Reliability and Validity of a Treatment Barriers Scale for Individuals With Alcohol Use Disorder.

Background: Few studies have measured addiction-specific barriers to treatment. A measurement of barriers with psychometric support that has been tested in diverse samples and that assesses multiple components of addiction treatment barriers is needed to inform providers and treatment programs.

Objectives: This paper aims to provide an initial psychometric investigation of a measure of barriers to seeking addictions treatment.

Ecological momentary assessment of PTSD symptoms and alcohol use in combat veterans.

Despite high rates of comorbid hazardous alcohol use and posttraumatic stress disorder (PTSD), the nature of the functional relationship between these problems is not fully understood. Insufficient evidence exists to fully support models commonly used to explain the relationship between hazardous alcohol use and PTSD including the self-medication hypothesis and the mutual maintenance model. Ecological momentary assessment (EMA) can monitor within-day fluctuations of symptoms and drinking to provide novel information regarding potential functional relationships and symptom interactions.

A Web-Based Self-Management Program for Recent Combat Veterans With PTSD and Substance Misuse: Program Development and Veteran Feedback.

Combat veterans from the wars in Iraq and Afghanistan commonly experience posttraumatic stress disorder (PTSD) and substance use problems. In addition, these veterans often report significant barriers to receiving evidence-based mental health and substance use care, such as individual beliefs that treatment will be unhelpful, inconvenient, or that they should be able to handle their problems on their own. To increase access to treatment for this underserved population, a Web-based patient self-management program that teaches cognitive-behavioral therapy (CBT) skills to manage PTSD symptoms and substance misuse was developed.

A randomized clinical trial of alcohol care management delivered in Department of Veterans Affairs primary care clinics versus specialty addiction treatment.

Background: Alcohol use disorder is one of the leading causes of disability worldwide. Despite the availability of efficacious treatments, few individuals with an alcohol use disorder are actively engaged in treatment. Available evidence suggests that primary care may play a crucial role in the identification of patients with an alcohol use disorder, delivery of interventions, and the success of treatment.

Healthcare utilization and symptom variation among veterans using Behavioral Telehealth Center services.

Substance use and mental health problems are often underdiagnosed and undertreated in primary care. Veterans affairs facilities are using the Behavioral Telehealth Center (BTC) to provide evidence-based assessments for primary care patients via telephone. Whether participation in BTC services is associated with (1) increases in healthcare utilization and (2) decreases in symptoms based on behavioral health screening instruments, post-BTC services compared with pre-BTC services were investigated.

Assessing daily fluctuations in posttraumatic stress disorder symptoms and substance use with Interactive Voice Response technology: protocol compliance and reactions.

PTSD symptoms and substance use commonly co-occur, but information is limited regarding their interplay. We used ecological momentary assessment (EMA) to capture fluctuations in PTSD symptoms and drinking within and across days. Fifty Iraq and Afghanistan War veterans completed four daily Interactive Voice Response (IVR) assessments of PTSD and substance use with cell phones for 28 days.

Family Support, Self-Rated Health, and Psychological Distress.

BACKGROUND: Comprehensive health care is becoming an important issue; however, little is known about the complex relationships between perceived family support, self-rated health, and psychological distress in mixed middle-aged/older primary care patient samples. METHOD: In this cross-sectional and predominantly male sample of 137 patients attending their appointments at a primary care clinic in a Department of Veterans Affairs Medical Center, participants completed several questionnaires including the Family Adaptation, Partnership, Growth, Affection, and Resolve; the General Health Questionnaire-12; the Symptom Checklist-10; and the Primary Care Evaluation of Mental Disorders (PRIME-MD) screening questionnaire and interview. Data were collected in 1998.

Mental Health Screening in Primary Care: A Comparison of 3 Brief Measures of Psychological Distress.

BACKGROUND: The current study compared 3 brief mental health screening measures in a sample of older patients in a primary care outpatient setting. Previous mental health screening research has been conducted primarily with younger patients, often with only 1 screening measure, thereby limiting the generalizability of findings. In addition, measures have not yet been compared in terms of their ability to discriminate between cases and noncases of psychiatric disorder.