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Article ; Online: If it's offered, will they come? Practical considerations when offering intensive PTSD treatment in an outpatient Veterans Affairs PTSD clinic.

Sciarrino, Nicole A / Myers, Ursula S

2023 Volume 87, Issue 1, Page(s) 46–62

Abstract: Evidence-based psychotherapies (EBPs) for posttraumatic stress disorder (PTSD) are efficacious; however, treatment dropout remains high. The delivery of intensive EBPs for PTSD (i.e., sessions three times per week or more) and telemental health may ... ...

Abstract	Evidence-based psychotherapies (EBPs) for posttraumatic stress disorder (PTSD) are efficacious; however, treatment dropout remains high. The delivery of intensive EBPs for PTSD (i.e., sessions three times per week or more) and telemental health may address barriers impacting dropout. Current evidence for intensive EBPs comes primarily from programs specifically designed for this level of care. Therefore, the feasibility of delivering intensive EBPs for PTSD in traditional outpatient clinics remains unclear. The aim of this pilot study was to identify veteran level of interest in intensive treatment and explore the feasibility of delivering intensive treatment via telemental health in an outpatient PTSD clinic at a Veterans Affairs (VA) hospital. One provider offered intensive treatment to 14 veterans. Three of the veterans initiated intensive treatment and completed with benefit. Veteranand system-level barriers, as well as veteran preferences for initiating intensive therapy and suggestions for implementing intensive EBPs in a routine outpatient clinic, are discussed.
MeSH term(s)	United States ; Humans ; Stress Disorders, Post-Traumatic ; Veterans ; Outpatients ; Pilot Projects ; Ambulatory Care Facilities
Language	English
Publishing date	2023-03-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	390416-7
ISSN	1943-2828 ; 0025-9284
ISSN (online)	1943-2828
ISSN	0025-9284
DOI	10.1521/bumc.2023.87.1.46
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Article ; Online: Psychiatric medication prescriptions increasing for college students above and beyond the COVID-19 pandemic.

Marconi, Agustina M / Myers, Ursula S / Hanson, Bjorn / Nolan, Sarah / Sarrouf, Elena Beatriz

Scientific reports

2023 Volume 13, Issue 1, Page(s) 19063

Abstract: Psychiatric medication prescriptions for college students have been rising since 2007, with approximately 17% of college students prescribed medication for a mental health issue. This increase mirrors overall increases in both mental health diagnoses and ...

Abstract	Psychiatric medication prescriptions for college students have been rising since 2007, with approximately 17% of college students prescribed medication for a mental health issue. This increase mirrors overall increases in both mental health diagnoses and treatment of university students. As psychiatric medication prescriptions for college students were increasing prior to pandemic, the goal of this study was to compare these prescriptions over the years, while accounting for the added stressor of the COVID-19 pandemic. This study utilized cross-sectional, retrospective data from a cohort of college students receiving care from the university's health service. We examined prescriptions for mental healthcare from 2015 to 2021. There was a significant increase in the percentage of psychiatric medication prescriptions in 2020 (baseline 15.8%; threshold 3.5%) and 2021 (baseline 41.3%; threshold 26.3%) compared to the historical baseline average for the whole sample and as well as for female students (2020 baseline 21.3% and threshold 4.6%; 2021 baseline 55.1% and threshold 33.7%). Within these years, we found higher trends for prescriptions in April-May as well as September-December. Overall, we found that psychiatric medication prescriptions have continued to rise through the years, with a large increase occurring during the pandemic. In addition, we found that these increases reflect the academic year, which is important for university health centers to consider when they are planning to staff clinics and plan the best way to treat college students with mental health difficulties in the future.
MeSH term(s)	Humans ; Female ; COVID-19/epidemiology ; Pandemics ; Retrospective Studies ; Cross-Sectional Studies ; Drug Prescriptions ; Students/psychology
Language	English
Publishing date	2023-11-04
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-023-46303-9
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Article ; Online: Atomoxetine in comorbid ADHD/PTSD: A randomized, placebo controlled, pilot, and feasibility study.

Wang, Zhewu / Zuschlag, Zachary D / Myers, Ursula S / Hamner, Mark

Depression and anxiety

2022 Volume 39, Issue 4, Page(s) 286–295

Abstract: ... by the Conners' Adult ADHD Rating Scales-Self-Report: Short Version (CAARS-S:S), the Barkley Adult ADHD Rating ... reductions in ADHD symptoms as defined by total scores on the CAARS-S:S (F: Conclusions: In Veterans ...

Abstract	Background: PTSD and ADHD often occur comorbidly. Research indicates that the cognitive deficits in PTSD may be related to the same disturbance of fronto-temporal systems as observed in ADHD, and ADHD has been shown to impact PTSD treatment outcomes. The presented study evaluated the safety and efficacy of atomoxetine in Veterans with comorbid ADHD/PTSD. Methods: A double blind, randomized, placebo controlled, cross-over pilot and feasibility study was conducted. Atomoxetine was examined as an adjunctive treatment over this 10 weeks, two phase, crossover study which compared treatment with atomoxetine 80 mg daily to placebo daily. The primary outcome was improvement in ADHD symptoms as measured by the Conners' Adult ADHD Rating Scales-Self-Report: Short Version (CAARS-S:S), the Barkley Adult ADHD Rating Scale-IV (BAARS-IV), and the Adult ADHD Quality of Life-29 (AAQoL-29). Secondary outcomes included the Clinician Administered PTSD Scale (CAPS), Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and the response inhibition task Go/NoGo (GNG). Results: Atomoxetine treated patients had greater reductions in ADHD symptoms as defined by total scores on the CAARS-S:S (F Conclusions: In Veterans with ADHD comorbid with PTSD, atomoxetine demonstrated modest efficacy for ADHD symptoms; quality of life measures and PTSD symptoms were not affected.
MeSH term(s)	Adrenergic Uptake Inhibitors/adverse effects ; Adult ; Atomoxetine Hydrochloride/therapeutic use ; Attention Deficit Disorder with Hyperactivity/drug therapy ; Attention Deficit Disorder with Hyperactivity/epidemiology ; Cross-Over Studies ; Double-Blind Method ; Feasibility Studies ; Humans ; Propylamines/adverse effects ; Quality of Life ; Stress Disorders, Post-Traumatic/drug therapy ; Stress Disorders, Post-Traumatic/epidemiology ; Treatment Outcome
Chemical Substances	Adrenergic Uptake Inhibitors ; Propylamines ; Atomoxetine Hydrochloride (57WVB6I2W0)
Language	English
Publishing date	2022-03-21
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	1378635-0
ISSN	1520-6394 ; 1091-4269
ISSN (online)	1520-6394
ISSN	1091-4269
DOI	10.1002/da.23248
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Article ; Online: Reduced working memory performance in PTSD and suicide among veterans presenting for treatment.

Albanese, Brian J / Myers, Ursula S / Fox, Hailey / Wangelin, Bethany C

Journal of psychiatric research

2022 Volume 156, Page(s) 299–307

Abstract: Suicide is among the leading causes of death in the United States, underscoring the continued need to understand the mechanisms underlying suicide risk. A growing body of research has examined the role of working memory deficits in suicidal thoughts and ... ...

Abstract	Suicide is among the leading causes of death in the United States, underscoring the continued need to understand the mechanisms underlying suicide risk. A growing body of research has examined the role of working memory deficits in suicidal thoughts and behaviors (STBs), yet little research has evaluated putative pathways via which working memory impairments may heighten suicide risk. Elevated posttraumatic stress symptoms (PTSS) represent one plausible mechanism through which poor working memory performance may increase STBs. The present study utilized data from 140 treatment-seeking veterans who presented for an intake evaluation in the PTSD Clinical Team of a large VA Medical Center. Veterans completed self-report measures, a semi-structured PTSD evaluation, and a digit span working memory test. In addition to concurrent suicidal ideation assessed during the intake, additional information regarding past suicide attempts, presence of a safety plan, documentation of past suicidal behaviors, and engagement with suicide crisis lines were collected via electronic medical records. Consistent with hypotheses, a significant indirect path emerged such that poor working memory performance predicted greater suicidal ideation, greater likelihood of a past suicide attempt, and greater latent suicide risk via increased PTSS. However, no direct effect of working memory on STBs or indirect paths of PTSS on STBs via working memory emerged. These findings suggest that the relation between working memory and STBs may be explained by PTSS severity.
Language	English
Publishing date	2022-10-20
Publishing country	England
Document type	Journal Article
ZDB-ID	3148-3
ISSN	1879-1379 ; 0022-3956
ISSN (online)	1879-1379
ISSN	0022-3956
DOI	10.1016/j.jpsychires.2022.10.043
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Article ; Online: Psychiatric medication prescriptions increasing for college students above and beyond the COVID-19 pandemic

Agustina M. Marconi / Ursula S. Myers / Bjorn Hanson / Sarah Nolan / Elena Beatriz Sarrouf

Scientific Reports, Vol 13, Iss 1, Pp 1-

2023 Volume 9

Abstract: ... receiving care from the university’s health service. We examined prescriptions for mental healthcare ...

Abstract	Abstract Psychiatric medication prescriptions for college students have been rising since 2007, with approximately 17% of college students prescribed medication for a mental health issue. This increase mirrors overall increases in both mental health diagnoses and treatment of university students. As psychiatric medication prescriptions for college students were increasing prior to pandemic, the goal of this study was to compare these prescriptions over the years, while accounting for the added stressor of the COVID-19 pandemic. This study utilized cross-sectional, retrospective data from a cohort of college students receiving care from the university’s health service. We examined prescriptions for mental healthcare from 2015 to 2021. There was a significant increase in the percentage of psychiatric medication prescriptions in 2020 (baseline 15.8%; threshold 3.5%) and 2021 (baseline 41.3%; threshold 26.3%) compared to the historical baseline average for the whole sample and as well as for female students (2020 baseline 21.3% and threshold 4.6%; 2021 baseline 55.1% and threshold 33.7%). Within these years, we found higher trends for prescriptions in April–May as well as September–December. Overall, we found that psychiatric medication prescriptions have continued to rise through the years, with a large increase occurring during the pandemic. In addition, we found that these increases reflect the academic year, which is important for university health centers to consider when they are planning to staff clinics and plan the best way to treat college students with mental health difficulties in the future.
Keywords	Medicine ; R ; Science ; Q
Subject code	796
Language	English
Publishing date	2023-11-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: When chaos is the norm: How some veterans with PTSD are continuing to engage in trauma-focused treatments during the COVID-19 pandemic.

Sciarrino, Nicole A / Myers, Ursula S / Wangelin, Bethany C

Psychological trauma : theory, research, practice and policy

2020 Volume 12, Issue S1, Page(s) S69–S70

Abstract: The COVID-19 pandemic has caused many Veterans Healthcare Administration providers working with veterans diagnosed with posttraumatic stress disorder to question the feasibility and appropriateness of continuing to provide trauma-focused treatment during ...

Abstract	The COVID-19 pandemic has caused many Veterans Healthcare Administration providers working with veterans diagnosed with posttraumatic stress disorder to question the feasibility and appropriateness of continuing to provide trauma-focused treatment during this crisis. The Veterans Healthcare Administration is in a unique position to continue to provide trauma-informed care because of its capacity to offer telemental health services. Data from a Veterans Affairs medical center's posttraumatic stress disorder clinical team suggest that not only are veterans interested in continuing with treatment but also that the treatments can be modified to accommodate the current climate. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
MeSH term(s)	Adult ; COVID-19 ; Coronavirus Infections ; Humans ; Male ; Mental Health Services ; Middle Aged ; Pandemics ; Pneumonia, Viral ; Psychological Trauma/therapy ; Stress Disorders, Post-Traumatic/therapy ; Telemedicine ; United States ; United States Department of Veterans Affairs ; Veterans
Keywords	covid19
Language	English
Publishing date	2020-05-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	2497028-1
ISSN	1942-969X ; 1942-9681
ISSN (online)	1942-969X
ISSN	1942-9681
DOI	10.1037/tra0000718
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Article ; Online: A protocol for a randomized controlled trial of exposure and response prevention for veterans with obsessive compulsive disorder.

Ponzini, Gabriella T / Hundt, Natalie E / Christie, Israel C / Chen, Patricia V / Ecker, Anthony H / Lindsay, Jan A / Teng, Ellen J / Storch, Eric A / Myers, Ursula S / Roussev, Milena S / Fletcher, Terri L

Contemporary clinical trials

2024 Volume 138, Page(s) 107445

Abstract: Background: Obsessive compulsive disorder (OCD) is effectively treated with exposure and response prevention (ERP), yet very few veterans receive ERP for OCD within the Veterans Health Administration (VHA). Veterans are a clinically complex population, ... ...

Abstract	Background: Obsessive compulsive disorder (OCD) is effectively treated with exposure and response prevention (ERP), yet very few veterans receive ERP for OCD within the Veterans Health Administration (VHA). Veterans are a clinically complex population, and no prior research has evaluated the effectiveness of ERP in veterans with OCD or comorbid OCD and posttraumatic stress disorder (PTSD). Given the limited accessibility of ERP-trained providers within VHA, assessment of video telehealth (VTH) delivery of ERP is warranted. Methods: A sample of 160 veterans with OCD (80 diagnosed with comorbid PTSD) will be randomly assigned to receive up to 16 sessions of ERP or a stress management training control delivered via VTH. Assessments will occur at baseline, posttreatment, and 6-month follow-up. The primary outcome will evaluate the impact of ERP on participants' functioning, and secondary outcomes will include quality of life and OCD symptoms. At posttreatment, qualitative interviews with veterans, clinicians, and administrators will explore barriers and facilitators to treatment delivery, and the implementation potential of ERP. Conclusions: Results will provide direction for the treatment of OCD and comorbid PTSD in veterans, as well as guidance for future implementation efforts for ERP within VHA. Clinicaltrials: gov Identifier:NCT05240924.
MeSH term(s)	Humans ; Implosive Therapy/methods ; Veterans ; Quality of Life ; Obsessive-Compulsive Disorder/epidemiology ; Obsessive-Compulsive Disorder/therapy ; Treatment Outcome ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2024-01-17
Publishing country	United States
Document type	Clinical Trial Protocol ; Journal Article
ZDB-ID	2182176-8
ISSN	1559-2030 ; 1551-7144
ISSN (online)	1559-2030
ISSN	1551-7144
DOI	10.1016/j.cct.2024.107445
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Article ; Online: Flattening the Curve by Getting Ahead of It: How the VA Healthcare System Is Leveraging Telehealth to Provide Continued Access to Care for Rural Veterans.

Myers, Ursula S / Birks, Anna / Grubaugh, Anouk L / Axon, R Neal

The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association

2020 Volume 37, Issue 1, Page(s) 194–196

MeSH term(s)	COVID-19/epidemiology ; Health Services Accessibility/organization & administration ; Humans ; Pandemics ; Rural Health Services/organization & administration ; SARS-CoV-2 ; Telemedicine/organization & administration ; United States/epidemiology ; United States Department of Veterans Affairs/organization & administration ; Veterans
Keywords	covid19
Language	English
Publishing date	2020-06-01
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639160-6
ISSN	1748-0361 ; 0890-765X
ISSN (online)	1748-0361
ISSN	0890-765X
DOI	10.1111/jrh.12449
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Article ; Online: Meta-Analysis of the Treatment of Posttraumatic Stress Disorder in Adults With Comorbid Severe Mental Illness.

Grubaugh, Anouk L / Brown, Wilson J / Wojtalik, Jessica A / Myers, Ursula S / Eack, Shaun M

The Journal of clinical psychiatry

2021 Volume 82, Issue 3

Abstract: Objective:: Data Sources:: Study Selection:: Data Extraction:: Results:: Conclusions: ...

Abstract	Objective: Data Sources: Study Selection: Data Extraction: Results: Conclusions:
MeSH term(s)	Bipolar Disorder/epidemiology ; Bipolar Disorder/therapy ; Comorbidity ; Depressive Disorder, Major/epidemiology ; Depressive Disorder, Major/therapy ; Eye Movement Desensitization Reprocessing/statistics & numerical data ; Humans ; Implosive Therapy/statistics & numerical data ; Outcome Assessment, Health Care ; Psychotherapy/statistics & numerical data ; Psychotherapy, Brief/statistics & numerical data ; Schizophrenia/epidemiology ; Schizophrenia/therapy ; Stress Disorders, Post-Traumatic/epidemiology ; Stress Disorders, Post-Traumatic/therapy
Language	English
Publishing date	2021-05-25
Publishing country	United States
Document type	Journal Article ; Meta-Analysis
ZDB-ID	716287-x
ISSN	1555-2101 ; 0160-6689
ISSN (online)	1555-2101
ISSN	0160-6689
DOI	10.4088/JCP.20r13584
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Article ; Online: When chaos is the norm

Sciarrino, Nicole A. / Myers, Ursula S. / Wangelin, Bethany C.

Psychological Trauma: Theory, Research, Practice, and Policy

How some veterans with PTSD are continuing to engage in trauma-focused treatments during the COVID-19 pandemic.

2020 Volume 12, Issue S1, Page(s) S69–S70

Keywords	Clinical Psychology ; Social Psychology ; covid19
Language	English
Publisher	American Psychological Association (APA)
Publishing country	us
Document type	Article ; Online
ZDB-ID	2497028-1
ISSN	1942-969X ; 1942-9681
ISSN (online)	1942-969X
ISSN	1942-9681
DOI	10.1037/tra0000718
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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