Pub Date : 2024-08-01Epub Date: 2023-08-21DOI: 10.1037/ser0000796
Roberto López, Katherine M Harris, Lauren Seibel, Sonia C Thomas, Rick N Leichtweis, Christianne Esposito-Smythers
Partial hospital programs (PHPs) are a vital mental health service for youth at risk for suicide. Yet, few studies have examined trajectories of suicidal ideation and depressive symptoms, two important risk factors for suicidal behavior, over the course of care. Moreover, little is known about factors that may impact these trajectories among youth in PHPs. The present study examined trajectories of suicidal ideation and depressive symptoms, as well as clinical and demographic predictors of these changes, among youth enrolled in two PHPs. A sample of 253 youth (Mage = 15.3; SD = 1.4; range = 12-18; 68.8% female; 63.2% White; 75.1% non-Hispanic/Latino/a/x) completed repeated measures of suicidal ideation severity and depressive symptoms during treatment. Trajectories of these outcomes were examined using two separate latent growth models. Recent history of self-injurious behaviors and demographics were tested as predictors of trajectories using a taxonomic approach. Overall, suicidal ideation and depressive symptoms declined over the course of care. Sex, history of self-injury, and sexual identity were associated with variability in one or both trajectories of change. Results suggest individual variability in the rate of change among youth in PHPs. Such information may be used to aid in treatment planning and quality improvement efforts within PHPs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
{"title":"Trajectories of adolescent suicidal ideation and depressive symptoms during partial hospitalization: Clinical and demographic characteristics as predictors of change.","authors":"Roberto López, Katherine M Harris, Lauren Seibel, Sonia C Thomas, Rick N Leichtweis, Christianne Esposito-Smythers","doi":"10.1037/ser0000796","DOIUrl":"10.1037/ser0000796","url":null,"abstract":"<p><p>Partial hospital programs (PHPs) are a vital mental health service for youth at risk for suicide. Yet, few studies have examined trajectories of suicidal ideation and depressive symptoms, two important risk factors for suicidal behavior, over the course of care. Moreover, little is known about factors that may impact these trajectories among youth in PHPs. The present study examined trajectories of suicidal ideation and depressive symptoms, as well as clinical and demographic predictors of these changes, among youth enrolled in two PHPs. A sample of 253 youth (<i>M</i><sub>age</sub> = 15.3; SD = 1.4; range = 12-18; 68.8% female; 63.2% White; 75.1% non-Hispanic/Latino/a/x) completed repeated measures of suicidal ideation severity and depressive symptoms during treatment. Trajectories of these outcomes were examined using two separate latent growth models. Recent history of self-injurious behaviors and demographics were tested as predictors of trajectories using a taxonomic approach. Overall, suicidal ideation and depressive symptoms declined over the course of care. Sex, history of self-injury, and sexual identity were associated with variability in one or both trajectories of change. Results suggest individual variability in the rate of change among youth in PHPs. Such information may be used to aid in treatment planning and quality improvement efforts within PHPs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10032502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01Epub Date: 2023-11-02DOI: 10.1037/ser0000816
Suzanne E Decker, Minnah W Farook, Sarah Meshberg-Cohen, Taiki Matsuura, Maggie Manning, Erica A Abel, Laura Blakley, Faith Prelli
The American Psychological Association's multicultural guidelines encourage psychologists to use language sensitive to the lived experiences of the individuals they serve. In organized care settings, psychologists have important decisions to make about the language they use in the electronic health record (EHR), which may be accessible to both the patient and other health care providers. Language about patient identities (including but not limited to race, ethnicity, gender, and sexual orientation) is especially important, but little guidance exists for psychologists on how and when to document these identities in the EHR. Moreover, organizational mandates, patient preferences, fluid identities, and shifting language may suggest different documentation approaches, posing ethical dilemmas for psychologists to navigate. In this article, we review the purposes of documentation in organized care settings, review how each of the five American Psychological Association Code of Ethics' General Principles relates to identity language in EHR documentation, and propose a set of questions for psychologists to ask themselves and their patients when making choices about documenting identity variables in the EHR. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
{"title":"Clinical documentation of patient identities in the electronic health record: Ethical principles to consider.","authors":"Suzanne E Decker, Minnah W Farook, Sarah Meshberg-Cohen, Taiki Matsuura, Maggie Manning, Erica A Abel, Laura Blakley, Faith Prelli","doi":"10.1037/ser0000816","DOIUrl":"10.1037/ser0000816","url":null,"abstract":"<p><p>The American Psychological Association's multicultural guidelines encourage psychologists to use language sensitive to the lived experiences of the individuals they serve. In organized care settings, psychologists have important decisions to make about the language they use in the electronic health record (EHR), which may be accessible to both the patient and other health care providers. Language about patient identities (including but not limited to race, ethnicity, gender, and sexual orientation) is especially important, but little guidance exists for psychologists on how and when to document these identities in the EHR. Moreover, organizational mandates, patient preferences, fluid identities, and shifting language may suggest different documentation approaches, posing ethical dilemmas for psychologists to navigate. In this article, we review the purposes of documentation in organized care settings, review how each of the five American Psychological Association Code of Ethics' General Principles relates to identity language in EHR documentation, and propose a set of questions for psychologists to ask themselves and their patients when making choices about documenting identity variables in the EHR. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71426301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01Epub Date: 2024-01-11DOI: 10.1037/ser0000833
Andrew M Sherrill, Mansi Mehta, Samantha C Patton, Kelsey Sprang Jones, Natalie Hellman, Julie Chrysosferidis, Carly W Yasinski, Barbara O Rothbaum, Sheila A M Rauch
Recent evidence supports the implementation of massed delivery of disorder-specific treatments in the military service member and veteran population. However, many treatment settings serve patients with a wide range of diagnoses, and often patients present with comorbid conditions. Growing evidence suggests transdiagnostic cognitive behavioral treatments are effective for a wide range of emotional disorders and may reduce barriers to access. Little is known about the feasibility and outcomes of the massed delivery of transdiagnostic treatments. The present study examined real-world outcomes of a 2-week intensive outpatient program using the Unified Protocol for emotional disorders (UP-IOP). The sample included military service members and veterans diagnosed with a range of emotional disorders, namely trauma- and stressor-related disorders, unipolar depressive disorders, and anxiety disorders. The present study examined outcomes of UP-IOP (depression, trauma-related symptom severity, and emotion dysregulation). Participants included all patients who sought UP-IOP in its first 15 months of operation (N = 117). A diagnosis of posttraumatic stress disorder (PTSD) was an exclusion criterion because the site had an established PTSD-specific IOP treatment option. Findings indicate UP-IOP was feasible, had 94% patient retention, and was effective in reducing symptom severity (Cohen's d = 0.76 for depression symptom severity, Cohen's d = 0.80 for trauma-related symptom severity). There was no observed reduction in emotion dysregulation over the 2-week course of treatment. The intensive transdiagnostic approach resulted in effective symptom reduction in an accelerated timeframe while minimizing patient attrition. These findings indicate massed delivery of transdiagnostic cognitive behavioral therapy (CBT) treatments should continue to be explored, especially for this population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
最近的证据支持在军人和退伍军人群体中实施针对特定疾病的大规模治疗。然而,许多治疗机构为诊断范围广泛的患者提供服务,而且患者往往伴有并发症。越来越多的证据表明,跨诊断认知行为治疗对多种情绪障碍有效,并可减少获得治疗的障碍。人们对大规模提供跨诊断治疗的可行性和结果知之甚少。本研究考察了使用情绪障碍统一方案(UP-IOP)进行为期两周的强化门诊治疗的实际效果。样本包括被诊断患有一系列情感障碍的军人和退伍军人,即创伤和压力相关障碍、单极性抑郁障碍和焦虑障碍。本研究考察了 UP-IOP 的结果(抑郁、创伤相关症状严重程度和情绪失调)。研究对象包括所有在UP-IOP运行的前15个月内就诊的患者(N = 117)。创伤后应激障碍(PTSD)诊断是一项排除标准,因为该研究机构已经建立了针对创伤后应激障碍的 IOP 治疗方案。研究结果表明,UP-IOP 是可行的,患者保留率为 94%,并能有效降低症状严重程度(抑郁症状严重程度的 Cohen's d = 0.76,创伤相关症状严重程度的 Cohen's d = 0.80)。在为期两周的治疗过程中,没有观察到情绪失调的减少。强化的跨诊断方法能在较短的时间内有效减轻症状,同时最大限度地减少患者的流失。这些研究结果表明,应继续探索大规模提供跨诊断认知行为疗法(CBT)的治疗方法,尤其是针对这类人群。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
{"title":"Effectiveness of the massed delivery of unified protocol for emotional disorders within an intensive outpatient program for military service members and veterans.","authors":"Andrew M Sherrill, Mansi Mehta, Samantha C Patton, Kelsey Sprang Jones, Natalie Hellman, Julie Chrysosferidis, Carly W Yasinski, Barbara O Rothbaum, Sheila A M Rauch","doi":"10.1037/ser0000833","DOIUrl":"10.1037/ser0000833","url":null,"abstract":"<p><p>Recent evidence supports the implementation of massed delivery of disorder-specific treatments in the military service member and veteran population. However, many treatment settings serve patients with a wide range of diagnoses, and often patients present with comorbid conditions. Growing evidence suggests transdiagnostic cognitive behavioral treatments are effective for a wide range of emotional disorders and may reduce barriers to access. Little is known about the feasibility and outcomes of the massed delivery of transdiagnostic treatments. The present study examined real-world outcomes of a 2-week intensive outpatient program using the Unified Protocol for emotional disorders (UP-IOP). The sample included military service members and veterans diagnosed with a range of emotional disorders, namely trauma- and stressor-related disorders, unipolar depressive disorders, and anxiety disorders. The present study examined outcomes of UP-IOP (depression, trauma-related symptom severity, and emotion dysregulation). Participants included all patients who sought UP-IOP in its first 15 months of operation (<i>N</i> = 117). A diagnosis of posttraumatic stress disorder (PTSD) was an exclusion criterion because the site had an established PTSD-specific IOP treatment option. Findings indicate UP-IOP was feasible, had 94% patient retention, and was effective in reducing symptom severity (Cohen's <i>d</i> = 0.76 for depression symptom severity, Cohen's <i>d</i> = 0.80 for trauma-related symptom severity). There was no observed reduction in emotion dysregulation over the 2-week course of treatment. The intensive transdiagnostic approach resulted in effective symptom reduction in an accelerated timeframe while minimizing patient attrition. These findings indicate massed delivery of transdiagnostic cognitive behavioral therapy (CBT) treatments should continue to be explored, especially for this population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01Epub Date: 2024-01-25DOI: 10.1037/ser0000838
Leanne K Knobloch, Jenny L Owens
Moral injury is a serious concern among first responders. Not only does moral injury occur with notable frequency among first response groups such as police, fire safety, and emergency medical personnel, but it also poses considerable mental health challenges. Despite a recent explosion of research on moral injury, the literature would benefit from a systematic investigation of how first responders describe their experiences in their own words. We conducted semistructured interviews with 36 graduates of a first responder trauma healing course. Participants described moral injury as (a) a byproduct of being a first responder, (b) occurring frequently but being difficult to identify, and (c) involving feelings of helplessness and guilt. Effects of moral injury included (a) wide-ranging negative consequences, (b) diminished self-esteem, (c) isolation from and suspicion of others, and (d) spiritual distress. When asked about the advice they would give to other people experiencing moral injury, first responders recommended (a) talking openly about the experience of moral injury, (b) being proactive in seeking help, (c) breaking free from the stigma of needing assistance, and (d) building a network of support. Taken together, these results suggest important guidelines for helping first responders cope with the aftermath of moral injury. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
{"title":"Moral injury among first responders: Experience, effects, and advice in their own words.","authors":"Leanne K Knobloch, Jenny L Owens","doi":"10.1037/ser0000838","DOIUrl":"10.1037/ser0000838","url":null,"abstract":"<p><p><i>Moral injury</i> is a serious concern among first responders. Not only does moral injury occur with notable frequency among first response groups such as police, fire safety, and emergency medical personnel, but it also poses considerable mental health challenges. Despite a recent explosion of research on moral injury, the literature would benefit from a systematic investigation of how first responders describe their experiences in their own words. We conducted semistructured interviews with 36 graduates of a first responder trauma healing course. Participants described moral injury as (a) a byproduct of being a first responder, (b) occurring frequently but being difficult to identify, and (c) involving feelings of helplessness and guilt. Effects of moral injury included (a) wide-ranging negative consequences, (b) diminished self-esteem, (c) isolation from and suspicion of others, and (d) spiritual distress. When asked about the advice they would give to other people experiencing moral injury, first responders recommended (a) talking openly about the experience of moral injury, (b) being proactive in seeking help, (c) breaking free from the stigma of needing assistance, and (d) building a network of support. Taken together, these results suggest important guidelines for helping first responders cope with the aftermath of moral injury. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139564730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01Epub Date: 2023-06-29DOI: 10.1037/ser0000788
Lynsay Ayer, Stephanie Holliday, Robin Beckman, Lisa H Jaycox, Daniel Elinoff, Rajeev Ramchand, Denis Agniel, Emily Hoch, Lisa Wagner
The goal of this study was to examine the factors associated with Army noncommissioned officer (NCO) experiences, attitudes, and behaviors in their role of identifying potential suicide risk factors in their fellow soldiers. To better understand the perspectives of NCOs, an anonymous survey was administered to 2,468 Army NCOs. Descriptive statistics and linear regressions were conducted to compare subgroups of NCOs. Most (71%) Army NCOs have received many (11 or more) hours of suicide prevention training, but training in soft skills that may be important for the gatekeeper role was less consistently reported. Active Component soldiers reported greater confidence in their intervention skills (Cohen's d = 0.25) and fewer logistical barriers (e.g., time and space to talk) to intervening with at-risk soldiers (Cohen's d = 0.80) compared to Reserve and National Guard soldiers. Formal coursework in mental health areas like psychology or chaplaincy was associated with a greater level of confidence in intervention skills (Cohen's d = 0.23) and in more frequent intervention behavior (Cohen's d = 0.13). Army NCO trainings should be modified to better equip soldiers with the soft skills (e.g., active listening skills and verbally and nonverbally conveying nonjudgment/acceptance and empathy) needed to have effective conversations with soldiers about suicide risk factors and other sensitive topics. Strategies used within mental health education, which appears to be a strength for NCO gatekeepers, could be used to achieve this goal. Reserve and Guard NCOs may need additional supports and tailored trainings to better fit their operational context. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
本研究的目的是探讨陆军军士(NCO)在识别士兵同伴潜在自杀风险因素方面的经验、态度和行为的相关因素。为了更好地了解军士的观点,我们对 2468 名陆军军士进行了匿名调查。通过描述性统计和线性回归对军士进行了分组比较。大多数(71%)陆军军士都接受过多小时(11 小时或以上)的自杀预防培训,但对把关人角色可能很重要的软技能培训却没有得到一致的报道。与后备役士兵和国民警卫队士兵相比,现役士兵对自己的干预技能更有信心(Cohen's d = 0.25),在干预高危士兵时遇到的后勤障碍(如谈话的时间和空间)也更少(Cohen's d = 0.80)。心理学或牧师等心理健康领域的正规课程与干预技能的信心水平(Cohen's d = 0.23)和更频繁的干预行为(Cohen's d = 0.13)相关。陆军军士培训应加以修改,使士兵更好地掌握与士兵就自杀风险因素和其他敏感话题进行有效对话所需的软技能(如积极倾听技能、口头和非口头表达不评判/接纳和同情)。心理健康教育似乎是军士长把关人的强项,可以利用心理健康教育中使用的策略来实现这一目标。后备役和近卫军军士可能需要额外的支持和量身定制的培训,以更好地适应他们的作战环境。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
{"title":"Upstream suicide prevention in the U.S. Army: Noncommissioned officers' perspectives.","authors":"Lynsay Ayer, Stephanie Holliday, Robin Beckman, Lisa H Jaycox, Daniel Elinoff, Rajeev Ramchand, Denis Agniel, Emily Hoch, Lisa Wagner","doi":"10.1037/ser0000788","DOIUrl":"10.1037/ser0000788","url":null,"abstract":"<p><p>The goal of this study was to examine the factors associated with Army noncommissioned officer (NCO) experiences, attitudes, and behaviors in their role of identifying potential suicide risk factors in their fellow soldiers. To better understand the perspectives of NCOs, an anonymous survey was administered to 2,468 Army NCOs. Descriptive statistics and linear regressions were conducted to compare subgroups of NCOs. Most (71%) Army NCOs have received many (11 or more) hours of suicide prevention training, but training in soft skills that may be important for the gatekeeper role was less consistently reported. Active Component soldiers reported greater confidence in their intervention skills (Cohen's <i>d</i> = 0.25) and fewer logistical barriers (e.g., time and space to talk) to intervening with at-risk soldiers (Cohen's <i>d</i> = 0.80) compared to Reserve and National Guard soldiers. Formal coursework in mental health areas like psychology or chaplaincy was associated with a greater level of confidence in intervention skills (Cohen's <i>d</i> = 0.23) and in more frequent intervention behavior (Cohen's <i>d</i> = 0.13). Army NCO trainings should be modified to better equip soldiers with the soft skills (e.g., active listening skills and verbally and nonverbally conveying nonjudgment/acceptance and empathy) needed to have effective conversations with soldiers about suicide risk factors and other sensitive topics. Strategies used within mental health education, which appears to be a strength for NCO gatekeepers, could be used to achieve this goal. Reserve and Guard NCOs may need additional supports and tailored trainings to better fit their operational context. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9701684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01Epub Date: 2023-06-19DOI: 10.1037/ser0000773
Leslie A Morland, Tamara Wachsman, Katelyn Webster, Skye Fitzpatrick, Robert Valela, Alexander O Crenshaw, Candice M Monson, Kayla C Knopp
Conjoint interventions for posttraumatic stress disorder (PTSD) offer an opportunity to target symptoms' broader social impact, including couples' relationship satisfaction. Technology-assisted interventions may help overcome access to care barriers for couples. Couple Helping Overcome PTSD and Enhance Satisfaction (HOPES) is a coached internet-based couples' intervention for PTSD adapted from cognitive behavioral conjoint therapy, an evidence-based dyadic therapy for PTSD. This pilot study examined the implementation feasibility, acceptability, and preliminary efficacy of Couple HOPES in a sample of 15 United States veterans with PTSD and their romantic partners within a Veterans Affairs (VA) Medical Center setting. There were significant improvements in veterans' PTSD symptoms (self- and partner-reported) and both veterans' and partners' relationship satisfaction, though the effect sizes were small (all g's < .40). Importantly, the 73% retention rate and participant feedback at postassessment suggest this online adaptation may help couples overcome barriers to accessing care. More broadly, this pilot study helps answer questions regarding where digital health interventions fit into the continuum of PTSD care within the VA system. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
针对创伤后应激障碍(PTSD)的联合干预为针对症状的更广泛社会影响(包括夫妻关系满意度)提供了机会。技术辅助干预措施可能有助于克服夫妻获得护理的障碍。帮助夫妻克服创伤后应激障碍并提高满意度(HOPES)是一种基于互联网的创伤后应激障碍夫妻辅导干预方法,它改编自认知行为联合疗法,这是一种以证据为基础的创伤后应激障碍夫妻疗法。这项试点研究在退伍军人事务(VA)医疗中心的环境中,以 15 名患有创伤后应激障碍的美国退伍军人及其恋爱伴侣为样本,考察了 "情侣希望 "疗法的实施可行性、可接受性和初步疗效。退伍军人的创伤后应激障碍症状(自我报告和伴侣报告)以及退伍军人和伴侣的关系满意度都有了明显改善,尽管效应大小很小(所有 g 均小于 0.40)。重要的是,73% 的保留率和参与者在评估后的反馈表明,这种在线调整可以帮助夫妻克服获得护理的障碍。从更广泛的意义上讲,这项试点研究有助于回答退伍军人事务部系统内创伤后应激障碍持续护理中数字健康干预措施的定位问题。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
{"title":"A pilot of couple HOPES within the U.S. Veterans Affairs Healthcare System: PTSD and relationship outcomes in veteran couples.","authors":"Leslie A Morland, Tamara Wachsman, Katelyn Webster, Skye Fitzpatrick, Robert Valela, Alexander O Crenshaw, Candice M Monson, Kayla C Knopp","doi":"10.1037/ser0000773","DOIUrl":"10.1037/ser0000773","url":null,"abstract":"<p><p>Conjoint interventions for posttraumatic stress disorder (PTSD) offer an opportunity to target symptoms' broader social impact, including couples' relationship satisfaction. Technology-assisted interventions may help overcome access to care barriers for couples. Couple Helping Overcome PTSD and Enhance Satisfaction (HOPES) is a coached internet-based couples' intervention for PTSD adapted from cognitive behavioral conjoint therapy, an evidence-based dyadic therapy for PTSD. This pilot study examined the implementation feasibility, acceptability, and preliminary efficacy of Couple HOPES in a sample of 15 United States veterans with PTSD and their romantic partners within a Veterans Affairs (VA) Medical Center setting. There were significant improvements in veterans' PTSD symptoms (self- and partner-reported) and both veterans' and partners' relationship satisfaction, though the effect sizes were small (all <i>g</i>'s < .40). Importantly, the 73% retention rate and participant feedback at postassessment suggest this online adaptation may help couples overcome barriers to accessing care. More broadly, this pilot study helps answer questions regarding where digital health interventions fit into the continuum of PTSD care within the VA system. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10037589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01Epub Date: 2024-05-23DOI: 10.1037/ser0000872
Hannah M Bashian, Jennifer S Daks, Lola Baird, Hannah Heintz, Jennifer Moye, Anica Pless Kaiser
Posttraumatic stress disorder (PTSD) is more prevalent in medically ill older Veterans in Home-Based Primary Care (HBPC) settings than in the general population, raising unique considerations. The aim of this qualitative project was to explore HBPC mental health providers' perceptions of the presentation and treatment of PTSD and trauma-related symptoms in this population of older Veterans, many of whom face additional barriers to treatment due to living in rural settings. Five focus groups and one one-on-one interview were conducted with 23 HBPC mental health providers serving rural or rural/urban mixed communities across the United States. We applied qualitative content analysis to the data. Three themes were found: (1) Presentation of Trauma-Related Symptoms and PTSD in HBPC Population; (2) Treatment Challenges in HBPC; and (3) PTSD Treatment Strategies. Each theme had multiple subthemes which illustrate unique issues in this population. Results of this project contribute to key insights surrounding the unique presentation of PTSD and trauma-related processes and treatment considerations in a medically, cognitively, and psychosocially complex group of veterans. Efforts to improve access to care should consider the specific needs of veterans who are homebound, live in rural settings and identify with rural cultural norms, and have difficulty engaging in specialized PTSD treatment due to the convergence of these factors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
{"title":"Home-based primary care providers' perspectives on the unique challenges of working with late life posttraumatic stress disorder within their population of Veterans.","authors":"Hannah M Bashian, Jennifer S Daks, Lola Baird, Hannah Heintz, Jennifer Moye, Anica Pless Kaiser","doi":"10.1037/ser0000872","DOIUrl":"10.1037/ser0000872","url":null,"abstract":"<p><p>Posttraumatic stress disorder (PTSD) is more prevalent in medically ill older Veterans in Home-Based Primary Care (HBPC) settings than in the general population, raising unique considerations. The aim of this qualitative project was to explore HBPC mental health providers' perceptions of the presentation and treatment of PTSD and trauma-related symptoms in this population of older Veterans, many of whom face additional barriers to treatment due to living in rural settings. Five focus groups and one one-on-one interview were conducted with 23 HBPC mental health providers serving rural or rural/urban mixed communities across the United States. We applied qualitative content analysis to the data. Three themes were found: (1) Presentation of Trauma-Related Symptoms and PTSD in HBPC Population; (2) Treatment Challenges in HBPC; and (3) PTSD Treatment Strategies. Each theme had multiple subthemes which illustrate unique issues in this population. Results of this project contribute to key insights surrounding the unique presentation of PTSD and trauma-related processes and treatment considerations in a medically, cognitively, and psychosocially complex group of veterans. Efforts to improve access to care should consider the specific needs of veterans who are homebound, live in rural settings and identify with rural cultural norms, and have difficulty engaging in specialized PTSD treatment due to the convergence of these factors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01Epub Date: 2023-10-12DOI: 10.1037/ser0000805
Omeid Heidari, Hridika Shah, Atharva Bhagwat, N Jia Ahmad, Sara Whaley, Susan G Sherman, Miles Morris, Brendan Saloner
Harm reduction and opioid treatment programs (OTPs) modified service delivery based on rapid changes to state and federal regulations during the COVID-19 pandemic. There is little evidence on how these regulations changed the delivery of medication for opioid use disorder and harm reduction services and whether certain regulations should be made permanent. This study explores how harm reduction OTPs across the United States leveraged changes in regulations and responded to impacts of COVID-19 to continue providing services and perspectives on future legislation that regulates their practice and practice sites. The COVID Harm Reduction and Treatment programs Survey study administered a survey that included closed-ended and free-response questions to 22 sites between August 2020 and January 2021. Program demographics and responses to survey items pertaining to site and service modifications were tabulated and proportions reported. A qualitative descriptive method was used to analyze free-response questions. All (100%) surveyed providers reported the need to modify their services. The majority (68%) reported an increase or no change in client volume; 68% reported increases in naloxone services and 77% reported increases in syringe services programs. Qualitative themes included (a) flexibility in reaching clients due to regulatory changes, (b) benefits and drawbacks of telehealth, and (c) increased vulnerabilities of their clients during the pandemic. Despite difficulties during the COVID-19 pandemic, harm reduction and OTP sites found that regulatory changes provided flexibility in service delivery and that they were better able to serve their clients. Future policies should bolster these sites to continue to provide low-barrier and high-quality services. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
{"title":"Changes in opioid treatment programs and harm reduction provider services during the COVID-19 pandemic: Findings from 10 states.","authors":"Omeid Heidari, Hridika Shah, Atharva Bhagwat, N Jia Ahmad, Sara Whaley, Susan G Sherman, Miles Morris, Brendan Saloner","doi":"10.1037/ser0000805","DOIUrl":"10.1037/ser0000805","url":null,"abstract":"<p><p>Harm reduction and opioid treatment programs (OTPs) modified service delivery based on rapid changes to state and federal regulations during the COVID-19 pandemic. There is little evidence on how these regulations changed the delivery of medication for opioid use disorder and harm reduction services and whether certain regulations should be made permanent. This study explores how harm reduction OTPs across the United States leveraged changes in regulations and responded to impacts of COVID-19 to continue providing services and perspectives on future legislation that regulates their practice and practice sites. The COVID Harm Reduction and Treatment programs Survey study administered a survey that included closed-ended and free-response questions to 22 sites between August 2020 and January 2021. Program demographics and responses to survey items pertaining to site and service modifications were tabulated and proportions reported. A qualitative descriptive method was used to analyze free-response questions. All (100%) surveyed providers reported the need to modify their services. The majority (68%) reported an increase or no change in client volume; 68% reported increases in naloxone services and 77% reported increases in syringe services programs. Qualitative themes included (a) flexibility in reaching clients due to regulatory changes, (b) benefits and drawbacks of telehealth, and (c) increased vulnerabilities of their clients during the pandemic. Despite difficulties during the COVID-19 pandemic, harm reduction and OTP sites found that regulatory changes provided flexibility in service delivery and that they were better able to serve their clients. Future policies should bolster these sites to continue to provide low-barrier and high-quality services. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11009379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41210624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01Epub Date: 2023-08-21DOI: 10.1037/ser0000797
Allison R Warren, Mark R Relyea, Georgina M Gross, Jacob R Eleazer, Joseph L Goulet, Cynthia A Brandt, Sally G Haskell, Galina A Portnoy
The present study describes intimate partner violence (IPV) perpetration and victimization alongside theoretically associated variables in a sample of lesbian, gay, and bisexual veterans. We conducted bivariate analyses (chi-square tests and independent t test) to examine whether the frequencies of IPV perpetration and victimization varied by demographic characteristics, military sexual trauma, alcohol use, and mental health symptoms. Out of the 69 lesbian, gay, and bisexual (LGB) veterans who answered the questions on IPV, 16 (23.2%) reported some form of IPV victimization in the past year, and 38 (55.1%) reported past-year perpetration. Among the 43 veterans who reported psychological IPV, roughly half (48.9%) reported bidirectional psychological IPV, 39.5% reported perpetration only, and 11.6% reported victimization only. LGB veterans who reported bidirectional psychological IPV in their relationships were younger and reported greater symptoms of posttraumatic stress disorder symptoms and depression. The results presented here call for universal screening of IPV perpetration and victimization to both accurately assess and ultimately intervene among all veterans. Inclusive interventions are needed for all genders and sexual orientations, specifically interventions that do not adhere to gendered assumptions of perpetrators and victims. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
{"title":"Intimate partner violence among lesbian, gay, and bisexual veterans.","authors":"Allison R Warren, Mark R Relyea, Georgina M Gross, Jacob R Eleazer, Joseph L Goulet, Cynthia A Brandt, Sally G Haskell, Galina A Portnoy","doi":"10.1037/ser0000797","DOIUrl":"10.1037/ser0000797","url":null,"abstract":"<p><p>The present study describes intimate partner violence (IPV) perpetration and victimization alongside theoretically associated variables in a sample of lesbian, gay, and bisexual veterans. We conducted bivariate analyses (chi-square tests and independent t test) to examine whether the frequencies of IPV perpetration and victimization varied by demographic characteristics, military sexual trauma, alcohol use, and mental health symptoms. Out of the 69 lesbian, gay, and bisexual (LGB) veterans who answered the questions on IPV, 16 (23.2%) reported some form of IPV victimization in the past year, and 38 (55.1%) reported past-year perpetration. Among the 43 veterans who reported psychological IPV, roughly half (48.9%) reported bidirectional psychological IPV, 39.5% reported perpetration only, and 11.6% reported victimization only. LGB veterans who reported bidirectional psychological IPV in their relationships were younger and reported greater symptoms of posttraumatic stress disorder symptoms and depression. The results presented here call for universal screening of IPV perpetration and victimization to both accurately assess and ultimately intervene among all veterans. Inclusive interventions are needed for all genders and sexual orientations, specifically interventions that do not adhere to gendered assumptions of perpetrators and victims. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10879444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10032498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01Epub Date: 2023-11-02DOI: 10.1037/ser0000806
Beth K Jaworski, Kelly M Ramsey, Katherine Taylor, Adrienne J Heinz, Sarah Senti, Margaret-Anne Mackintosh, Craig S Rosen, Jason E Owen, Robert H Pietrzak
U.S. veterans have historically experienced more mental health concerns as compared to the general population, yet face a variety of barriers to accessing care. Evidence-based and accessible resources, such as mobile apps, are needed to respond to the unique needs of a diverse veteran population. The U.S. Department of Veterans Affairs (VA's) National Center for Posttraumatic Stress Disorder has created a one-of-a-kind portfolio of mental health apps to target the needs of veterans and support the self-management of common concerns related to posttraumatic stress disorder. Using data from a nationally representative sample of U.S. veterans, the present study sought to examine how veterans perceived the importance of making each self-management app available to other Veterans; factors impacting veterans' intent to try each app; and actual uptake of each app. Results revealed that while 46.7%-75.0% of veterans reported that the apps are important for veterans, 5.8%-19.2% reported that they would be likely to download the apps, and only 5.0% reported having ever used any of them. Veterans who used any of the apps were more likely to be employed, have served two or more deployments, be married or partnered, use the VA as their primary source of health care, had more medical conditions, and were less likely to identify as Black. With respect to future app use, Black veterans were to 2-5 times more likely than White veterans to indicate a desire to download each of the apps. Other variables that showed consistent associations with increased likelihood of app download included greater smartphone utilization, being married or having a partner, lower household income, and history of mental health treatment. Implications of these results for the broader dissemination of mental health apps and promotion of their uptake are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
{"title":"Mental health apps and U.S. military veterans: Perceived importance and utilization of the National Center for Posttraumatic Stress Disorder app portfolio.","authors":"Beth K Jaworski, Kelly M Ramsey, Katherine Taylor, Adrienne J Heinz, Sarah Senti, Margaret-Anne Mackintosh, Craig S Rosen, Jason E Owen, Robert H Pietrzak","doi":"10.1037/ser0000806","DOIUrl":"10.1037/ser0000806","url":null,"abstract":"<p><p>U.S. veterans have historically experienced more mental health concerns as compared to the general population, yet face a variety of barriers to accessing care. Evidence-based and accessible resources, such as mobile apps, are needed to respond to the unique needs of a diverse veteran population. The U.S. Department of Veterans Affairs (VA's) National Center for Posttraumatic Stress Disorder has created a one-of-a-kind portfolio of mental health apps to target the needs of veterans and support the self-management of common concerns related to posttraumatic stress disorder. Using data from a nationally representative sample of U.S. veterans, the present study sought to examine how veterans perceived the importance of making each self-management app available to other Veterans; factors impacting veterans' intent to try each app; and actual uptake of each app. Results revealed that while 46.7%-75.0% of veterans reported that the apps are important for veterans, 5.8%-19.2% reported that they would be likely to download the apps, and only 5.0% reported having ever used any of them. Veterans who used any of the apps were more likely to be employed, have served two or more deployments, be married or partnered, use the VA as their primary source of health care, had more medical conditions, and were less likely to identify as Black. With respect to future app use, Black veterans were to 2-5 times more likely than White veterans to indicate a desire to download each of the apps. Other variables that showed consistent associations with increased likelihood of app download included greater smartphone utilization, being married or having a partner, lower household income, and history of mental health treatment. Implications of these results for the broader dissemination of mental health apps and promotion of their uptake are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71426305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}