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Topics
- Anxiety (2)
- (-) Behavioral Health (19)
- Brain Injury (5)
- Caregiving (1)
- Children/Adolescents (3)
- Chronic Conditions (3)
- Community-Based Practice (1)
- Depression (2)
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- Diagnostic Safety and Quality (2)
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- Medicare (1)
- Medication (2)
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- Obesity: Weight Management (1)
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- Patient-Centered Outcomes Research (1)
- Practice Patterns (1)
- Provider (1)
- Racial and Ethnic Minorities (1)
- Risk (1)
- Screening (1)
- Social Stigma (1)
- Stress (4)
- Training (2)
- (-) Trauma (19)
- Treatments (2)
- Vulnerable Populations (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 19 of 19 Research Studies DisplayedHeld P, Splaine CC, Smith DL
Examining trauma cognition change trajectories among initial PTSD treatment non-optimal responders: a potential avenue to guide subsequent treatment selection.
The purpose of this study was to examine negative post-trauma cognitions (NPCs) change trajectories in individuals who were determined to be non-optimally responsive to intensive PTSD treatment. The researchers utilized a 3-week Cognitive Processing Therapy-based intensive PTSD treatment (ITP) sample of 243 participants. Analyses were replicated in a separate 2-week ITP sample of 215 participants. The study found that in both non-optimal responder samples, two trajectories emerged; a no NPC change group which represented those with an overall lack of NPC change throughout treatment and an NPC change group which represented those with an overall reduction of NPCs occurring primarily later in treatment. Changes in PTSD symptom severity during treatment was the only consistent predictor of NPC change trajectory group membership among treatment non-optimal responders across ITPs.
AHRQ-funded; HS028511.
Citation: Held P, Splaine CC, Smith DL .
Examining trauma cognition change trajectories among initial PTSD treatment non-optimal responders: a potential avenue to guide subsequent treatment selection.
Eur J Psychotraumatol 2023; 14(2):2237361. doi: 10.1080/20008066.2023.2237361..
Keywords: Trauma, Behavioral Health, Stress
Goldstein E, King C, Crits-Cristoph P
The association between trauma and interpersonal problems in a United States community mental health setting.
Prior studies have established connections between traumatic experiences and issues in interpersonal relationships. The purpose of this study was to explore the influence of trauma on interpersonal difficulties in depressed individuals seeking assistance within a community mental health framework. The study included 453 patients who sought treatment and were screened for a comparative effectiveness analysis of depression therapies. The relationship between the 32-item Inventory of Interpersonal Problems (IIP-32) and trauma indicators was investigated. The study found that a staggering 99.1% of participants had undergone a traumatic event. Notable correlations were identified between the total count of traumas, the number of sexually and physically abusive traumas, and factors such as gender and ethnicity. The number of sexually abusive traumas demonstrated a significant connection to the IIP-32 "excessively nurturing" subscale. After adjusting for demographic variables and other IIP-32 subscales, the overall number of traumas retained a significant association with the IIP-32 "excessively nurturing" category.
AHRQ-funded; HS018440
Citation: Goldstein E, King C, Crits-Cristoph P .
The association between trauma and interpersonal problems in a United States community mental health setting.
J Clin Psychol 2023 Apr;79(4):1192-207. doi: 10.1002/jclp.23467.
Keywords: Trauma, Behavioral Health, Community-Based Practice
Wells KB, Skrine Jeffers K, Mango J
Integration of arts and health sciences in developing an opera on veteran resilience and recovery.
This case study describes development of an opera on veteran resilience and recovery that integrated arts and health sciences. The opera libretto was developed using themes informed from deidentified interviews from 280 adults with a history of depression at 10-year follow-up to a randomized trial. The opera was written using the following key themes: a) resilience in the face of stress; b) post-Vietnam depression or anxiety; c) pathways to recovery; and d) a “collage” of coping strategies. Three main lead characters were developed including a lead veteran, the veteran’s wife, and a second veteran.
AHRQ-funded; HS008349.
Citation: Wells KB, Skrine Jeffers K, Mango J .
Integration of arts and health sciences in developing an opera on veteran resilience and recovery.
Health Promot Pract 2023 Mar; 24(2):207-13. doi: 10.1177/15248399211065402..
Keywords: Social Stigma, Trauma, Behavioral Health
Bowden CF, Simmel C, Mendez A
The complexity of psychotropic medication prescription and treating trauma among youth in foster care: perspectives from the lived experience.
The purpose of this study was to examine stakeholders' perspectives of the relationship between psychotropic medications and trauma informed care (TIC) for youth in foster care. The researchers recruited foster caseworkers, prescribing clinicians, caregivers, and alumni of the foster care system and conducted semi-structured individual and group interviews. Data were recorded and transcribed verbatim and analyzed using a directed content analysis approach. Five themes emerged across the recorded and transcribed data within stakeholder groups: 1) acknowledging trauma; 2) role of psychotropic medication; 3) psychosocial resources; 4) additional supports; and, 5) training and education. Stakeholders identified TIC as an important component of mental health services for youth in foster care. Most stakeholders felt that psychotropic medication was overused in treating trauma. Respondents suggested including additional supportive team members to help guide youth through the mental health treatment system and stated the importance of support from individuals with common lived experiences. The study concluded that there is a need for: improved training and education for stakeholders, additional sources of support for youth in foster care, and an overall system that emphasizes trauma-sensitive clinical interactions and psychosocial supports.
AHRQ-funded; HS02600101A1.
Citation: Bowden CF, Simmel C, Mendez A .
The complexity of psychotropic medication prescription and treating trauma among youth in foster care: perspectives from the lived experience.
Adm Policy Ment Health 2022 Sep;49(5):821-33. doi: 10.1007/s10488-022-01203-4..
Keywords: Children/Adolescents, Vulnerable Populations, Behavioral Health, Trauma, Medication
Marks MR, Dux MC, Rao V
Treatment patterns of anxiety and posttraumatic stress disorder following traumatic brain injury.
Investigators examined psychotropic medication use and psychotherapy patterns among individuals diagnosed with anxiety disorders and PTSD post-traumatic brain injury (TBI). They found that receipt of pharmacotherapy pre- and post-TBI was considerably more common than receipt of psychotherapy. Individuals diagnosed with anxiety were 66% less likely to receive psychotherapy compared with individuals diagnosed with PTSD. Overall, psychotropic medication use and rates of antidepressant prescription use in the anxiety group were higher compared to those in the PTSD group.
AHRQ-funded; HS024560.
Citation: Marks MR, Dux MC, Rao V .
Treatment patterns of anxiety and posttraumatic stress disorder following traumatic brain injury.
J Neuropsychiatry Clin Neurosci 2022 Summer;34(3):247-53. doi: 10.1176/appi.neuropsych.21040104..
Keywords: Anxiety, Behavioral Health, Trauma, Brain Injury, Treatments, Practice Patterns, Medication
Johnson BN, McKernan L
Co-occurring trauma and non-suicidal self-injury among people with chronic pain: a systematic review.
The authors conducted a systematic review on the intersection of trauma, chronic pain, and non-suicidal self-injury (NSSI). They found that self-harm rates varied across studies, though appeared elevated among patients with chronic pain, and childhood trauma was linked to this co-occurrence. Further, causal links between trauma, NSSI, and pain were proposed, highlighting the need for a comprehensive theoretical model. They recommended assessing for childhood trauma when treating patients with chronic pain and querying regarding NSSI when patients present with indicators of NSSI risk and to treat or refer such patients to specialized treatment.
AHRQ-funded; HS022990.
Citation: Johnson BN, McKernan L .
Co-occurring trauma and non-suicidal self-injury among people with chronic pain: a systematic review.
Curr Pain Headache Rep 2021 Nov 11;25(11):70. doi: 10.1007/s11916-021-00984-x..
Keywords: Trauma, Behavioral Health, Chronic Conditions
Johnson BN, Lumley MA, Cheavens JS
Exploring the links among borderline personality disorder symptoms, trauma, and pain in patients with chronic pain disorders.
The authors compared study participants high or low on borderline personality disorder (BPD) symptoms on patterns of pain experience and types of child and adult traumas. They found that BPD symptoms were associated with increased clinical severity among patients with chronic pain as well as a unique manifestation of pain experiencing. Childhood trauma of all types is associated with chronic pain and BPD co-occurrence. They recommended that researchers and clinicians assess for BPD in people with chronic pain to enhance conceptual models of the transaction between these disorders and to improve clinical care.
AHRQ-funded; HS022990.
Citation: Johnson BN, Lumley MA, Cheavens JS .
Exploring the links among borderline personality disorder symptoms, trauma, and pain in patients with chronic pain disorders.
J Psychosom Res 2020 Aug;135:110164. doi: 10.1016/j.jpsychores.2020.110164..
Keywords: Behavioral Health, Trauma, Pain, Chronic Conditions
Darling KE, Ranzenhofer LM, Hadley W
Negative childhood experiences and disordered eating in adolescents in a weight management program: the role of depressive symptoms.
This cross-sectional study examined the association between stressful life events and weight-related outcomes including weight status, disordered eating behaviors, and insulin sensitivity in treatment-seeking adolescents with overweight and obesity. The authors were also looking at the potential mediating role of depression. The study included 170 adolescents (mean age 14.8, 62% female) enrolled in an interdisciplinary weight management program. Findings were that stressful childhood experiences were significantly related to weight status and disordered eating but not insulin sensitivity. Depressive symptoms were related to stressful experiences and disordered eating patterns but not weight status or insulin sensitivity.
AHRQ-funded; HS027071.
Citation: Darling KE, Ranzenhofer LM, Hadley W .
Negative childhood experiences and disordered eating in adolescents in a weight management program: the role of depressive symptoms.
Eat Behav 2020 Aug;38:101402. doi: 10.1016/j.eatbeh.2020.101402..
Keywords: Children/Adolescents, Obesity: Weight Management, Obesity, Stress, Depression, Behavioral Health, Trauma
Rudd BN, Last BS, Gregor C
Benchmarking treatment effectiveness of community-delivered trauma-focused cognitive behavioral therapy.
The objectives of the current study are to (a) evaluate the effectiveness of trauma-focused cognitive behavioral therapy (TF-CBT) delivered from 2013 to 2016 in 15 behavioral health agencies on youth PTSD as well as general mental health symptoms and functioning, and (b) benchmark these clinical outcomes against other published efficacy and effectiveness trials. This study is the first benchmarking study of TF-CBT and provides preliminary findings with regard to the effectiveness, and transportability, of TF-CBT to urban community settings that serve youth in poverty.
AHRQ-funded; HS000084.
Citation: Rudd BN, Last BS, Gregor C .
Benchmarking treatment effectiveness of community-delivered trauma-focused cognitive behavioral therapy.
Am J Community Psychol 2019 Dec;64(3-4):438-50. doi: 10.1002/ajcp.12370..
Keywords: Children/Adolescents, Behavioral Health, Trauma, Stress, Outcomes, Treatments
Cook JM, Newman E, Simiola V
Trauma training: competencies, initiatives, and resources.
Traumatic stress is currently not a required component of the standard curricula in graduate-level education in clinical and counseling psychology. However, due to the high prevalence of trauma and its potentially deleterious physical and mental health effects in the general and clinical populations, it is imperative that psychology graduate students and practitioners understand the relevance of trauma in their clients' lives and its impact in clinical research. This paper discusses competencies, initiatives and resources related to trauma training.
AHRQ-funded; HS021602.
Citation: Cook JM, Newman E, Simiola V .
Trauma training: competencies, initiatives, and resources.
Psychotherapy 2019 Sep;56(3):409-21. doi: 10.1037/pst0000233..
Keywords: Education: Continuing Medical Education, Behavioral Health, Provider, Stress, Training, Trauma
McKernan LC, Johnson BN, Crofford LJ
Posttraumatic stress symptoms mediate the effects of trauma exposure on clinical indicators of central sensitization in patients with chronic pain.
This study examines the relationship between posttraumatic stress disorder (PTSD) and chronic pain involving central sensitization (CS). A sample of 202 patients (79% female) with chronic pain filled out surveys describing their trauma exposure, current PTSD symptoms, experiential avoidance and 3 manifestations of CS which are widespread pain, greater pain severity, and polysomatic symptom reporting. All 3 clinical indicators of CS were significantly associated with trauma exposure and PTSD symptoms. Further investigation is needed on the mediating effect of current PTSD symptoms.
AHRQ-funded; HS022990.
Citation: McKernan LC, Johnson BN, Crofford LJ .
Posttraumatic stress symptoms mediate the effects of trauma exposure on clinical indicators of central sensitization in patients with chronic pain.
Clin J Pain 2019 May;35(5):385-93. doi: 10.1097/ajp.0000000000000689..
Keywords: Chronic Conditions, Behavioral Health, Pain, Trauma
Albrecht JS, Barbour L, Abariga SA
Risk of depression after traumatic brain injury in a large national sample.
The goal of this study was to estimate the risk of depression post-traumatic brain injury (TBI) among adults 18 years of age and older and to identify risk factors associated with developing depression post-TBI. Claims data for privately insured and Medicare Advantage enrollees was used. Results showed that history of neuropsychiatric disturbances pre-TBI was the strongest predictor of depression post-TBI. The risk of depression increases substantially post-TBI. Groups at increased risk include those with a history of neuropsychiatric disturbances, older adults, and men. This study highlights the importance of long-term monitoring for depression post-TBI.
AHRQ-funded; HS024560.
Citation: Albrecht JS, Barbour L, Abariga SA .
Risk of depression after traumatic brain injury in a large national sample.
J Neurotrauma 2019 Jan 15;36(2):300-07. doi: 10.1089/neu.2017.5608..
Keywords: Depression, Behavioral Health, Brain Injury, Trauma, Risk
McKernan LC, Johnson BN, Reynolds WS
Posttraumatic stress disorder in interstitial cystitis/bladder pain syndrome: relationship to patient phenotype and clinical practice implications.
The relationship between exposure to abuse and interstitial cystitis/bladder pain syndrome (IC/BPS) is well-documented. However, studies have yet to examine posttraumatic stress disorder (PTSD), which develops following exposure to trauma and worsens health outcomes in chronic pain. The authors of this study aimed to assess the prevalence and impact of PTSD in patients with IC/BPS, including their relation to genitourinary symptom presentation and widespread pain phenotype.
AHRQ-funded; HS022990.
Citation: McKernan LC, Johnson BN, Reynolds WS .
Posttraumatic stress disorder in interstitial cystitis/bladder pain syndrome: relationship to patient phenotype and clinical practice implications.
Neurourol Urodyn 2019 Jan;38(1):353-62. doi: 10.1002/nau.23861..
Keywords: Behavioral Health, Pain, Trauma
Albrecht JS, O'Hara LM, Moser KA
Perception of barriers to the diagnosis and receipt of treatment for neuropsychiatric disturbances after traumatic brain injury.
This study explored perceptions of barriers and facilitators to the diagnosis and receipt of treatment for neuropsychiatric disturbances (NPDs) after traumatic brain injury (TBI). Using semistructured interviews and focus groups, it found that barriers included poor provider education on TBI NPDs and limited access to care due to lack of insurance, transportation, and income. Facilitators included patient education on TBI NPDs and strong caregiver support.
AHRQ-funded; HS024560.
Citation: Albrecht JS, O'Hara LM, Moser KA .
Perception of barriers to the diagnosis and receipt of treatment for neuropsychiatric disturbances after traumatic brain injury.
Arch Phys Med Rehabil 2017 Dec;98(12):2548-52. doi: 10.1016/j.apmr.2017.06.007.
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Keywords: Brain Injury, Caregiving, Diagnostic Safety and Quality, Behavioral Health, Trauma
O'Neil ME, Callahan M, Carlson KF
Postconcussion symptoms reported by Operation Enduring Freedom/Operation Iraqi Freedom veterans with and without blast exposure, mild traumatic brain injury, and posttraumatic stress disorder.
This study examined symptom reporting related to the 10th Edition of the International Statistical Classification of Diseases (ICD-10) criteria for postconcussional syndrome (PCS) in veterans. One aim was to examine relationships among PCS symptoms by using the British Columbia Postconcussion Symptom Inventory (BC-PSI). BC-PSI factors were interpreted as cognitive, vestibular, affective, anger, and somatic. Items and factor scores were highest for veterans with blast exposure plus mTBI, and lowest for controls.
AHRQ-funded; HS022981.
Citation: O'Neil ME, Callahan M, Carlson KF .
Postconcussion symptoms reported by Operation Enduring Freedom/Operation Iraqi Freedom veterans with and without blast exposure, mild traumatic brain injury, and posttraumatic stress disorder.
J Clin Exp Neuropsychol 2017 Jun;39(5):449-58. doi: 10.1080/13803395.2016.1232699.
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Keywords: Brain Injury, Diagnostic Safety and Quality, Behavioral Health, Trauma
Albrecht JS, Peters ME, Smith GS
Anxiety and posttraumatic stress disorder among Medicare beneficiaries after traumatic brain injury.
This study estimated rates of anxiety and posttraumatic stress disorder (PTSD) diagnoses after traumatic brain injury (TBI) among Medicare beneficiaries. After TBI, 16,519 (17 percent) beneficiaries were diagnosed with anxiety and 269 (0.3 percent) were diagnosed with PTSD. Rates of anxiety and PTSD diagnoses were highest in the first 5 months post-TBI and decreased over time.
AHRQ-funded; HS024560.
Citation: Albrecht JS, Peters ME, Smith GS .
Anxiety and posttraumatic stress disorder among Medicare beneficiaries after traumatic brain injury.
J Head Trauma Rehabil 2017 May/Jun;32(3):178-84. doi: 10.1097/htr.0000000000000266.
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Keywords: Anxiety, Brain Injury, Medicare, Behavioral Health, Trauma
Goins RT, Noonan C, Gonzales K
Association of depressive symptomology and psychological trauma with diabetes control among older American Indian women: does social support matter?
Among older American Indian women with type 2 diabetes (T2DM), the researchers examined the association between mental health and T2DM control and if social support modifies the association. They found that there was not a significant association between depressive symptomatology and higher HbA1c although increased depressive symptomatology was associated with higher HbA1c values among participants with low social support.
AHRQ-funded; HS000078.
Citation: Goins RT, Noonan C, Gonzales K .
Association of depressive symptomology and psychological trauma with diabetes control among older American Indian women: does social support matter?
J Diabetes Complications 2017 Apr;31(4):669-74. doi: 10.1016/j.jdiacomp.2017.01.004.
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Keywords: Diabetes, Elderly, Behavioral Health, Racial and Ethnic Minorities, Trauma
Wegener ST, Pollak AN, Frey KP
The Trauma Collaborative Care Study (TCCS).
This article describes the Trauma Collaborative Care (TCC) program and the design of a multicenter study to evaluate its effectiveness for improving patient outcomes after major, high-energy orthopaedic trauma at level 1 trauma centers. Compared with standard treatment alone, it is hypothesized that access to the TCC program plus standard treatment will result in lower rates of poor patient-reported function, depression, and posttraumatic stress disorder.
AHRQ-funded; HS000029.
Citation: Wegener ST, Pollak AN, Frey KP .
The Trauma Collaborative Care Study (TCCS).
J Orthop Trauma 2017 Apr;31 Suppl 1:S78-s87. doi: 10.1097/bot.0000000000000792.
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Keywords: Injuries and Wounds, Outcomes, Patient-Centered Outcomes Research, Behavioral Health, Screening, Trauma
Cook JM, Newman E
A consensus statement on trauma mental health: the New Haven Competency Conference process and major findings.
The purpose of this article was to state the need for a comprehensive model of trauma-focused, empirically informed competencies for psychiatrists, and describe the work resulting from the New Haven Competencies consensus conference. The 60 participating experts outlined 5 broad foundational and functional competencies in the areas of trauma-focused and trauma-informed scientific knowledge, psychosocial assessment, psychosocial interventions, professionalism, and relational and systems. Eight cross-cutting competencies were voted into the resulting consensus statement.
AHRQ-funded; HS021602.
Citation: Cook JM, Newman E .
A consensus statement on trauma mental health: the New Haven Competency Conference process and major findings.
Psychol Trauma 2014 Jul;6(4):300-07. doi: 10.1037/a0036747..
Keywords: Trauma, Behavioral Health, Evidence-Based Practice, Education: Continuing Medical Education, Training