Feasibility of an intensive outpatient treatment program for posttraumatic stress disorder within the veterans health care administration.

Trauma-focused treatments for posttraumatic stress disorder (PTSD), such as Prolonged Exposure (PE) therapy and Cognitive Processing Therapy (CPT), are effective and supported by various Clinical Practice Guidelines; however, drop-out rates for the treatments are as high as 40% within clinical programs. One promising solution is delivering the evidence-based psychotherapies (EBPs) three or more times per week within an intensive outpatient program (IOP) for PTSD. The present study examined the feasibility and effectiveness of a relatively low-resourced PTSD IOP within a larger PTSD program at the Veterans Healthcare Administration.

Exploring Predictors of Sleep State Misperception in Women with Posttraumatic Stress Disorder.

Objectives: Insomnia is a common symptom of posttraumatic stress disorder (PTSD) that is resistant to first-line cognitive behavioral interventions. However, research suggests that, among individuals with PTSD, self-reported sleep impairment is typically more severe than what is objectively observed, a phenomenon termed . Relatively little research has examined which individuals with PTSD are most likely to exhibit sleep state misperception.

Association of statewide stay-at-home orders with utilization of case management and supportive services for veterans experiencing housing insecurity.

The US Department of Housing and Urban Development-Department of Veterans Affairs (VA) Supportive Housing (HUD-VASH) program provides Veterans with a subsidy for rent and case management. In response to the Coronavirus 2019 pandemic, many states enacted stay-at-home orders that may have limited access to case managers. Therefore, we examined the association between statewide stay-at-home orders and utilization of HUD-VASH case management.

A role for deficits in GABAergic neurosteroids and their metabolites with NMDA receptor antagonist activity in the pathophysiology of posttraumatic stress disorder.

Trauma-focused psychotherapies show general efficacy in post-traumatic stress disorder (PTSD), although outcomes vary substantially among individuals with PTSD and many patients do not achieve clinically meaningful symptom improvement. Several factors may contribute to poor treatment response, including genetic or environmental (e.g.

Socioeconomic challenges during the COVID-19 pandemic for Veterans with psychosis or recent homelessness.

The COVID-19 pandemic and social distancing have directly impacted the socioeconomic well-being of most Americans. Veterans with psychosis (PSY) and Veterans who were recently housed (RHV) through a supportive housing programme may be especially vulnerable to experiencing negative socioeconomic effects of the pandemic. In this study, we investigated socioeconomic experiences and challenges during the pandemic in these two putatively vulnerable Veteran groups and in Veterans with no history of PSY or homeless (i.

Discharges against medical advice and 30-day healthcare costs: an analysis of commercially insured adults.

Prior literature detailing the consequences of a discharge against medical advice (DAMA) has not focused on costs. We examine costs following a DAMA. This retrospective cohort study utilized the IQVIA PharMetrics Plus database to identify adults hospitalized during 2007-2015.

Mental Health Care Use Among U.S. Military Veterans: Results From the 2019-2020 National Health and Resilience in Veterans Study.

Objective: Psychiatric and substance use disorders are prevalent among U.S. military veterans, yet many veterans do not engage in treatment.

Prevalence of Alzheimer's disease and related dementias among veterans experiencing housing insecurity.

Introduction: Housing insecure veterans are aging, but the prevalence of Alzheimer's disease and related dementias (AD/ADRD) in the population is unknown.

Methods: We calculated the prevalence of AD/ADRD diagnoses in 2018 among veterans that experienced homelessness, were at-risk for homelessness, or were stably housed. We determined acute care (emergency department, hospitalizations, psychiatric hospitalizations), and any long-term care (nursing home, and community-based) use by housing status among veterans with an AD/ADRD diagnosis.

Editorial: Applications of Cognitive and Behavioral Therapy in Response to COVID-19.

The corona virus (COVID-19) continues to have a devastating health, economic, and social impact on our local and international communities. Cognitive and Behavioral Therapies (CBTs), as a family of therapies that posit cognitive, behavioral, emotional, and interpersonal change processes in the understanding and successful treatment of mental health disorders, have risen to the challenge. This special issue represents contributions from CBT experts on the impact on psychopathology, new assessment methods, adaptations of integrated behavioral health, telehealth, psychology training, and discusses a public health framework.

Suppression and acceptance in unipolar depression: Short-term and long-term effects on emotional responding.

Objectives: Transdiagnostic treatments increasingly include emotion regulation training focused on use of emotional suppression and acceptance. Despite the frequent use of these treatments in depression, little is known about the effects of these strategies in this population.

Design: An experimental study.

Hearing Health Care Utilization Following Automated Hearing Screening.

Background: The study examined follow-up rates for pursuing hearing health care (HHC) 6 to 8 months after participants self-administered one of three hearing screening methods: an automated method for testing of auditory sensitivity (AMTAS), a four-frequency pure-tone screener (FFS), or a digits-in-noise test (DIN), with and without the presentation of a 2-minute educational video about hearing.

Purpose: The study aims to determine if the type of self-administered hearing screening method (with or without an educational video) affects HHC follow-up rates.

Research Design: The study is a randomized controlled trial of three automated hearing screening methods, plus control group, with and without an educational video.

Delirious Mania: An Approach to Diagnosis and Treatment.

The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry.

Incidence of Homelessness among Veterans Newly Diagnosed with Alzheimer's Disease and Related Dementias.

Background: To determine the incidence of homelessness among Veterans diagnosed with Alzheimer's disease and related dementias (ADRD).

Methods: We used Veterans Affairs (VA) administrative records to identify Veterans with a new ADRD diagnosis anytime between 2010-2019. Among these Veterans, we calculated the incidence of homelessness, and estimated the association between demographics, comorbidities and hazard of homelessness.

Clinical and functional effects of the COVID-19 pandemic and social distancing on vulnerable veterans with psychosis or recent homelessness.

The COVID-19 pandemic has upended the lives of everyone in the United States, negatively impacting social interactions, work, and living situations, and potentially exacerbating mental health issues in vulnerable individuals. Within the Department of Veterans Affairs (VA) healthcare system, two vulnerable groups include those with a psychotic disorder (PSY) and those who have recently experienced homelessness (recently housed Veterans, RHV). We conducted phone interviews with PSY (n = 81), RHV (n = 76) and control Veterans (CTL, n = 74) between mid-May - mid-August 2020 ("initial") and between mid-August - mid-October 2020 ("follow-up").

Drinking to Cope with Posttraumatic Stress: A Nationally Representative Study of Men with and without Military Combat Experience.

Posttraumatic stress disorder (PTSD) and hazardous alcohol use are prevalent among trauma survivors. Despite higher rates of both PTSD and hazardous alcohol use among military combat veterans than civilians, scant research has examined whether military combat experience is associated with with PTSD symptoms. This study tested the hypothesis that compared to trauma-exposed men without combat experience, men military combat experience would be more likely to endorse drinking alcohol to cope with their PTSD symptoms.

An Evaluation of Cognitive Behavioral Therapy for Insomnia: A Systematic Review and Application of Tolin's Criteria for Empirically Supported Treatments.

The American Psychological Association's Society of Clinical Psychology recently adopted the "Tolin Criteria" to evaluate empirically supported treatments. These criteria better account for strength and quality of rapidly accumulating evidence bases for various treatments. Here we apply this framework to cognitive behavioral therapy for insomnia (CBT-I).

The Problem of Veteran Homelessness: An Update for the New Decade.

Introduction: There has been a decade-long federal commitment to prevent and end homelessness among U.S. military veterans.

Neurobiology of the Rapid-Acting Antidepressant Effects of Ketamine: Impact and Opportunities.

The discovery of the rapid-acting antidepressant effects of ketamine has 1) led to a paradigm shift in our perception of what is possible in treating severe depression; 2) spurred a wave of basic, translation, and clinical research; and 3) provided an unprecedented investigational tool to conduct longitudinal mechanistic studies that may capture behavioral changes as complex as clinical remission and relapse within hours and days of treatment. Unfortunately, these advances did not yet translate into clinical biomarkers or novel treatments, beyond ketamine. In contrast to slow-acting antidepressants, in which targeting monoaminergic receptors identified several efficacious drugs with comparable mechanisms, the focus on the receptor targets of ketamine has failed in several clinical trials over the past decade.