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Receptivity to Alcohol-Related Care among US Women Veterans with Alcohol Misuse.

Receptivity to Alcohol-Related Care among US Women Veterans with Alcohol Misuse.

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Receptivity to Alcohol-Related Care among US Women Veterans with Alcohol Misuse.

J Addict Dis. 2016 Apr 6;:0

Authors: Lewis ET, Jamison AL, Ghaus S, Durazo EM, Frayne SM, Hoggatt KJ, Bean-Mayberry B, Timko C, Cucciare MA

Abstract

BACKGROUND: Previous research indicates women Veterans have a potentially large, unmet need for alcohol-related care but are under-represented in treatment settings.

OBJECTIVE: This study’s purpose was to identify factors associated with women Veterans’ receptivity to a recommendation for alcohol-related care when they present to Veterans Affairs (VA) primary care with alcohol misuse.

METHODS: Semi-structured interviews were conducted in 2012-2013 with 30 women Veterans at two VA facilities who screened positive for alcohol misuse during a primary care visit and discussed their alcohol use with their primary care provider. Qualitative analyses identified nine themes women used to describe what affected their receptivity to a recommendation for alcohol-related care (i.e., VA specialty substance use disorder services).

RESULTS: The most common themes positively associated with women’s receptivity included self-appraisal of their drinking behavior as more severe; the provider’s presentation of treatment options; availability of gender-specific services; and worse physical and mental health.

DISCUSSION: The themes identified here may have important implications for the clinical strategies providers can use to present alcohol-related care options to women Veterans to facilitate their use of care. These strategies include educating women about the health effects of alcohol misuse and increasing providers’ knowledge about available care options (within the care organization or the community), including the availability of gender-specific services.

PMID: 27049338 [PubMed – as supplied by publisher]

Late-life exacerbation of PTSD symptoms in US veterans: results from the National Health and Resilience in Veterans Study.

Late-life exacerbation of PTSD symptoms in US veterans: results from the National Health and Resilience in Veterans Study.

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Late-life exacerbation of PTSD symptoms in US veterans: results from the National Health and Resilience in Veterans Study.

J Clin Psychiatry. 2016 Mar;77(3):348-54

Authors: Mota N, Tsai J, Kirwin PD, Harpaz-Rotem I, Krystal JH, Southwick SM, Pietrzak RH

Abstract

OBJECTIVE: More than 60% of US military veterans are 55 years or older. Although several case studies have suggested that older age is associated with a higher likelihood of reactivated or delayed-onset posttraumatic stress disorder (PTSD) symptoms in veterans, population-based data on the prevalence and determinants of this phenomenon are lacking.

METHOD: Using data from the National Health and Resilience in Veterans Study (NHRVS: Wave 1 = October 2011-December 2011; Wave 2 = September 2013), a nationally representative, cohort study of US veterans, we evaluated the prevalence and determinants of exacerbated PTSD symptoms in 1,441 veterans 55 years or older using a DSM-IV-based measure in 2011 and a DSM-5-based measure in 2013. Veterans whose worst trauma occurred at least 5 years prior to Wave 2 of the NHRVS (mean = 28.6 years) and who reported a clinically significant increase (ie, ≥ 0.5 standard deviation [SD]; mean = 1.27, SD = 0.78) in PTSD symptoms from Wave 1 (lifetime) to Wave 2 (past-month) were identified as having exacerbated PTSD symptoms.

RESULTS: Results revealed that 9.9% of older US veterans experienced exacerbated PTSD symptoms an average of nearly 3 decades after their worst trauma. A multivariable logistic regression model indicated that greater self-reported cognitive difficulties at Wave 1 independently predicted exacerbated PTSD symptoms at Wave 2. Post hoc analysis revealed that this association was driven by greater severity of executive dysfunction (adjusted odds ratio range, 1.27-3.22).

CONCLUSIONS: Approximately 1 in 10 older US veterans experiences a clinically significant exacerbation of PTSD symptoms in late life. Executive dysfunction may contribute to risk for exacerbated PTSD symptoms. These results suggest that exacerbated PTSD symptoms are prevalent in US veterans and highlight potential targets for identifying veterans at risk for this phenomenon.

PMID: 27046308 [PubMed – in process]

Comparison of Blast-Exposed OEF/OIF Veterans with and without a History of TBI Symptoms on a Brief Computerized Neuropsychological Battery.

Comparison of Blast-Exposed OEF/OIF Veterans with and without a History of TBI Symptoms on a Brief Computerized Neuropsychological Battery.

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Comparison of Blast-Exposed OEF/OIF Veterans with and without a History of TBI Symptoms on a Brief Computerized Neuropsychological Battery.

Appl Neuropsychol Adult. 2016 Apr 4;:1-6

Authors: Kalkstein S, Scott JC, Biester R, Brownlow JA, Harpaz-Rotem I, Gur RC

Abstract

Mild traumatic brain injuries (mild TBIs) resulting from exposure to Improvised Explosive Devices (IEDs) are highly prevalent among veterans of the wars in Iraq and Afghanistan. This exploratory study compared the neurocognitive performance of blast-exposed veterans with (n = 19) and without (n = 15) reported symptoms of mild TBI. All subjects had diagnoses of posttraumatic stress disorder (PTSD). Neurocognitive testing was administered using a well-established computerized battery, the Penn Computerized Neuropsychological Battery (CNB), and groups were well matched on age, race, education, and time since most recent blast exposure. Although differences were not observed on CNB accuracy scores, MANOVAs revealed slower processing speed in the mTBI group when answering correctly on tests of simple and sustained attention, with large effect sizes. Results suggest a potential speed-accuracy tradeoff in blast-related mild TBI, which should be further examined in larger samples.

PMID: 27045712 [PubMed – as supplied by publisher]

Influence of Mild Traumatic Brain Injury (TBI) and Posttraumatic Stress Disorder (PTSD) on Pain Intensity Levels in OEF/OIF/OND Veterans.

Influence of Mild Traumatic Brain Injury (TBI) and Posttraumatic Stress Disorder (PTSD) on Pain Intensity Levels in OEF/OIF/OND Veterans.

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Influence of Mild Traumatic Brain Injury (TBI) and Posttraumatic Stress Disorder (PTSD) on Pain Intensity Levels in OEF/OIF/OND Veterans.

Pain Med. 2016 Apr 3;

Authors: Stojanovic MP, Fonda J, Fortier CB, Higgins DM, Rudolph JL, Milberg WP, McGlinchey RE

Abstract

OBJECTIVE: Mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) are common among US veterans of Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND). We postulated that these injuries may modulate pain processing in these individuals and affect their subjective pain levels.

DESIGN: Cross-sectional.

SUBJECTS: 310 deployed service members of OEF/OIF/OND without a lifetime history of moderate or severe TBI were included in this study.

METHODS: All participants completed a comprehensive evaluation for Blast Exposure, mTBI, PTSD, and Pain Levels. The Boston Assessment of TBI-Lifetime Version (BAT-L) was used to assess blast exposure and potential brain injury during military service. The Clinician-Administered PTSD Scale (CAPS) characterized presence and severity of PTSD. The Visual Analog Scale (VAS) was used to assess pain intensity over the previous month before the interview, with higher scores indicative of worse pain. Statistical analysis was performed by ANOVA and results were adjusted for co-morbidities, clinical characteristics and demographic data.

RESULTS: In comparison to control participants (veterans without mTBI or current PTSD), veterans with both current PTSD and mTBI reported the highest pain intensity levels, followed by veterans with PTSD only (P < 0.0001 andP = 0.0005, respectively). Pain levels in veterans with mTBI only were comparable to control participants.

CONCLUSIONS: Comorbid PTSD and mTBI is associated with increased self-reported pain intensity. mTBI alone was not associated with increased pain.

PMID: 27040665 [PubMed – as supplied by publisher]

EPIGENETIC VARIATION AT SKA2 PREDICTS SUICIDE PHENOTYPES AND INTERNALIZING PSYCHOPATHOLOGY.

EPIGENETIC VARIATION AT SKA2 PREDICTS SUICIDE PHENOTYPES AND INTERNALIZING PSYCHOPATHOLOGY.

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EPIGENETIC VARIATION AT SKA2 PREDICTS SUICIDE PHENOTYPES AND INTERNALIZING PSYCHOPATHOLOGY.

Depress Anxiety. 2016 Apr;33(4):308-15

Authors: Sadeh N, Wolf EJ, Logue MW, Hayes JP, Stone A, Griffin LM, Schichman SA, Miller MW

Abstract

BACKGROUND: DNA methylation of the SKA2 gene has recently been implicated as a biomarker of suicide risk and posttraumatic stress disorder (PTSD). To examine the specificity and reliability of these findings, we examined associations between SKA2 DNA methylation, broad dimensions of psychiatric symptoms, and suicide phenotypes in adults with high levels of trauma exposure.

METHODS: A total of 466 White, non-Hispanic veterans and their intimate partners (65% male) underwent clinical assessment and had blood drawn for genotyping and methylation analysis. DNA methylation of the CpG locus cg13989295 and genotype at the methylation-associated single-nucleotide polymorphism (SNP) rs7208505 were examined in relation to current and lifetime PTSD, internalizing and externalizing psychopathology, and suicide phenotypes (ideation, plans, and attempts).

RESULTS: DNA methylation at the previously implicated SKA2 CpG locus (cg13989295) was associated with current and lifetime symptoms of internalizing (but not externalizing) disorders. SKA2 methylation levels also predicted higher rates of current suicidal thoughts and behaviors, even after including well-established psychiatric risk factors for suicide in the model. Associations between PTSD and SKA2 were not significant, and genetic variation at the methylation-associated SNP (rs7208505) was not related to any of the phenotypes examined.

CONCLUSIONS: SKA2 methylation may index a general propensity to experience stress-related psychopathology, including internalizing disorders and suicidal thoughts and behaviors. This study demonstrates that SKA2 methylation levels explain unique variance in suicide risk not captured by clinical symptom interviews, providing further evidence of its potential utility as a biomarker of suicide risk and stress-related psychopathology.

PMID: 27038412 [PubMed – in process]