Sustaining the collaborative chronic care model in outpatient mental health: a matrixed multiple case study.

Background: Sustaining evidence-based practices (EBPs) is crucial to ensuring care quality and addressing health disparities. Approaches to identifying factors related to sustainability are critically needed. One such approach is Matrixed Multiple Case Study (MMCS), which identifies factors and their combinations that influence implementation.

Effectiveness of residential treatment services for veterans with substance use disorders: A propensity score matching evaluation.

Background: Prior reviews of substance use disorder (SUD) treatment have found mixed support for residential level of care but are limited by methodology problems and the ethical concerns of randomizing patients with severe SUD to lower levels of care.

Methods: The present study is the first to use a large archival SUD residential sample with a matched comparison group and one-year follow-up period to examine the benefits of residential treatment provided to adults clinically assessed as warranting SUD residential care. We used propensity score matching in our sample (N = 6177) of veterans with a SUD who were screened and accepted for Veterans Affairs (VA) SUD residential treatment between January 1st, 2019 and June 30th, 2019.

Understanding veteran barriers to specialty outpatient PTSD clinical care.

Objective: Veterans seeking treatment for posttraumatic stress disorder (PTSD) commonly report general and veteran-specific barriers to treatment such as stigma and challenges with navigating the Veterans Health Affairs (VHA) system. This study aimed to characterize barriers endorsed by a national sample of veterans seeking care in VHA PTSD specialty outpatient clinics, as well as to examine the impact of demographics on endorsed barriers.

Methods: This study included 17,069 veterans referred to PTSD specialty outpatient clinics in the VHA during Fiscal Year 2019.

Measurement-based care in Veterans Health Administration mental health residential treatment.

In 2016, the Veterans Health Administration (VHA) launched the Measurement-Based Care (MBC) in Mental Health Initiative to support the use of patient-reported outcome measures (PROMs) across mental health services to increase veteran engagement and promote collaborative treatment planning. The present study reported on the administrations of PROMs across all residential stays within the VHA's Mental Health Residential Rehabilitation Treatment Programs between October 1, 2018, and September 30, 2019 ( = 29,111). We subsequently explored a subsample of veterans attending substance use residential treatment during the same period who completed the Brief Addiction Monitor-Revised (BAM-R; Cacciola et al.

Benchmarking quality of life to posttraumatic stress disorder symptom changes in cognitive processing therapy.

Although there is ample evidence that PTSD is effectively treated by first-line therapies such as Cognitive Processing Therapy (CPT), it is less clear to what degree these treatments improve quality of life (QOL), a common presenting concern of treatment-seeking individuals (Rosen et al., 2013). Only two studies, both conducted in military veteran samples, have examined the magnitude of PTSD symptom change needed in order to achieve corresponding changes in QOL during treatment.

A randomized controlled trial examining the effects of intranasal oxytocin on alcohol craving and intimate partner aggression among couples.

Background: While alcohol use disorder (AUD) is a well-established risk factor for intimate partner aggression (IPA), effective treatments for co-occurring AUD and IPA (AUD/IPA) are lacking. Oxytocin is one promising pharmacological candidate for AUD/IPA given its potential to modulate social behavior and attenuate alcohol use. However, emerging data suggests that oxytocin's prosocial effects are inconsistent, and a small number of studies have also found that oxytocin might have the potential to be aggressogenic.

In vivo defensive behaviors, fear, and attention bias to physical and negative evaluation threats.

Aggressive behavior is a major public health issue for which there are few efficacious treatments. Although much of information processing is automatic, there are few studies of early-stage decoding biases (e.g.

Applying Organizational Change Theory to Address the Long-Standing Problem of Harassment in Medical Education.

Harassment is a common experience for medical and healthcare trainees. Experiencing harassment can have significant consequences for trainees in multiple domains, including mental, physical, social, and occupational well-being. Harassment remains entrenched in medical education despite efforts to address it.

Early discontinuation of pharmacotherapy in U.S. veterans diagnosed with PTSD and the role of psychotherapy.

More than 50% of individuals who enter treatment for posttraumatic stress disorder (PTSD) are prescribed a psychotropic medication. To date, however, data are limited regarding the prevalence and determinants of discontinuation of psychotropic medication in this population. To address this gap, we analyzed data from 154,953 veterans newly diagnosed with PTSD who were seeking VA treatment and followed them for one year to identify the prevalence and determinants of medication discontinuation.

Sex Differences in Associations Between Depression and Posttraumatic Stress Disorder Symptoms and Tobacco Use Among Veterans of Recent Conflicts.

Rates of tobacco use, posttraumatic stress disorder (PTSD), and depression are higher for veterans compared to their civilian counterparts. Female veterans have high rates of tobacco use and mental health (MH) conditions; however, little is known about sex differences in the association of depression and PTSD symptoms with postdeployment tobacco use. Cross-sectional associations and binary logistic regression models were conducted using baseline interview data from the Survey of Experiences of Returning Veterans sample (850 recently returned veterans; 352 women; age mean [standard deviation, SD] = 35.

Comparing the effectiveness of VA residential PTSD treatment for veterans who do and do not report a history of MST: A national investigation.

The Department of Veterans Affairs (VA) has implemented initiatives to promote veterans' recovery from the health sequelae of military sexual trauma (MST), including posttraumatic stress disorder (PTSD). MST can impact emotion regulation, interpersonal functioning, and perceptions of trust and safety, as well as increase risk for psychiatric comorbidity, which may impede PTSD treatment..

Posttraumatic stress symptom courses in U.S. military veterans: A seven-year, nationally representative, prospective cohort study.

The current study examined the nature and correlates of seven-year posttraumatic stress disorder (PTSD) symptom courses in a nationally representative, prospective cohort of U.S. military veterans.

Predictors of Dropout From Residential Treatment for Posttraumatic Stress Disorder Among Military Veterans.

Successful psychotherapy for posttraumatic stress disorder (PTSD) necessitates initial and sustained engagement. However, treatment dropout is common, with rates of 50-70% depending on the setting, type of treatment and how dropout is calculated. Dropout from residential treatment is less understood and could be impacted by participation of more symptomatic patient populations and reduced day-to-day barriers to engagement.

Experimentally unpacking cognitive behavioral therapy: The effects of completing a thought record on affect and neuroendocrine responses to stress.

Despite overall effectiveness of cognitive behavioral therapy (CBT), little is known about the effects of specific techniques used in CBT. Thought records are widely employed in CBT across disorders to target cognitions. The current study examined the effects of thought record completion on affective and physiological responses to a laboratory stressor.