Patterns of Treatment Disengagement and Personality Traits Associated With Posttraumatic Stress Disorder in Recent-Era U.S. Veterans Receiving Cognitive Processing Therapy.

Low treatment engagement is a barrier to implementation of empirically supported treatments for posttraumatic stress disorder (PTSD) among veterans. Understanding personality traits that predict dropout may help focus attempts to improve engagement. The current study included 90 veterans who served in recent conflicts in Iraq and/or Afghanistan and participated in a trial of cognitive processing therapy for PTSD.

Veterans self-reported reasons for non-attendance in psychotherapy for posttraumatic stress disorder.

This study explored rates of non-attendance (i.e., non-initiation, inconsistent attendance, early discontinuation) in cognitive processing therapy (CPT) and other posttraumatic stress disorder (PTSD) focused individual and group psychotherapies (i.

The Interactive Influence of Social Anxiety and Experimentally Induced Postevent Processing on Cannabis Use.

Cannabis use is a major public health concern, and identification of factors that increase risk of negative consequences of cannabis use may aid in the prevention and treatment of such disorders. Social anxiety has been shown to be robustly linked to negative consequences of cannabis use and cannabis use disorder. However, mechanisms that underlie these co-occurring conditions are not well understood.

Personality disorder traits: Testing insight regarding presence of traits, impairment, and desire for change.

Mixed findings exist as to whether personality pathology involves a critical lack of awareness and insight. Research questions about insight and awareness in personality pathology are typically assessed via comparing self- and informant reports of traits. However, recent studies have measured insight by asking individuals to evaluate additional questions about impairment and desire to change.

Posttraumatic stress disorder in opioid agonist therapy: A review.

Objective: Posttraumatic stress disorder (PTSD) and opioid use disorder (OUD) co-occur at high rates, and this co-occurrence is associated with a range of problems related to mental and physical health. OUD is commonly treated with opioid agonist therapies (OAT), which have been shown to be effective for reducing opiate use and related negative health consequences. Given the high comorbidity of PTSD and OUD, many individuals in OAT have PTSD and continue to experience symptoms of both disorders despite OAT treatment.

Increased utilization of prolonged exposure and cognitive processing therapy over time: A case example from a large Veterans Affairs posttraumatic stress disorder clinic.

Prior single-site and regional studies have documented difficulties in implementing prolonged exposure (PE) and cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) into practice in Veterans Affairs (VA) Medical Centers, estimating that between 6% and 13% of VA patients with PTSD receive PE or CPT (Lu, Plagge, Marsiglio, & Dobscha, 2016; Mott et al., 2014; Shiner et al., 2013).

Provider Beliefs and Practices About Assessing Sexual Orientation in Two Veterans Health Affairs Hospitals.

Purpose: Despite known health disparities for lesbian, gay, and bisexual (LGB) individuals, research in the civilian sector has documented low rates of patient disclosure and provider assessment of this domain. Very little is known about Veterans Health Affairs (VHA) providers' care of LGB veterans, a population that has been relatively invisible until recently because of the vestiges of the Department of Defense policy of "Don't Ask, Don't Tell." This study examined the attitudes, beliefs, and clinical practices of VHA healthcare providers regarding sexual minority veterans.

Predisposing, enabling, and need factors as predictors of low and high psychotherapy utilization in veterans.

This study used national administrative data from the Veterans Health Administration (VHA) to examine predisposing, enabling, and need factors related to multiple levels of psychotherapy utilization in a sample of veterans with posttraumatic stress disorder (PTSD), depression, or anxiety. The database was queried for all veterans who were newly diagnosed with PTSD, depression, or anxiety during the 2010 fiscal year and received at least 1 outpatient psychotherapy session in the year following diagnosis (N = 130,331). Veterans were classified as low (51.

Acceptance of home-based telehealth problem-solving therapy for depressed, low-income homebound older adults: qualitative interviews with the participants and aging-service case managers.

Purpose: To report low-income homebound older adults' experience of telehealth problem-solving therapy (tele-PST) and aging-service case managers' (CMs') experience/perception of client-level personal barriers to accessing psychotherapy in general and PST specifically.

Design And Methods: The study sample consisted of 42 homebound older adults who participated in the feasibility and efficacy trial of tele-PST and completed 36-week follow-up assessments and 12 CMs of a large home-delivered meals program who referred their clients to the tele-PST trial. In-depth interviews with the older adults and written feedback and focus group discussions with the CMs provided the data.

Rates and predictors of referral for individual psychotherapy, group psychotherapy, and medications among Iraq and Afghanistan veterans with PTSD.

This study examined rates of referral for medication, individual psychotherapy, and group psychotherapy within a Veterans Affairs (VA) posttraumatic stress disorder (PTSD) specialty mental health clinic. Participants were 388 Iraq and Afghanistan veterans who were referred for PTSD treatment following a mental health evaluation required for all new VA enrollees. The majority of the sample was referred for medication (79 %), with comparatively fewer referrals for individual (39 %) or group psychotherapy (24 %).

The peaceful mind program: a pilot test of a cognitive-behavioral therapy-based intervention for anxious patients with dementia.

Objectives: To assess feasibility and to conduct a preliminary evaluation of outcomes following Peaceful Mind, a cognitive-behavioral therapy-based intervention for anxiety in dementia, relative to usual care.

Design: Pilot randomized controlled trial including assessments at baseline and 3 and 6 months.

Setting: Houston, TX.

Predictors of treatment satisfaction among older adults with anxiety in a primary care psychology program.

Increasing numbers of patients are treated in integrated primary care mental health programs. The current study examined predictors of satisfaction with treatment in patients from a randomized clinical trial of late-life generalized anxiety disorder (GAD) in primary care. Higher treatment satisfaction was associated with receiving CBT rather than enhanced usual care.

The relationship between use of CBT skills and depression treatment outcome: a theoretical and methodological review of the literature.

Cognitive and behavioral therapies emphasize the importance of skill acquisition and use, and these skills are proposed to mediate treatment outcomes. Despite its theoretical importance, research on skill use as a mechanism of change in CBT and its measurement is still in its infancy. A search of online databases was conducted to identify and review the literature testing the meditational effect of CBT skills on treating depression in adults.

Improving secondary stroke self-care among underserved ethnic minority individuals: a randomized clinical trial of a pilot intervention.

The overall purpose of this study was to pilot a multibehavioral, brief, stroke self-care treatment adapted for implementation with underserved racial/ethnic minority groups and to test the moderating effects of anxiety and depression on engagement in secondary stroke-prevention behaviors. Fifty-two participants were randomized to the secondary stroke prevention (STOP) (N = 27) or usual care (N = 25) group. The STOP program consisted of 3 culturally tailored information sessions and goal-setting activities that were delivered in person by a research assistant.

Characteristics of Depressed Caregivers of Veterans With Dementia.

This study examined the characteristics of caregivers and persons with dementia (PWD) to determine their association with caregiver depression. Participants included 508 PWD (veterans) and 486 caregivers from Boston, Houston, Providence, Beaumont (Texas), and Oklahoma City, identified from diagnoses from medical records and recruited from February 2007 to July 2009, for a larger study evaluating Partners in Dementia Care, a care-coordination intervention. Characteristics evaluated for PWD included activities of daily living, instrumental activities of daily living, cognitive impairment, and disruptive behavior.

Behavioral health coaching for rural-living older adults with diabetes and depression: an open pilot of the HOPE Study.

Background: Patients with diabetes are at increased risk for depression, compounding the burden of disease. When comorbid with diabetes, depression leads to poorer health outcomes and often complicates diabetes self-management. Unfortunately, treatment options for these complex patients are limited and comprehensive services are rarely available for patients in rural settings.

Effects of depression and social support on comprehension and recall of informed consent information among Parkinson disease patients and their caregivers.

Objective: Relatively little attention has focused on the impact of psychiatric conditions on human subjects' comprehension of consent information. The purpose of this randomized study was to determine whether depression affects comprehension and recall of informed consent information among persons with Parkinson's disease and their caregivers and to evaluate the effects of support on comprehension and recall during the consent process.

Method: Comprehension and recall of information were assessed using a modified version of the Modified Quality of Informed Consent Questionnaire, taken 1 week and 1 month later, and scored using a consensus-based algorithm.

Development and pilot testing of a standardized training program for a patient-mentoring intervention to increase adherence to outpatient HIV care.

Although peer interventionists have been successful in medication treatment-adherence interventions, their role in complex behavior-change approaches to promote entry and reentry into HIV care requires further investigation. The current study sought to describe and test the feasibility of a standardized peer-mentor training program used for MAPPS (Mentor Approach for Promoting Patient Self-Care), a study designed to increase engagement and attendance at HIV outpatient visits among high-risk HIV inpatients using HIV-positive peer interventionists to deliver a comprehensive behavioral change intervention. Development of MAPPS and its corresponding training program included collaborations with mentors from a standing outpatient mentor program.

Irritability and social isolation in dementia patients with and without depression.

Unlabelled: This study examined the prevalence of irritability and social isolation in veterans with dementia, with and without depression. Participants were diagnosed with dementia and enrolled in a dementia care-coordination and support-service intervention. Participants were interviewed and underwent assessment with the 10-item Center for Epidemiologic Studies Depression scale, a Patient Strain Measure and the Short Blessed Test.

Use of administrative data to identify colorectal liver metastasis.

Background: The ability to identify patients with colorectal cancer (CRC) liver metastasis (LM) using administrative data is unknown. The goals of this study were to evaluate whether administrative data can accurately identify patients with CRCLM and to develop a diagnostic algorithm capable of identifying such patients.

Materials And Methods: A retrospective cohort study was conducted to validate the diagnostic and procedural codes found in administrative databases of the Veterans Administration (VA) system.

Accuracy of a urinary catheter surveillance protocol.

Background: Many hospitals are increasing surveillance for catheter-associated urinary tract infections, which requires documentation of urinary catheter device-days. However, device-days are usually obtained by chart review or nursing reports. The aim of this study was to demonstrate that chart review can provide accurate urinary catheter data compared with physical inspection of the urinary catheter at the bedside.