Refugee-related trauma patterns and mental health symptoms across three generations of Hmong Americans.

Hmong adults who are Vietnam War refugees have been exposed to refugee-related trauma, but little is known about associations between patterns of trauma exposure and mental health outcomes in Hmong adults. We examined patterns of trauma exposure and mental health symptoms (i.e.

The My Life, My Story Program: Sustained Impact of Veterans' Personal Narratives on Healthcare Providers 5 Years After Implementation.

Patient-centered care promotes positive patient, staff, and organizational outcomes. Communication is one critical element of patient-centered care. Establishing a patient-provider relationship in which a patient feels comfortable sharing their goals, preferences, and values is important to support patient-centered care and positive health outcomes.

Predischarge Injectable Versus Oral Naltrexone to Improve Postdischarge Treatment Engagement Among Hospitalized Veterans with Alcohol Use Disorder: A Randomized Pilot Proof-of-Concept Study.

Background: Injectable naltrexone for alcohol use disorders (AUDs) has been efficacious in several studies. It has not been (i) compared head-to-head with oral naltrexone or (ii) examined in the hospital setting as an intervention that might facilitate treatment attendance after hospital discharge.

Methods: Fifty-four hospitalized veterans identified as having DSM-IV-TR alcohol dependence were randomized to receive (i) a 50 mg oral naltrexone plus a 30-day prescription or (ii) a 380 mg intramuscular naltrexone injection prior to discharge.

Interprofessional Education in Patient Aligned Care Team Primary Care-Mental Health Integration.

Interprofessional education is an effective approach for preparing health care providers for team-based practice.

Using organizational and clinical performance data to increase the value of mental health care.

U.S. health systems, policy makers, and patients increasingly demand high-value care that improves health outcomes at lower cost.

Measurement-based management of mental health quality and access in VHA: SAIL mental health domain.

We outline the development of a Mental Health Domain to track accessibility and quality of mental health care in the United States Veterans Health Administration (VHA) as part of a broad-based performance measurement system. This domain adds an important element to national performance improvement efforts by targeting regional and facility leadership and providing them a concise yet comprehensive measure to identify facilities facing challenges in their mental health programs. We present the conceptual framework and rationale behind measure selection and development.

Maintenance of certification: How performance in practice changes improve tobacco cessation in addiction psychiatrists' practice.

Background And Objectives: In 2000, the American Board of Medical Specialties implemented the Maintenance of Certification (MOC), a structured process to help physicians identify and implement a quality improvement project to improve patient care. This study reports on findings from an MOC Performance in Practice (PIP) module designed and evaluated by addiction psychiatrists who are members of the American Academy of Addiction Psychiatry (AAAP).

Method: A 3-phase process was utilized to recruit AAAP members to participate in the study.

Using Life Stories to Connect Veterans and Providers.

The My Life, My Story patient-centered program uses veterans' personal narratives by veterans to create a strong connection between patients and providers.

Effects of Cognitive Behavioral Stress Management on Negative Mood and Cardiac Autonomic Activity in ICD Recipients.

Background: Behavioral intervention studies in patients with an implantable cardioverter-defibrillator (ICD) show promise in improving psychosocial outcomes but inconclusive effects on cardiovascular outcome. We assessed the effects of cognitive behavioral stress management (CBSM) on mood state and potentially arrhythmogenic cardiovascular responses to mental stress in ICD patients, in support of further larger scale arrhythmia trials.

Methods: A total of 103 ICD recipients were randomly assigned to 10-week programs of CBSM or "Patient Education" (ED).

Family care map: Sustaining family-centered care in Polytrauma Rehabilitation Centers.

The study assessed sustainability of the Family Care Map, a family-centered approach to providing care for Veterans with polytrauma-related injuries, in four Department of Veterans Affairs Polytrauma Rehabilitation Centers. We applied a mixed-methods approach. Staff surveys used standardized measures of sustainability, commitment to change, information, and participation during implementation.

Effectiveness of nasal irrigation for chronic rhinosinusitis and fatigue in patients with Gulf War illness: protocol for a randomized controlled trial.

Introduction: Gulf War Illness (GWI) affects 1 in 7 returned Persian Gulf War veterans. Quality-of-life impact is large; there is no cure. Chronic sinus symptoms and fatigue are common.

Psychiatry student interest groups: what they are and what they could be.

Objective: Medical student interest groups across all specialties help students explore various specialties. There are no published reports on psychiatry student interest group (PSIG) curricula. The aim was to develop elements of a curriculum for such groups, based on data elicited from medical students and faculty members through a multi-institutional online survey.

Sustainability in primary care and Mental Health Integration projects in Veterans Health Administration.

Objective: To explore staff perceptions about sustainability, commitment to change, participation in change process, and information received about the change project within the Veterans Administration Primary Care and Mental Health Integration (PC-MHI) initiative and to examine differences from the Veterans Health Administration Mental Health Systems Redesign (MHSR) initiative.

Data Sources: Surveys of change team members involved in the Veterans Affairs PC-MHI and MHSR initiatives.

Study Design: One-way analysis of variance examined the relationship between commitment, participation and information, and sustainability.

Exemplars in the use of technology for management of depression in primary care.

Purpose: Depression care management as part of larger efforts to integrate behavioral health care into primary care has been shown to be effective in helping patients and primary care clinicians achieve improved outcomes within the primary care environment. Central to care management systems is the use of registries which enable effective clinic population management. The aim of this article is to detail the methods and utility of technology in depression care management processes while also highlighting the real-world variations and barriers that exist in different clinical environments, namely a federally qualified health center and a Veterans Administration clinic.

Measuring sustainability within the Veterans Administration Mental Health System Redesign initiative.

Objective: To examine how attributes affecting sustainability differ across Veterans Health Administration organizational components and by staff characteristics.

Subjects: Surveys of 870 change team members and 50 staff interviews within the Veterans Affairs' Mental Health System Redesign initiative.

Methods: A 1-way ANOVA with a Tukey post hoc test examined differences in sustainability by Veteran Integrated Service Networks, job classification, and tenure from staff survey data of the Sustainability Index.

A review of atypical antipsychotic medications for posttraumatic stress disorder.

Posttraumatic stress disorder (PTSD) can be a chronic and disabling illness with a limited response to antidepressant treatment, particularly in the case of combat-induced PTSD. The purpose of this study is to review randomized controlled and open-label trials of atypical antipsychotics for the treatment of PTSD. We conducted PUBMED and PILOTS database searches for clinical trials of atypical antipsychotic medications for PTSD in May 2010.

Age-related changes in drinking patterns from mid- to older age: results from the Wisconsin longitudinal study.

Background: Drinking has generally been shown to decline with age in older adults. However, results vary depending on the measure of alcohol consumption used and the study population. The goals of this study were to (i) describe changes in drinking in a current cohort of older adults using a variety of measures of drinking and (ii) examine a number of different possible predictors of change.

Nonconsensual sexual experiences and alcohol consumption among women entering college.

The authors investigated the relationship between precollege nonconsensual sexual experiences (NSEs) and drinking among women entering college. College women (N = 797) at a midwestern university participated. Eighteen percent reported one or more NSE prior to arriving at college.

Longitudinal course of substance treatment benefits in older male veteran at-risk drinkers.

Background: This investigation aims to determine the 12-month drinking trajectory of older at-risk drinkers in treatment. Furthermore, the drinking trajectory between at-risk drinkers who had met the threshold suggestive of alcohol dependence (problem at-risk drinkers) and those who did not meet this threshold (nonproblematic at-risk drinkers) were compared.

Methods: This investigation is a component of the PRISM-E (Primary Care Research in Substance Abuse and Mental Health for the Elderly) Study, a multisite randomized trial comparing service use, outcomes, and cost between Integrated (IC) versus Enhanced Specialty Referral (ESR) care models for older (65+ years) adults with depression, anxiety, and/or at-risk alcohol consumption.

Fear, anxiety, and the neuroimaging of PTSD.

The clinical manifestations of Posttraumatic Stress Disorder (PTSD) include both fear and anxiety symptoms. Animal studies provide significant information about the neurobiological pathways involved in fear and anxiety and are relevant to the study of PTSD. These studies are reviewed along with Rauch's proposed neurobiologic model for PTSD.

Effect of depression treatment on depressive symptoms in older adulthood: the moderating role of pain.

Objectives: To investigate whether pain severity and interference with normal work activities moderate the effects of depression treatment on changes in depressive symptoms over time in older adults in primary care.

Design: Patient-randomized, clinical trial.

Setting: Multisite: three clinics located in Veterans Affairs Medical Centers.

PRISM-E: comparison of integrated care and enhanced specialty referral in managing at-risk alcohol use.

Objective: This study was part of the Primary Care Research in Substance Abuse and Mental Health for the Elderly study (PRISM-E) and determined the relative effectiveness of two different models of care for reducing at-risk alcohol use among primary care patients aged 65 and older.

Methods: This multisite study was a randomized clinical trial comparing integrated care with enhanced specialty referral for older primary care patients screened and identified to have at-risk drinking.

Results: Before the study, the 560 participants consumed a mean of 17.

PRISM-E: comparison of integrated care and enhanced specialty referral models in depression outcomes.

Objective: This study, entitled Primary Care Research in Substance Abuse and Mental Health for the Elderly, examined six-month outcomes for older primary care patients with depression who received different models of treatment.

Methods: Clinical outcomes were compared for patients who were randomly assigned to integrated care or enhanced specialty referral. Integrated care consisted of mental health services co-located in primary care in collaboration with primary care physicians.

Satisfaction with mental health services in older primary care patients.

Objective: This study examines whether older adult primary care patients are satisfied with two intervention models designed to ameliorate their behavioral health problems.

Methods: A total of 1,052 primary care patients aged 65 and older with depression, anxiety, or at-risk drinking were randomly assigned to and participated in either integrated care (IC) or enhanced specialty referral (ESR) model and completed the Client Satisfaction Questionnaire (CSQ) administered at three-month follow-up assessment.

Results: Older adult patients' satisfaction with IC (mean: 3.