2023
Understanding 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 sample
2021
Racial 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 ResearchMeSH KeywordsHumansPsychotherapyRacial GroupsResidential TreatmentStress Disorders, Post-TraumaticUnited StatesUnited States Department of Veterans AffairsVeteransConceptsResidential 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 programIn Their Own Words: Veteran Experiences with Evidence-Based Treatments for PTSD in the Veterans Health Administration
Doran JM, O’Shea M, Harpaz-Rotem I. In Their Own Words: Veteran Experiences with Evidence-Based Treatments for PTSD in the Veterans Health Administration. Psychiatric Quarterly 2021, 92: 961-980. PMID: 33409926, DOI: 10.1007/s11126-020-09861-z.Peer-Reviewed Original ResearchMeSH KeywordsEvidence-Based PracticeHumansImplosive TherapyStress Disorders, Post-TraumaticUnited StatesUnited States Department of Veterans AffairsVeteransVeterans HealthConceptsVeterans Affairs Healthcare SystemEvidence-based psychotherapiesVeterans Health AdministrationEvidence-based treatmentsOutpatient PTSD clinicVeterans' experiencesTreatment completionTreatment outcomesPTSD clinicTreatment protocolHealth AdministrationHealthcare systemTreatmentPTSDOutcomesVeteransVeterans' perceptionsMultiple barriersTreatment dropAssessment toolPresent study
2020
Early 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 ResearchMeSH KeywordsHumansPsychotherapyPsychotropic DrugsStress Disorders, Post-TraumaticUnited StatesUnited States Department of Veterans AffairsVeteransConceptsPosttraumatic 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 treatment
2019
Adoption 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 postdischargeVeterans
2018
In 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 ResearchMeSH KeywordsAdultAttitude of Health PersonnelCognitive Behavioral TherapyEvidence-Based PracticeFemaleHumansImplementation ScienceImplosive TherapyMaleMiddle AgedStress Disorders, Post-TraumaticUnited StatesUnited States Department of Veterans AffairsVeteransConceptsVeterans Affairs Healthcare SystemEvidence-based psychotherapiesClinician experienceVeteran populationVeterans Health AdministrationOutpatient PTSD clinicClinicians' perceptionsPTSD clinicClinical practiceHealth AdministrationTreatment effectivenessHealthcare systemPTSDTreatmentOne-hour focus groupsCliniciansRepresentative quotesPresent studyFocus groupsActive ingredientsChange/improvementClinicPopulation
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 ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overFemaleHousingHumansIll-Housed PersonsIncidenceMaleMental DisordersMental Health ServicesMiddle AgedRetrospective StudiesSubstance-Related DisordersUnited StatesUnited States Department of Veterans AffairsVeteransYoung AdultConceptsSpecialty 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 careIncidencePsychotherapy Utilization and Retention in a National Sample of Veterans With PTSD
Doran JM, Pietrzak RH, Hoff R, Harpaz‐Rotem I. Psychotherapy Utilization and Retention in a National Sample of Veterans With PTSD. Journal Of Clinical Psychology 2017, 73: 1259-1279. PMID: 28186638, DOI: 10.1002/jclp.22445.Peer-Reviewed Original ResearchAdultAgedFemaleHumansMaleMiddle AgedPatient Acceptance of Health CarePsychotherapyStress Disorders, Post-TraumaticUnited StatesUnited States Department of Veterans AffairsVeteransYoung Adult
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 ResearchMeSH KeywordsAdultAggressionAlcoholismFemaleHumansMaleMiddle AgedPsychiatric Status Rating ScalesRegression AnalysisResidential TreatmentStress Disorders, Post-TraumaticSuicide, AttemptedUnited StatesUnited States Department of Veterans AffairsVeteransConceptsSuicide 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 planningVeteransAccuracy of screening for posttraumatic stress disorder in specialty mental health clinics in the U.S. Veterans Affairs Healthcare System
Tsai J, Pietrzak RH, Hoff RA, Harpaz-Rotem I. Accuracy of screening for posttraumatic stress disorder in specialty mental health clinics in the U.S. Veterans Affairs Healthcare System. Psychiatry Research 2016, 240: 157-162. PMID: 27107669, DOI: 10.1016/j.psychres.2016.04.036.Peer-Reviewed Original ResearchConceptsOEF/OIF/OND veteransPTSD diagnosisU.S. Veterans Affairs healthcare systemSpecialty mental health clinicsVeterans Affairs Healthcare SystemElectronic medical record dataOptimal screening criteriaMedical record dataStructured Clinical InterviewMental health clinicsPositive PTSD screenCharacteristic curve analysisPosttraumatic stress disorderUseful screening toolPCL-M scoresVersion criteriaPTSD screenSpecialty clinicHealth clinicsMale veteransClinical InterviewFemale veteransVeteran subgroupsYouden indexProbable PTSD
2015
“I’m Coming Home, Tell the World I’m Coming Home”. The Long Homecoming and Mental Health Treatment of Iraq and Afghanistan War Veterans
Rozanova J, Noulas P, Smart K, Roy A, Southwick SM, Davidson L, Harpaz-Rotem I. “I’m Coming Home, Tell the World I’m Coming Home”. The Long Homecoming and Mental Health Treatment of Iraq and Afghanistan War Veterans. Psychiatric Quarterly 2015, 87: 427-443. PMID: 26566926, DOI: 10.1007/s11126-015-9398-7.Peer-Reviewed Original ResearchAdultAfghan Campaign 2001-Career ChoiceFemaleHumansIraq War, 2003-2011MaleMental DisordersMental Health ServicesMiddle AgedMilitary PersonnelPatient Acceptance of Health CareQualitative ResearchSocial IdentificationSocial StigmaUnited StatesUnited States Department of Veterans AffairsVeteransVocational GuidanceYoung AdultMental Health Treatment for Older Veterans Newly Diagnosed with PTSD: A National Investigation
Smith NB, Cook JM, Pietrzak R, Hoff R, Harpaz-Rotem I. Mental Health Treatment for Older Veterans Newly Diagnosed with PTSD: A National Investigation. American Journal Of Geriatric Psychiatry 2015, 24: 201-212. PMID: 25772341, DOI: 10.1016/j.jagp.2015.02.001.Peer-Reviewed Original ResearchConceptsMental health treatmentPosttraumatic stress disorderOlder veteransVA healthcare systemHealth treatmentClinical characteristicsDecreased oddsNational administrative data setVeterans AffairsMental health service utilizationAppropriate mental health treatmentOdds of treatmentMental health visitsHealth service utilizationHealthcare systemPharmacy recordsHealth visitsCox regressionPsychiatric comorbidityPsychotherapy visitsService utilizationLarge cohortMedical appointmentsAdministrative data setsNew diagnosis
2014
Determinants of Prospective Engagement in Mental Health Treatment Among Symptomatic Iraq/Afghanistan Veterans
Harpaz-Rotem I, Rosenheck RA, Pietrzak RH, Southwick SM. Determinants of Prospective Engagement in Mental Health Treatment Among Symptomatic Iraq/Afghanistan Veterans. The Journal Of Nervous And Mental Disease 2014, 202: 97-104. PMID: 24469520, DOI: 10.1097/nmd.0000000000000078.Peer-Reviewed Original ResearchMeSH KeywordsAdultAfghan Campaign 2001-DepressionFemaleHospitals, VeteransHumansIraq War, 2003-2011MaleMental Health ServicesSeverity of Illness IndexStress Disorders, Post-TraumaticUnited StatesUnited States Department of Veterans AffairsVeteransVeterans HealthYoung AdultConceptsMental health treatmentPosttraumatic stress disorderIraq/Afghanistan veteransHealth treatmentAfghanistan veteransSymptomatic veteransMental health visitsMental health screeningMental health statusMental health servicesHealth visitsHealth screeningService utilizationRe-experiencing symptomsDepressive symptomsHealth statusHealth servicesPsychosocial determinantsStress disorderSymptomsVeteransTreatmentConsistent determinantsNumbing symptomsProspective engagement
2013
Military Sexual Assault and Homeless Women Veterans: Clinical Correlates and Treatment Preferences
Decker SE, Rosenheck RA, Tsai J, Hoff R, Harpaz-Rotem I. Military Sexual Assault and Homeless Women Veterans: Clinical Correlates and Treatment Preferences. Women's Health Issues 2013, 23: e373-e380. PMID: 24183412, DOI: 10.1016/j.whi.2013.09.002.Peer-Reviewed Original ResearchMeSH KeywordsAdultCrime VictimsFemaleHumansIll-Housed PersonsMental HealthMiddle AgedMilitary PersonnelMultivariate AnalysisPatient Acceptance of Health CarePatient PreferencePrevalenceRetrospective StudiesRisk FactorsSelf ReportSex OffensesSocioeconomic FactorsStress Disorders, Post-TraumaticSurveys and QuestionnairesUnited StatesUnited States Department of Veterans AffairsVeteransConceptsMilitary sexual assaultHomeless female veteransFemale veteransSexual assaultGreater mental health symptomsMental health symptomsSerious psychological sequelaePsychological distressPsychological sequelaeHomeless women veteransHealth symptomsThird of participantsTreatment preferencesPsychiatric symptomsCurrent homelessnessVeteransWomen veteransAssaultGreater severityClinical correlatesPTSDClinical symptomsHomeless womenObservational studyHigh risk
2011
Residential treatment for homeless female veterans with psychiatric and substance use disorders: Effect on 1-year clinical outcomes
Harpaz-Rotem I, Rosenheck RA, Desai R. Residential treatment for homeless female veterans with psychiatric and substance use disorders: Effect on 1-year clinical outcomes. The Journal Of Rehabilitation Research And Development 2011, 48: 891. PMID: 22068368, DOI: 10.1682/jrrd.2010.10.0195.Peer-Reviewed Original ResearchMeSH KeywordsAdultDiagnosis, Dual (Psychiatry)EmploymentFemaleFollow-Up StudiesHousingHumansIll-Housed PersonsLength of StayMental DisordersMiddle AgedRecurrenceResidential TreatmentSocial SupportSubstance-Related DisordersTime FactorsTreatment OutcomeUnited StatesUnited States Department of Veterans AffairsVeteransConceptsClinical outcomesResidential treatmentHomeless female veteransPsychiatric symptomsFemale veteransSerious mental illnessSubstance use disordersUse of drugsGroup of veteransMental health outcomesNRT groupRT groupPsychiatric problemsUse disordersBetter outcomesHealth outcomesMental illnessHomeless womenVeterans AffairsAlcohol useBeneficial effectsLimited evidenceSubstance useOutcomesProgram entry
2009
Duration of Pharmacotherapy with Long-Acting Injectable Risperidone in the Treatment of Schizophrenia
Mohamed S, Rosenheck R, Harpaz-Rotem I, Leslie D, Sernyak MJ. Duration of Pharmacotherapy with Long-Acting Injectable Risperidone in the Treatment of Schizophrenia. Psychiatric Quarterly 2009, 80: 241-249. PMID: 19768543, DOI: 10.1007/s11126-009-9111-9.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAntipsychotic AgentsDrug Administration RoutesDrug Delivery SystemsFemaleHumansLogistic ModelsMaleMiddle AgedRisperidoneSchizophreniaTime FactorsUnited StatesUnited States Department of Veterans AffairsConceptsSecond-generation antipsychoticsInjectable risperidoneLong-Acting Injectable RisperidoneDuration of pharmacotherapyOral conventional antipsychoticsHalf of patientsMultivariable logistic regressionTreatment of schizophreniaDuration of treatmentProportional hazards modelOral antipsychoticsTreatment discontinuationOral medicationsReal-world practiceConventional antipsychoticsPatient characteristicsMedication adherenceAntipsychotic medicationVA patientsHazards modelAntipsychoticsMedicationsPatientsLogistic regressionRisperidoneTracing the Flow of Knowledge: Geographic Variability in the Diffusion of Prazosin Use for the Treatment of Posttraumatic Stress Disorder Nationally in the Department of Veterans Affairs
Harpaz-Rotem I, Rosenheck RA. Tracing the Flow of Knowledge: Geographic Variability in the Diffusion of Prazosin Use for the Treatment of Posttraumatic Stress Disorder Nationally in the Department of Veterans Affairs. JAMA Psychiatry 2009, 66: 417-421. PMID: 19349311, DOI: 10.1001/archgenpsychiatry.2008.536.Peer-Reviewed Original ResearchMeSH KeywordsAdrenergic alpha-AntagonistsCombat DisordersDiffusion of InnovationDrug Information ServicesEvidence-Based MedicineHealth Services AccessibilityHumansPrazosinStress Disorders, Post-TraumaticTreatment OutcomeUnited StatesUnited States Department of Veterans AffairsVeteransConceptsPosttraumatic stress disorderHealth care systemVeterans AffairsStress disorderSound Health Care SystemCare systemUse of prazosinPercentage of patientsTreatment of patientsTreatment of nightmaresPrazosin usePatient characteristicsNational health care systemMedical CenterMAIN OUTCOMEPrazosinPassive disseminationPatientsClinical practiceNew treatmentsPassive diffusionPrazosin hydrochlorideFiscal year 2004TreatmentPreliminary evidence