RH. Posttraumatic stress symptom courses in U.S. military veterans: A seven-year, nationally representative, prospective cohort study. Journal Of Psychiatric Research 2019, 119: 23-31. PMID: 31546045, DOI: 10.1016/j.jpsychires.2019.09.005.Peer-Reviewed Original ResearchConceptsPTSD symptom courseSymptom courseU.S. military veteransLatent growth mixture modelingProspective cohort studyMilitary veteransLifetime psychiatric historyMental health treatmentPhysical health difficultiesLifetime traumatic eventsTrauma-exposed veteransProtective psychosocial characteristicsCohort studyProspective cohortModerate symptomsModifiable correlatesNational HealthSymptomatic coursePsychiatric historyHealth treatmentU.S. veteransVeterans StudyPsychosocial characteristicsHigher symptomsHealth difficulties
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 solutionDisordersVeterans
2017
One-Year Incidence and Predictors of Homelessness Among 300,000 U.S. Veterans Seen in Specialty Mental Health Care
Tsai J, Hoff RA, Harpaz-Rotem I. One-Year Incidence and Predictors of Homelessness Among 300,000 U.S. Veterans Seen in Specialty Mental Health Care. Psychological Services 2017, 14: 203-207. PMID: 28481605, DOI: 10.1037/ser0000083.Peer-Reviewed Original ResearchConceptsSpecialty mental health clinicsMental health clinicsHealth clinicsRetrospective cohort study designVeterans AffairsSpecialty mental health careCohort study designVA medical recordsDrug use disordersMental health careVA homeless servicesClinical predictorsProspective studyMedical recordsDisorders ClinicInternational ClassificationUse disordersVA facilitiesU.S. veteransEarly signsStudy designVA effortsClinicHealth careIncidenceCortical thickness reduction in combat exposed U.S. veterans with and without PTSD
Wrocklage KM, Averill LA, Scott J, Averill CL, Schweinsburg B, Trejo M, Roy A, Weisser V, Kelly C, Martini B, Harpaz-Rotem I, Southwick SM, Krystal JH, Abdallah CG. Cortical thickness reduction in combat exposed U.S. veterans with and without PTSD. European Neuropsychopharmacology 2017, 27: 515-525. PMID: 28279623, PMCID: PMC5429865, DOI: 10.1016/j.euroneuro.2017.02.010.Peer-Reviewed Original ResearchConceptsClinician-Administered PTSD ScalePTSD symptom dimensionsPTSD diagnosisCombat exposureCortical thicknessSymptom dimensionsMagnetic resonance imagingPosttraumatic stress disorder (PTSD) symptomsU.S. veteransCortical thinningUnique brain regionsLeft lateral prefrontalAnxious arousalPTSD dimensionsNeural correlatesHigh-resolution magnetic resonance imagingCortical thickness reductionsLateral prefrontalPTSD symptomsDisorder symptomsCombat severityCurrent PTSDPTSD ScalePrefrontal cortexPotential confounds
2016
Co-occurring aggression and suicide attempt among veterans entering residential treatment for PTSD: The role of PTSD symptom clusters and alcohol misuse
Watkins LE, Sippel LM, Pietrzak RH, Hoff R, Harpaz-Rotem I. Co-occurring aggression and suicide attempt among veterans entering residential treatment for PTSD: The role of PTSD symptom clusters and alcohol misuse. Journal Of Psychiatric Research 2016, 87: 8-14. PMID: 27984702, DOI: 10.1016/j.jpsychires.2016.12.009.Peer-Reviewed Original ResearchConceptsSuicide attemptsAlcohol misuseU.S. veteransSymptom clustersPTSD symptom clustersVeterans Health Administration sitesSerious public health concernPTSD re-experiencing symptomsResidential treatmentDysphoric arousal symptomsPublic health concernCo-occurring aggressionLogistic regression modelsMultinomial logistic regression modelsPosttraumatic stress disorder (PTSD) symptom clustersRisk factorsRe-experiencing symptomsCorrelates of aggressionAdministration siteHealth concernMisuse symptomsSymptomsArousal symptomsTreatment planningVeteransHostility and telomere shortening among U.S. military veterans: Results from the National Health and Resilience in Veterans Study
Watkins LE, Harpaz-Rotem I, Sippel LM, Krystal JH, Southwick SM, Pietrzak RH. Hostility and telomere shortening among U.S. military veterans: Results from the National Health and Resilience in Veterans Study. Psychoneuroendocrinology 2016, 74: 251-257. PMID: 27689898, DOI: 10.1016/j.psyneuen.2016.09.006.Peer-Reviewed Original ResearchConceptsU.S. military veteransClinical variablesNational HealthTelomere lengthMilitary veteransMultivariable binary logistic regression analysisVeterans StudyAccelerated cellular agingBinary logistic regression analysisLogistic regression analysisU.S. veteran populationNon-veteran populationsAge-related disordersPolymerase chain reaction methodChronic disordersRisk factorsChain reaction methodQuantitative polymerase chain reaction methodVeteran populationU.S. veteransSecondary analysisTreatment effortsVeteransRegression analysisBiological age