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Article ; Online: Factor structure and psychometric performance of the PCL-5 in a clinical sample of veterans seeking treatment in a VA PTSD outpatient clinic.

Jenkins-Guarnieri, Michael / McEuin, Courtney / Smolenski, Derek / Hosey, Ryan / Macobin, Brian / Prins, Annabel

2023 Volume 35, Issue 4, Page(s) 325–338

Abstract: There is a clear need to improve the measurement of posttraumatic symptoms in veterans seeking trauma-focused treatment. We evaluated the structure and psychometric performance of the Posttraumatic Stress Disorder (PTSD) Checklist for ... ...

Abstract	There is a clear need to improve the measurement of posttraumatic symptoms in veterans seeking trauma-focused treatment. We evaluated the structure and psychometric performance of the Posttraumatic Stress Disorder (PTSD) Checklist for the
MeSH term(s)	Humans ; Stress Disorders, Post-Traumatic/diagnosis ; Stress Disorders, Post-Traumatic/therapy ; Stress Disorders, Post-Traumatic/epidemiology ; Veterans/psychology ; Psychometrics ; Ambulatory Care Facilities ; Diagnostic and Statistical Manual of Mental Disorders
Language	English
Publishing date	2023-01-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	1000939-5
ISSN	1939-134X ; 1040-3590
ISSN (online)	1939-134X
ISSN	1040-3590
DOI	10.1037/pas0001208
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Article ; Online: Preliminary Investigation Into the Effectiveness of Group webSTAIR for Trauma-exposed Veterans in Primary Care.

Kim, Jamie S / Prins, Annabel / Hirschhorn, Elizabeth W / Legrand, Alison C / Macia, Kathryn S / Yam, Sherry S / Cloitre, Marylene

Military medicine

2024

Abstract: Introduction: A substantial number of trauma-exposed veterans seen in primary care report significant symptoms of PTSD and depression. While primary care mental health integration (PCMHI) providers have been successful in delivering brief mental health ... ...

Abstract	Introduction: A substantial number of trauma-exposed veterans seen in primary care report significant symptoms of PTSD and depression. While primary care mental health integration (PCMHI) providers have been successful in delivering brief mental health treatments in primary care, few studies have evaluated interventions that combine mobile health resources with PCMHI groups. This pilot study assessed the potential benefits of webSTAIR, a 10-module transdiagnostic treatment for trauma-exposed individuals, supported by 5 biweekly group sessions delivered via telehealth. The transdiagnostic and mobile health nature of the treatment, as well as the therapist and peer support provided through group sessions, may offer an innovative approach to increasing access to patient-centered and trauma-informed treatment in primary care settings. Materials and methods: Thirty-nine male and female veterans with trauma-related symptoms (i.e., PTSD and/or depression) participated in group webSTAIR. Mixed effects analyses were conducted to assess changes in PTSD and depression at pre-, mid-, and post-treatment. Baseline symptom severity was assessed as a predictor of module completion and group attendance. The project was part of a VHA quality improvement project, and IRB approval was waived by the affiliated university. Results: Analyses revealed significant pre-to-post improvement in both PTSD and depression outcomes with a large effect size for PTSD (Hedges' gav = 0.88) and medium to large for depression (Hedges' gav = 0.73). Of participants who completed the baseline assessment, 90% began webSTAIR; of those, 71% completed the program. Baseline symptoms of PTSD and depression did not predict group attendance or module completion. Conclusions: Good outcomes and a satisfactory retention rate suggest that group webSTAIR may provide easily accessible, high-quality, and effective treatment for patients presenting with trauma-related problems without increasing therapist or system burdens. The results suggest the value of conducting a randomized controlled trial to test the effectiveness of group webSTAIR relative to PCMHI usual care or other evidence-based, disorder-specific (e.g., PTSD) treatments for trauma-exposed individuals in PCMHI.
Language	English
Publishing date	2024-03-04
Publishing country	England
Document type	Journal Article
ZDB-ID	391061-1
ISSN	1930-613X ; 0026-4075
ISSN (online)	1930-613X
ISSN	0026-4075
DOI	10.1093/milmed/usae052
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Article: The international trauma questionnaire (ITQ) measures reliable and clinically significant treatment-related change in PTSD and complex PTSD.

Cloitre, Marylène / Hyland, Philip / Prins, Annabel / Shevlin, Mark

European journal of psychotraumatology

2021 Volume 12, Issue 1, Page(s) 1930961

Abstract: ... ...

Abstract	Background
MeSH term(s)	Adult ; Clinical Trials as Topic ; Female ; Humans ; International Classification of Diseases ; Internet ; Male ; Psychometrics/standards ; Reproducibility of Results ; Rural Population ; Stress Disorders, Post-Traumatic/classification ; Stress Disorders, Post-Traumatic/diagnosis ; Stress Disorders, Post-Traumatic/therapy ; Surveys and Questionnaires/standards ; Surveys and Questionnaires/statistics & numerical data ; United States ; Veterans/psychology ; Veterans/statistics & numerical data
Language	English
Publishing date	2021-06-22
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	2586642-4
ISSN	2000-8066
ISSN	2000-8066
DOI	10.1080/20008198.2021.1930961
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Article ; Online: A home-based telehealth randomized controlled trial of skills training in affective and interpersonal regulation versus present-centered therapy for women veterans who have experienced military sexual trauma.

Cloitre, Marylene / Morabito, Danielle / Macia, Kathryn / Speicher, Sarah / Froelich, Jessilyn / Webster, Katelyn / Prins, Annabel / Villasenor, Diana / Bauer, Asha / Jackson, Christie / Fabricant, Laura / Wiltsey-Stirman, Shannon / Morland, Leslie

Journal of consulting and clinical psychology

2024

Abstract: Objective: This randomized trial tested the effectiveness of Skills Training in Affective and Interpersonal Regulation (STAIR) compared to present-centered therapy (PCT) delivered virtually to women veterans who had experienced military sexual trauma ( ... ...

Abstract	Objective: This randomized trial tested the effectiveness of Skills Training in Affective and Interpersonal Regulation (STAIR) compared to present-centered therapy (PCT) delivered virtually to women veterans who had experienced military sexual trauma (MST) and screened positive for posttraumatic stress disorder (PTSD). Method: One hundred sixty-one eligible women veterans were randomized into the study. The primary outcome was clinician-assessed PTSD severity (Clinician-Administered PTSD Scale-5), while secondary outcomes included social support and several other symptom measures at posttreatment through 2- and 4-month follow-up. Results: PTSD severity decreased in both conditions by posttreatment but significantly more ( Conclusion: STAIR provided superior outcomes compared to PCT regarding PTSD, social support, and multiple types of mental health problems among women veterans with MST. The application of STAIR to other populations with social support and related concerns warrants investigation. The substantial effect sizes for PTSD symptoms in both treatments suggest that they are practical alternatives for individuals who do not wish to participate in trauma-focused therapy and may increase engagement in mental health services. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Language	English
Publishing date	2024-01-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	121321-0
ISSN	1939-2117 ; 0022-006X
ISSN (online)	1939-2117
ISSN	0022-006X
DOI	10.1037/ccp0000872
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Article ; Online: A Randomized Clinical Trial of Clinician-Supported PTSD Coach in VA Primary Care Patients.

Possemato, Kyle / Johnson, Emily / Barrie, Kimberly / Ghaus, Sharfun / Noronha, Delilah / Wade, Michael / Greenbaum, Mark A / Rosen, Craig / Cloitre, Marylene / Owen, Jason / Jain, Shaili / Beehler, Gregory / Prins, Annabel / Seal, Karen / Kuhn, Eric

Journal of general internal medicine

2023 Volume 38, Issue Suppl 3, Page(s) 905–912

Abstract: Background: Posttraumatic stress disorder (PTSD) is common in primary care patients; however, evidence-based treatments are typically only available in specialty mental healthcare settings and often not accessed.: Objective: To test the effectiveness ...

Abstract	Background: Posttraumatic stress disorder (PTSD) is common in primary care patients; however, evidence-based treatments are typically only available in specialty mental healthcare settings and often not accessed. Objective: To test the effectiveness of a brief primary care-based treatment, Clinician-Supported PTSD Coach (CS PTSD Coach) was compared with Primary Care Mental Health Integration-Treatment as Usual (PCMHI-TAU) in (1) reducing PTSD severity, (2) engaging veterans in specialty mental health care, and (3) patient satisfaction with care. Design: Multi-site randomized pragmatic clinical trial. Participants: A total of 234 veterans with PTSD symptoms who were not currently accessing PTSD treatment. Intervention: CS PTSD Coach was designed to be implemented in Veterans Affairs PCMHI and combines mental health clinician support with the "PTSD Coach" mobile app. Four 30-min sessions encourage daily use of symptom management strategies. Main measures: PTSD severity was measured by clinician-rated interviews pre- and post-treatment (8 weeks). Self-report measures assessed PTSD, depression, and quality of life at pretreatment, posttreatment, and 16- and 24-week follow-ups, and patient satisfaction at post-treatment. Mental healthcare utilization was extracted from medical records. Key results: Clinician-rated PTSD severity did not differ by condition at post-treatment. CS PTSD Coach participants improved more on patient-reported PTSD severity at post-treatment than TAU participants (D = .28, p = .021). Coach participants who continued to have problematic PTSD symptoms at post-treatment were not more likely to engage in 2 sessions of specialty mental health treatment than TAU participants. Coach participants engaged in 74% more sessions in the intervention and reported higher treatment satisfaction than TAU participants (p < .001). Conclusions: A structured 4-session intervention designed to align with patient preferences for care resulted in more patient-reported PTSD symptom relief, greater utilization of mental health treatment, and overall treatment satisfaction than TAU, but not more clinician-rated PTSD symptom relief or engagement in specialty mental health.
MeSH term(s)	Humans ; Stress Disorders, Post-Traumatic/diagnosis ; Stress Disorders, Post-Traumatic/therapy ; Stress Disorders, Post-Traumatic/psychology ; Quality of Life ; Treatment Outcome ; Psychotherapy ; Veterans/psychology ; Primary Health Care/methods
Language	English
Publishing date	2023-03-17
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	639008-0
ISSN	1525-1497 ; 0884-8734
ISSN (online)	1525-1497
ISSN	0884-8734
DOI	10.1007/s11606-023-08130-6
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Article ; Online: Diagnostic Accuracy and Acceptability of the Primary Care Posttraumatic Stress Disorder Screen for the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) Among US Veterans.

Bovin, Michelle J / Kimerling, Rachel / Weathers, Frank W / Prins, Annabel / Marx, Brian P / Post, Edward P / Schnurr, Paula P

JAMA network open

2021 Volume 4, Issue 2, Page(s) e2036733

Abstract: Importance: Posttraumatic stress disorder (PTSD) is a serious mental health disorder that can be effectively treated with empirically based practices. PTSD screening is essential for identifying undetected cases and providing patients with appropriate ... ...

Abstract	Importance: Posttraumatic stress disorder (PTSD) is a serious mental health disorder that can be effectively treated with empirically based practices. PTSD screening is essential for identifying undetected cases and providing patients with appropriate care. Objective: To determine whether the Primary Care PTSD screen for the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (PC-PTSD-5) is a diagnostically accurate and acceptable measure for use in Veterans Affairs (VA) primary care clinics. Design, setting, and participants: This cross-sectional, diagnostic accuracy study enrolled participants from May 19, 2017, to September 26, 2018. Participants were recruited from primary care clinics across 2 VA Medical Centers. Session 1 was conducted in person, and session 2 was completed within 30 days via telephone. A consecutive sample of 1594 veterans, aged 18 years or older, who were scheduled for a primary care visit was recruited. Data analysis was performed from March 2019 to August 2020. Exposures: In session 1, participants completed a battery of questionnaires. In session 2, a research assistant administered the PC-PTSD-5 to participants, and then a clinician assessor blind to PC-PTSD-5 results conducted a structured diagnostic interview for PTSD. Main outcomes and measures: The range of PC-PTSD-5 cut points overall and across gender was assessed, and diagnostic performance was evaluated by calculating weighted κ values. Results: In total, 495 of 1594 veterans (31%) participated, and 396 completed all measures and were included in the analyses. Participants were demographically similar to the VA primary care population (mean [SD] age, 61.4 [15.5] years; age range, 21-93 years) and were predominantly male (333 participants [84.1%]) and White (296 of 394 participants [75.1%]). The PC-PTSD-5 had high levels of diagnostic accuracy for the overall sample (area under the receiver operating characteristic curve [AUC], 0.927; 95% CI, 0.896-0.959), men (AUC, 0.932; 95% CI, 0.894-0.969), and women (AUC, 0.899, 95% CI, 0.824-0.974). A cut point of 4 ideally balanced false negatives and false positives for the overall sample and for men. However, for women, this cut point resulted in high numbers of false negatives (6 veterans [33.3%]). A cut point of 3 fit better for women, despite increasing the number of false positives. Participants rated the PC-PTSD-5 as highly acceptable. Conclusions and relevance: The PC-PTSD-5 is an accurate and acceptable screening tool for use in VA primary care settings. Because performance parameters will change according to sample, clinicians should consider sample characteristics and screening purposes when selecting a cut point.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Area Under Curve ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Humans ; Male ; Mass Screening/methods ; Middle Aged ; Patient Acceptance of Health Care ; Patient Health Questionnaire ; Primary Health Care ; ROC Curve ; Sensitivity and Specificity ; Sex Factors ; Stress Disorders, Post-Traumatic/diagnosis ; United States ; United States Department of Veterans Affairs ; Veterans/psychology ; Young Adult
Language	English
Publishing date	2021-02-01
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2020.36733
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Article ; Online: Web-Based Problem-solving Training With and Without Peer Support in Veterans With Unmet Mental Health Needs: Pilot Study of Feasibility, User Acceptability, and Participant Engagement.

Possemato, Kyle / Wu, Justina / Greene, Carolyn / MacQueen, Rex / Blonigen, Daniel / Wade, Michael / Owen, Jason / Keane, Terence / Brief, Deborah / Lindley, Steven / Prins, Annabel / Mackintosh, Margaret-Anne / Carlson, Eve

Journal of medical Internet research

2022 Volume 24, Issue 1, Page(s) e29559

Abstract: Background: eHealth tools have the potential to meet the mental health needs of individuals who experience barriers to accessing in-person treatment. However, most users have less than optimal engagement with eHealth tools. Coaching from peer ... ...

Abstract	Background: eHealth tools have the potential to meet the mental health needs of individuals who experience barriers to accessing in-person treatment. However, most users have less than optimal engagement with eHealth tools. Coaching from peer specialists may increase their engagement with eHealth. Objective: This pilot study aims to test the feasibility and acceptability of a novel, completely automated web-based system to recruit, screen, enroll, assess, randomize, and then deliver an intervention to a national sample of military veterans with unmet mental health needs; investigate whether phone-based peer support increases the use of web-based problem-solving training compared with self-directed use; and generate hypotheses about potential mechanisms of action for problem-solving and peer support for future full-scale research. Methods: Veterans (N=81) with unmet mental health needs were recruited via social media advertising and enrolled and randomized to the self-directed use of a web-based problem-solving training called Moving Forward (28/81, 35%), peer-supported Moving Forward (27/81, 33%), or waitlist control (26/81, 32%). The objective use of Moving Forward was measured with the number of log-ins. Participants completed pre- and poststudy measures of mental health symptoms and problem-solving confidence. Satisfaction was also assessed post treatment. Results: Automated recruitment, enrollment, and initial assessment methods were feasible and resulted in a diverse sample of veterans with unmet mental health needs from 38 states. Automated follow-up methods resulted in 46% (37/81) of participants completing follow-up assessments. Peer support was delivered with high fidelity and was associated with favorable participant satisfaction. Participants randomized to receive peer support had significantly more Moving Forward log-ins than those of self-directed Moving Forward participants, and those who received peer support had a greater decrease in depression. Problem-solving confidence was associated with greater Moving Forward use and improvements in mental health symptoms among participants both with and without peer support. Conclusions: Enrolling and assessing individuals in eHealth studies without human contact is feasible; however, different methods or designs are necessary to achieve acceptable participant engagement and follow-up rates. Peer support shows potential for increasing engagement in web-based interventions and reducing symptoms. Future research should investigate when and for whom peer support for eHealth is helpful. Problem-solving confidence should be further investigated as a mechanism of action for web-based problem-solving training. Trial registration: ClinicalTrials.gov NCT03555435; http://clinicaltrials.gov/ct2/show/NCT03555435.
MeSH term(s)	Feasibility Studies ; Humans ; Internet-Based Intervention ; Mental Health ; Pilot Projects ; Veterans
Language	English
Publishing date	2022-01-13
Publishing country	Canada
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	2028830-X
ISSN	1438-8871 ; 1439-4456
ISSN (online)	1438-8871
ISSN	1439-4456
DOI	10.2196/29559
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Article ; Online: Reduction of Burnout in Mental Health Care Providers Using the Provider Resilience Mobile Application.

Wood, Amanda Ernst / Prins, Annabel / Bush, Nigel E / Hsia, Jennifer F / Bourn, Laura E / Earley, Michael D / Walser, Robyn D / Ruzek, Josef

Community mental health journal

2017 Volume 53, Issue 4, Page(s) 452–459

Abstract: This pilot study examined the usability, acceptability, and effectiveness of a free Provider Resilience (PR) mobile application (app) designed by the National Center for Telehealth and Technology to reduce provider burnout. Outpatient mental health ... ...

Abstract	This pilot study examined the usability, acceptability, and effectiveness of a free Provider Resilience (PR) mobile application (app) designed by the National Center for Telehealth and Technology to reduce provider burnout. Outpatient mental health providers (N = 30) used the PR app for 1 month. Participants rated the PR app on the System Usability Scale with an overall score of 79.7, which is in the top quartile for usability. Results of paired sample t tests on the Professional Quality of Life Scale indicated significant decreases on the Burnout (t = 3.65, p < .001) and Compassion Fatigue (t = 4.54, p < .001) subscales. The Provider Resilience app shows promise in reducing burnout and compassion fatigue in mental health care providers.
Language	English
Publishing date	2017-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	215855-3
ISSN	1573-2789 ; 0010-3853
ISSN (online)	1573-2789
ISSN	0010-3853
DOI	10.1007/s10597-016-0076-5
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Article: Identifying PTSD in primary care: comparison of the Primary Care-PTSD screen (PC-PTSD) and the General Health Questionnaire-12 (GHQ).

Ouimette, Paige / Wade, Michael / Prins, Annabel / Schohn, Mary

Journal of anxiety disorders

2008 Volume 22, Issue 2, Page(s) 337–343

Abstract: The aim of this study was to compare the PC-PTSD and GHQ-12 in detecting new cases of PTSD among primary care patients. Data on the PC-PTSD, GHQ-12 and psychiatric diagnoses was extracted from clinical databases for 11,230 VA primary care patients. ... ...

Abstract	The aim of this study was to compare the PC-PTSD and GHQ-12 in detecting new cases of PTSD among primary care patients. Data on the PC-PTSD, GHQ-12 and psychiatric diagnoses was extracted from clinical databases for 11,230 VA primary care patients. Signal detection analyses and likelihood ratios were used to compare screens. Logistic regression analysis was used to examine the prediction of PTSD by the PC-PTSD after controlling for the GHQ. The PC-PTSD had a higher positive predictive value than the GHQ (41 percent vs. 31 percent). Combining positive results on the two screens in predicting PTSD yielded the highest likelihood ratio (LR=17.3) compared to a positive result on the PC-PTSD only (LR=8.3) or the GHQ only (LR=4.6). The PC-PTSD performed slightly better than the GHQ and provided unique information in identifying PTSD, suggesting that disorder specific screens are important to use in primary care settings.
MeSH term(s)	Female ; Health Status ; Humans ; Incidence ; International Classification of Diseases/statistics & numerical data ; Logistic Models ; Male ; Mass Screening/methods ; Mass Screening/statistics & numerical data ; Middle Aged ; New York/epidemiology ; Primary Health Care/methods ; Primary Health Care/statistics & numerical data ; Probability ; Stress Disorders, Post-Traumatic/diagnosis ; Stress Disorders, Post-Traumatic/epidemiology ; Stress Disorders, Post-Traumatic/psychology ; Surveys and Questionnaires ; Veterans/statistics & numerical data
Language	English
Publishing date	2008
Publishing country	Netherlands
Document type	Comparative Study ; Evaluation Studies ; Journal Article
ZDB-ID	619417-5
ISSN	1873-7897 ; 0887-6185
ISSN (online)	1873-7897
ISSN	0887-6185
DOI	10.1016/j.janxdis.2007.02.010
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Article ; Online: A preliminary study of an internet-based intervention for OEF/OIF veterans presenting for VA specialty PTSD care.

Belsher, Bradley E / Kuhn, Eric / Maron, David / Prins, Annabel / Cueva, David / Fast, Elsbeth / France, Deborah

Journal of traumatic stress

2015 Volume 28, Issue 2, Page(s) 153–156

Abstract: This preliminary study sought to evaluate the feasibility and potential effectiveness of a cognitive-behavioral, web-based intervention for posttraumatic stress in Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans who are not able to ... ...

Abstract	This preliminary study sought to evaluate the feasibility and potential effectiveness of a cognitive-behavioral, web-based intervention for posttraumatic stress in Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans who are not able to participate, or not eligible to participate, in evidence-based posttraumatic stress disorder (PTSD) treatments. The study used an uncontrolled pre-posttest design with a sample of 24 OEF/OIF veterans presenting to a VA PTSD specialty clinic. Participants used the afterdeployment.org, Post-Traumatic Stress (PTS) Workshop, which was supplemented with brief weekly telephone calls. Half of the participants (n = 12) completed at least 5 of the 8 workshop sessions. At posttreatment, 40.0% of completers demonstrated reliable reductions on PTSD symptoms and overall d = 1.04. Treatment satisfaction and acceptability was generally positive based on Likert ratings. This web-based intervention for PTS appears to be a feasible and potentially helpful intervention for veterans who may not otherwise receive psychosocial interventions. Given the minimal resources required and the potential reach, this web-based intervention could be a viable addition to services provided to OEF/OIF veterans seeking PTSD specialty care. Efforts to further develop and more rigorously evaluate this approach are warranted.
MeSH term(s)	Adult ; Afghan Campaign 2001- ; Cognitive Therapy/methods ; Feasibility Studies ; Humans ; Internet ; Iraq War, 2003-2011 ; Male ; Middle Aged ; Patient Satisfaction ; Self Care ; Severity of Illness Index ; Stress Disorders, Post-Traumatic/therapy ; Telephone ; United States ; United States Department of Veterans Affairs ; Veterans/psychology ; Young Adult
Language	English
Publishing date	2015-04
Publishing country	United States
Document type	Clinical Trial ; Journal Article
ZDB-ID	639478-4
ISSN	1573-6598 ; 0894-9867
ISSN (online)	1573-6598
ISSN	0894-9867
DOI	10.1002/jts.21994
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