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Article ; Online: John L. McNulty (1955-2023).

Bryant, William T / Miles, Shannon R / Arbisi, Paul A / Ben-Porath, Yossef S / Harkness, Allan R

2024

Abstract: Dr. John L. McNulty, born on January 25, 1955, in Bartlesville, Oklahoma, passed away on October 31, 2023, in Tulsa, Oklahoma, at the age of 68 years. Ever the pragmatist and always bringing a critical mindset to test use, Dr. McNulty coauthored seminal ... ...

Abstract	Dr. John L. McNulty, born on January 25, 1955, in Bartlesville, Oklahoma, passed away on October 31, 2023, in Tulsa, Oklahoma, at the age of 68 years. Ever the pragmatist and always bringing a critical mindset to test use, Dr. McNulty coauthored seminal articles demonstrating the absence of predictive bias among African Americans. His commitment to diversity more recently focused on contemporary assessment with transgender and gender-diverse individuals. While Dr. McNulty's empirical work advanced the field of personality and psychopathology, his relationships with colleagues and mentees are his most lasting legacy. Dr. McNulty inspired many while he was here, and his memory will inspire many into the future. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Language	English
Publishing date	2024-04-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	209464-2
ISSN	1935-990X ; 0003-066X
ISSN (online)	1935-990X
ISSN	0003-066X
DOI	10.1037/amp0001340
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Article ; Online: Mental Health Pocket Card for Management of Patients with Posttraumatic Stress Disorder and Mild Traumatic Brain Injury.

Johnston-Brooks, Catharine H / Miles, Shannon R / Brostow, Diana P

Archives of physical medicine and rehabilitation

2021 Volume 103, Issue 3, Page(s) 611–615

MeSH term(s)	Brain Concussion ; Brain Injuries/psychology ; Humans ; Mental Health ; Stress Disorders, Post-Traumatic/psychology ; Stress Disorders, Post-Traumatic/therapy ; Veterans/psychology
Language	English
Publishing date	2021-12-23
Publishing country	United States
Document type	Practice Guideline
ZDB-ID	80057-0
ISSN	1532-821X ; 0003-9993
ISSN (online)	1532-821X
ISSN	0003-9993
DOI	10.1016/j.apmr.2021.10.013
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Article ; Online: Putting the pieces together to understand anger in combat veterans and service members: Psychological and physical contributors.

Miles, Shannon R / Martindale, Sarah L / Flanagan, Julianne C / Troyanskaya, Maya / Reljic, Tea / Gilmore, Amanda K / Wyant, Hannah / Nakase-Richardson, Risa

Journal of psychiatric research

2023 Volume 159, Page(s) 57–65

Abstract: Dysregulated anger can result in devastating health and interpersonal consequences for individuals, families, and communities. Compared to civilians, combat veterans and service members (C-V/SM) report higher levels of anger and often have risk factors ... ...

Abstract	Dysregulated anger can result in devastating health and interpersonal consequences for individuals, families, and communities. Compared to civilians, combat veterans and service members (C-V/SM) report higher levels of anger and often have risk factors for anger including posttraumatic stress disorder (PTSD), traumatic brain injury (TBI), pain, alcohol use, and impaired sleep. The current study examined the relative contributions of established variables associated with anger (e.g., combat exposure, current PTSD symptoms, history of TBI, pain interference, and hazardous alcohol use) in 1263 C-V/SM. Sleep impairments, represented by poor sleep quality and obstructive sleep apnea (OSA) risk, were also evaluated as potential mediators of the relationships between established risk factors and anger, and therefore potential modifiable treatment targets. Multiple regression model results revealed that PTSD symptoms (β = 0.517, p < .001), OSA risk (β = 0.057, p = .016), pain interference (β = 0.214, p < .001), and hazardous alcohol use (β = 0.054, p = .009) were significantly associated with anger. Results of the mediation models revealed that OSA risk accounted for the association between PTSD and anger, in addition to the association between pain interference and anger. The current study extends previous literature by simultaneously examining factors associated with anger using a multivariable model in a large sample of C-V/SM. Additionally, treating OSA may be a novel way to reduce anger in C-V/SM who have PTSD and/or pain interference.
MeSH term(s)	Humans ; Veterans/psychology ; Anger ; Stress Disorders, Post-Traumatic/psychology ; Brain Injuries, Traumatic/psychology ; Sleep Apnea, Obstructive ; Pain
Language	English
Publishing date	2023-01-11
Publishing country	England
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	3148-3
ISSN	1879-1379 ; 0022-3956
ISSN (online)	1879-1379
ISSN	0022-3956
DOI	10.1016/j.jpsychires.2023.01.013
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Article ; Online: Exploring the relationship between sleep apnea and vestibular symptoms following traumatic brain injury.

Skop, Karen M / Bajor, Laura / Sevigny, Mitch / Swank, Chad / Tallavajhula, Sudha / Nakase-Richardson, Risa / Miles, Shannon R

PM & R : the journal of injury, function, and rehabilitation

2023 Volume 15, Issue 12, Page(s) 1524–1535

Abstract: Background: Traumatic brain injury (TBI) is a complex health problem in military veterans and service members (V/SM) that often involves comorbid vestibular impairment. Sleep apnea is another comorbidity that may exacerbate, and/or be exacerbated by, ... ...

Abstract	Background: Traumatic brain injury (TBI) is a complex health problem in military veterans and service members (V/SM) that often involves comorbid vestibular impairment. Sleep apnea is another comorbidity that may exacerbate, and/or be exacerbated by, vestibular dysfunction. Objective: To examine the relationship between sleep apnea and vestibular symptoms in V/SM diagnosed with TBI of any severity. Design: Multicenter cohort study; cross-sectional sample. Setting: In-patient TBI rehabilitation units within five Veterans Affairs (VA) Polytrauma Rehabilitation Centers. Participants: V/SM with a diagnosis of TBI (N = 630) enrolled in the VA TBI Model Systems study. Intervention: Not applicable. Methods: A multivariable regression model was used to evaluate the association between sleep apnea and vestibular symptom severity while controlling for relevant covariates, for example, posttraumatic stress disorder (PTSD). Main outcome measures: Lifetime history of sleep apnea was determined via best source reporting. Vestibular disturbances were measured with the 3-item Vestibular subscale of the Neurobehavioral Symptom Inventory (NSI). Results: One third (30.6%) of the sample had a self-reported sleep apnea diagnosis. Initial analysis showed that participants who had sleep apnea had more severe vestibular symptoms (M = 3.84, SD = 2.86) than those without sleep apnea (M = 2.88, SD = 2.67, p < .001). However, when the data was analyzed via a multiple regression model, sleep apnea no longer reached the threshold of significance as a factor associated with vestibular symptoms. PTSD severity was shown to be significantly associated with vestibular symptoms within this sample (p < .001). Conclusion: Analysis of these data revealed a relationship between sleep apnea and vestibular symptoms in V/SM with TBI. The significance of this relationship was affected when PTSD symptoms were factored into a multivariable regression model. However, given that the mechanisms and directionality of these relationships are not yet well understood, we assert that in terms of clinical relevance, providers should emphasize screening for each of the three studied comorbidities (sleep apnea, vestibular symptoms, and PTSD).
MeSH term(s)	Humans ; Cohort Studies ; Cross-Sectional Studies ; Brain Injuries, Traumatic/complications ; Brain Injuries, Traumatic/diagnosis ; Brain Injuries, Traumatic/rehabilitation ; Veterans ; Stress Disorders, Post-Traumatic/diagnosis ; Stress Disorders, Post-Traumatic/epidemiology ; Stress Disorders, Post-Traumatic/etiology ; Sleep Apnea Syndromes/diagnosis ; Sleep Apnea Syndromes/epidemiology ; Sleep Apnea Syndromes/etiology
Language	English
Publishing date	2023-09-25
Publishing country	United States
Document type	Multicenter Study ; Journal Article
ZDB-ID	2608988-9
ISSN	1934-1563 ; 1934-1482
ISSN (online)	1934-1563
ISSN	1934-1482
DOI	10.1002/pmrj.13044
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Article ; Online: Response to letter regarding "Exploring the relationship between sleep apnea and vestibular symptoms following traumatic brain injury".

Skop, Karen M / Bajor, Laura / Sevigny, Mitch / Swank, Chad / Tallavajhula, Sudha / Nakase-Richardson, Risa / Miles, Shannon R

PM & R : the journal of injury, function, and rehabilitation

2023 Volume 16, Issue 3, Page(s) 307–308

MeSH term(s)	Humans ; Brain Injuries, Traumatic/complications ; Brain Injuries, Traumatic/diagnosis ; Sleep Apnea Syndromes/diagnosis
Language	English
Publishing date	2023-11-14
Publishing country	United States
Document type	Letter
ZDB-ID	2608988-9
ISSN	1934-1563 ; 1934-1482
ISSN (online)	1934-1563
ISSN	1934-1482
DOI	10.1002/pmrj.13074
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Article ; Online: Mental health treatment utilization patterns among 108,457 Afghanistan and Iraq veterans with depression.

Panaite, Vanessa / Cohen, Nathan J / Luther, Stephen L / Finch, Dezon K / Alman, Amy / Schultz, Susan K / Haun, Jolie / Miles, Shannon R / Belanger, Heather G / Kozel, F Andrew / Rottenberg, Jonathan / Pfeiffer, Paul N

Psychological services

2024

Abstract: People with depression often underutilize mental health care. This study was conceived as a first step toward a clinical decision support tool that helps identify patients who are at higher risk of underutilizing care. The primary goals were to (a) ... ...

Abstract	People with depression often underutilize mental health care. This study was conceived as a first step toward a clinical decision support tool that helps identify patients who are at higher risk of underutilizing care. The primary goals were to (a) describe treatment utilization patterns, early termination, and return to care; (b) identify factors associated with early termination of treatment; and (c) evaluate the accuracy of regression models to predict early termination. These goals were evaluated in a retrospective cohort analysis of 108,457 U.S. veterans who received care from the Veterans Health Administration between 2001 and 2021. Our final sample was 16.5% female with an average age of 34.5. Veterans were included if they had a depression diagnosis, a positive depression screen, and received general health care services at least a year before and after their depression diagnosis. Using treatment quality guidelines, the threshold for treatment underutilization was defined as receiving fewer than four psychotherapy sessions or less than 84 days of antidepressants. Over one fifth of veterans (21.6%) received less than the minimally recommended care for depression. The odds of underutilizing treatment increased with lack of Veterans Administration benefits, male gender, racial/ethnic minority status, and having received mental health treatment in the past (adjusted
Language	English
Publishing date	2024-02-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2156662-8
ISSN	1939-148X ; 1541-1559
ISSN (online)	1939-148X
ISSN	1541-1559
DOI	10.1037/ser0000819
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Article: Mild traumatic brain injury, PTSD symptom severity, and behavioral dyscontrol: a LIMBIC-CENC study.

Stromberg, Kelsee M / Martindale, Sarah L / Walker, William C / Ou, Zhining / Pogoda, Terri K / Miles, Shannon R / Dismuke-Greer, Clara E / Carlson, Kathleen F / Rowland, Jared A / O'Neil, Maya E / Pugh, Mary Jo

Frontiers in neurology

2024 Volume 14, Page(s) 1286961

Abstract: Background: Behavioral dyscontrol occurs commonly in the general population and in United States service members and Veterans (SM/V). This condition merits special attention in SM/V, particularly in the aftermath of deployments. Military deployments ... ...

Abstract	Background: Behavioral dyscontrol occurs commonly in the general population and in United States service members and Veterans (SM/V). This condition merits special attention in SM/V, particularly in the aftermath of deployments. Military deployments frequently give rise to posttraumatic stress disorder (PTSD) and deployment-related mild TBI traumatic brain injury (TBI), potentially leading to manifestations of behavioral dyscontrol. Objective: Examine associations among PTSD symptom severity, deployment-related mild traumatic brain injury, and behavioral dyscontrol among SM/V. Design: Secondary cross-sectional data analysis from the Long-Term Impact of Military-Relevant Brain Injury Consortium - Chronic Effects of Neurotrauma Consortium prospective longitudinal study among SM/V ( Methods: Univariable and multivariable linear regression models assessed the association and interaction effects between PTSD symptom severity, as assessed by the PTSD Checklist for the Diagnostic and Statistical Manual, 5th edition (PCL-5), and deployment-related mild TBI on behavioral dyscontrol, adjusting for demographics, pain, social support, resilience, and general self-efficacy. Results: Among the 1,808 individuals in our sample, PTSD symptom severity ( Conclusion: Results indicated an association between PTSD symptom severity, deployment-related mild TBI, and behavioral dyscontrol among SM/V. Notably, the effect of deployment-related mild TBI was pronounced for individuals with lower PTSD symptom severity. Higher social support scores were associated with lower dyscontrol, emphasizing the potential for social support to be a protective factor. General self-efficacy was also associated with reduced behavioral dyscontrol.
Language	English
Publishing date	2024-01-11
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2023.1286961
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Article ; Online: Childhood trauma and posttraumatic stress disorder in a real-world Veterans Affairs clinic: Examining treatment preferences and dropout.

Miles, Shannon R / Thompson, Karin E

Psychological trauma : theory, research, practice and policy

2016 Volume 8, Issue 4, Page(s) 464–467

Abstract: Objective: The Department of Veterans Affairs (VA) has promoted large-scale dissemination efforts of evidence-based psychotherapies (EBPs) for posttraumatic stress disorder (PTSD). In spite of efforts to make gold-standard treatments available to ... ...

Abstract	Objective: The Department of Veterans Affairs (VA) has promoted large-scale dissemination efforts of evidence-based psychotherapies (EBPs) for posttraumatic stress disorder (PTSD). In spite of efforts to make gold-standard treatments available to veterans, few veterans with PTSD receive a full course of psychotherapy. It is unclear if type of trauma experienced is related to treatment initiation and completion. This study aimed to identify patient factors, including experiencing childhood trauma that related to treatment preferences and dropout in a real-world VA PTSD clinic. Method: A chart review was conducted for veterans who were referred for individual EBPs for PTSD (N = 199). Extracted variables included demographics, PTSD symptoms, treatment preferences, and treatment completion/dropout. Results: Veterans choose to engage in individual EBP (48%), group treatment (11%), nontrauma focused psychotherapy (15%), or no psychotherapy (26%). Slightly over half of the veterans who began individual EBP completed it, with no statistical differences in completion rates for prolonged exposure and cognitive processing therapy. Childhood trauma was the second-most common type of trauma experienced, next to combat exposure. Those who completed EBP had higher rates of combat trauma (88%) than noncompleters (70%), and noncompleters (50%) had higher rates of childhood trauma than completers (29%). Regardless of trauma experienced, those who completed an EBP experienced substantial reductions in PTSD symptoms. Conclusions: Assessing veterans for childhood trauma and emotion regulation difficulties may be beneficial even in VA clinics where treatment is most often focused on combat trauma. (PsycINFO Database Record
MeSH term(s)	Adult ; Adult Survivors of Child Adverse Events/statistics & numerical data ; Combat Disorders/epidemiology ; Combat Disorders/therapy ; Evidence-Based Practice/statistics & numerical data ; Female ; Humans ; Male ; Middle Aged ; Patient Compliance/statistics & numerical data ; Patient Preference/statistics & numerical data ; Psychotherapy/statistics & numerical data ; Stress Disorders, Post-Traumatic/epidemiology ; Stress Disorders, Post-Traumatic/therapy ; United States ; United States Department of Veterans Affairs/statistics & numerical data
Language	English
Publishing date	2016-03-31
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	2497028-1
ISSN	1942-969X ; 1942-9681
ISSN (online)	1942-969X
ISSN	1942-9681
DOI	10.1037/tra0000132
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Article ; Online: Neurobehavioral Symptoms in U.S. Special Operations Forces in Rehabilitation After Traumatic Brain Injury: A TBI Model Systems Study.

Garcia, Amanda / Miles, Shannon R / Reljic, Tea / Silva, Marc A / Dams-O'Connor, Kristen / Belanger, Heather G / Bajor, Laura / Richardson, Risa

Military medicine

2022 Volume 187, Issue 11-12, Page(s) 1412–1421

Abstract: Introduction: Special Operations Forces (SOF) personnel are at increased risk for traumatic brain injury (TBI), when compared with conventional forces (CF). Prior studies of TBI in military samples have not typically investigated SOF vs. CF as specific ... ...

Abstract	Introduction: Special Operations Forces (SOF) personnel are at increased risk for traumatic brain injury (TBI), when compared with conventional forces (CF). Prior studies of TBI in military samples have not typically investigated SOF vs. CF as specific subgroups, despite documented differences in premorbid resilience and post-injury comorbidity burden. The aim of the current study was to compare SOF vs. CF on the presence of neurobehavioral symptoms after TBI, as well as factors influencing perception of symptom intensity. Materials and methods: This study conducted an analysis of the prospective veterans affairs (VA) TBI Model Systems Cohort, which includes service members and veterans (SM/V) who received inpatient rehabilitation for TBI at one of the five VA Polytrauma Rehabilitation Centers. Of those with known SOF status (N = 342), 129 participants identified as SOF (average age = 43 years, 98% male) and 213 identified as CF (average age = 38.7 years, 91% male). SOF vs. CF were compared on demographics, injury characteristics, and psychological and behavioral health symptoms. These variables were then used to predict neurobehavioral symptom severity in univariable and multivariable analyses. Results: SOF personnel reported significantly greater posttraumatic stress disorder (PTSD) symptoms but less alcohol and drug use than the CF. SOF also reported greater neurobehavioral symptoms. When examining those with TBIs of all severities, SOF status was not associated with neurobehavioral symptom severity, while race, mechanism of TBI, and PTSD symptoms were. When examining only those with mTBI, SOF status was associated with lower neurobehavioral symptoms, while PTSD severity, white race, and certain mechanisms of injury were associated with greater neurobehavioral symptoms. Conclusions: Among those receiving inpatient treatment for TBI, SOF SM/V reported higher neurobehavioral and symptom severity. PTSD was the strongest predictor of neurobehavioral symptoms and should be considered an important treatment target in both SOF and CF with co-morbid PTSD/TBI. A proactive human performance approach towards identification and treatment of psychological and neurobehavioral symptoms is recommended for SOF.
MeSH term(s)	Male ; Humans ; Adult ; Female ; Prospective Studies ; Brain Injuries, Traumatic/psychology ; Veterans/psychology ; Stress Disorders, Post-Traumatic/epidemiology ; Stress Disorders, Post-Traumatic/etiology ; Stress Disorders, Post-Traumatic/diagnosis ; Military Personnel/psychology
Language	English
Publishing date	2022-06-14
Publishing country	England
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	391061-1
ISSN	1930-613X ; 0026-4075
ISSN (online)	1930-613X
ISSN	0026-4075
DOI	10.1093/milmed/usab347
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Article ; Online: Predictive modeling of initiation and delayed mental health contact for depression.

Panaite, Vanessa / Finch, Dezon K / Pfeiffer, Paul / Cohen, Nathan J / Alman, Amy / Haun, Jolie / Schultz, Susan K / Miles, Shannon R / Belanger, Heather G / Kozel, F Andrew F / Rottenberg, Jonathan / Devendorf, Andrew R / Barrett, Blake / Luther, Stephen L

BMC health services research

2024 Volume 24, Issue 1, Page(s) 529

Abstract: Background: Depression is prevalent among Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) Veterans, yet rates of Veteran mental health care utilization remain modest. The current study examined: factors in electronic health records (EHR) ...

Abstract	Background: Depression is prevalent among Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) Veterans, yet rates of Veteran mental health care utilization remain modest. The current study examined: factors in electronic health records (EHR) associated with lack of treatment initiation and treatment delay; the accuracy of regression and machine learning models to predict initiation of treatment. Methods: We obtained data from the VA Corporate Data Warehouse (CDW). EHR data were extracted for 127,423 Veterans who deployed to Iraq/Afghanistan after 9/11 with a positive depression screen and a first depression diagnosis between 2001 and 2021. We also obtained 12-month pre-diagnosis and post-diagnosis patient data. Retrospective cohort analysis was employed to test if predictors can reliably differentiate patients who initiated, delayed, or received no mental health treatment associated with their depression diagnosis. Results: 108,457 Veterans with depression, initiated depression-related care (55,492 Veterans delayed treatment beyond one month). Those who were male, without VA disability benefits, with a mild depression diagnosis, and had a history of psychotherapy were less likely to initiate treatment. Among those who initiated care, those with single and mild depression episodes at baseline, with either PTSD or who lacked comorbidities were more likely to delay treatment for depression. A history of mental health treatment, of an anxiety disorder, and a positive depression screen were each related to faster treatment initiation. Classification of patients was modest (ROC AUC = 0.59 95%CI = 0.586-0.602; machine learning F-measure = 0.46). Conclusions: Having VA disability benefits was the strongest predictor of treatment initiation after a depression diagnosis and a history of mental health treatment was the strongest predictor of delayed initiation of treatment. The complexity of the relationship between VA benefits and history of mental health care with treatment initiation after a depression diagnosis is further discussed. Modest classification accuracy with currently known predictors suggests the need to identify additional predictors of successful depression management.
MeSH term(s)	Humans ; Male ; Female ; Adult ; Veterans/psychology ; Veterans/statistics & numerical data ; Retrospective Studies ; United States/epidemiology ; Depression/epidemiology ; Depression/therapy ; Depression/diagnosis ; Mental Health Services/statistics & numerical data ; Iraq War, 2003-2011 ; Afghan Campaign 2001- ; Electronic Health Records/statistics & numerical data ; Patient Acceptance of Health Care/statistics & numerical data ; Middle Aged ; Time-to-Treatment/statistics & numerical data ; United States Department of Veterans Affairs ; Machine Learning
Language	English
Publishing date	2024-04-25
Publishing country	England
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	2050434-2
ISSN	1472-6963 ; 1472-6963
ISSN (online)	1472-6963
ISSN	1472-6963
DOI	10.1186/s12913-024-10870-y
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