VISN 19 MIRECC Specialties: Evidence Based Treatment

Research, Education and Clinical Care Related to
Evidence Based Treatment

Research Projects

Development of an Intervention for Soldiers and Veterans with Co-Occurring Traumatic Brain Injury and Substance Use Disorders

Research Team: Deborah Yurgelun-Todd PhD, Elliott Bueler

Purpose: To design a novel substance abuse intervention and related treatment manual for individuals who served in the military and have co-occurring mild TBI and substance use disorders.

Keywords: Evidence-Based Treatments, Substance Use Disorders (SUD), Traumatic Brain Injury (TBI)

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Home-Based Mental Health Evaluation (HOME): A Model for Assisting Suicidal Veterans with the Transition from Inpatient to Outpatient Settings

Research Team: Bridget B. Matarazzo PsyD, Michael H. Allen MD, Sean M. Barnes PhD, Herbert Nagamoto MD, Deborah Yurgelun-Todd PhD, Lisa A. Brenner PhD

Project Summary: The intent of the proposed clinical demonstration project, Home-Based Mental Health Evaluation (HOME) is to enhance the VA infrastructure for ensuring that Veterans with recent suicidal crises receive the care they need during the often difficult transition from psychiatric inpatient hospitalization to home. This will be accomplished by meeting Veterans in the home environment to review and revise aftercare plans. The primary goal of the HOME project is to increase engagement with aftercare, and decrease the risk of suicide during this time of transition and elevated suicide risk. The HOME demonstration project will be conducted in Denver and Salt Lake City.

Keywords: Evidence-Based Treatments, Suicide Prevention

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Lithium Augmentation for Hyperarousal Symptoms of PTSD: Pilot Study

Research Team: Hal S. Wortzel MD, Thomas Beresford MD, Lisa A. Brenner PhD, Peter M. Gutierrez PhD, Jeri E.Forster PhD, Jeffrey Rings PhD, Latoya Conner BA

The proposed investigation is a pilot study intended to establish the safety and tolerability of lithium augmentation of standard psychopharmacological treatment of PTSD for combat veterans seeking treatment at the Denver VA Medical Center.

Keywords: Evidence-Based Treatments, Post Traumatic Stress Disorder (PTSD)

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Military Suicide Research Consortium (MSRC)

Research Team: Peter M. Gutierrez PhD, Thomas Joiner PhD, Greg Riccardi PhD, Daniel McGee Sr. PhD, Kelly Moroney MA, James Pease MSW, Jetta Hanson MA

Consortium seeks to develop more effective prevention interventions, risk assessment methods, and treatments to decrease suicide in the military.

Keywords: Evidence-Based Treatments, Suicide Prevention

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Neurobiology of Suicide Risk in Traumatic Brain Injury and Substance Abuse

Research Team: Deborah Yurgelun-Todd PhD, Elliott Bueler

Traumatic brain injury is an important medical problem for Veterans. Individuals with traumatic brain injuries are at increased risk for various psychiatric problems, including those associated with suicide. This study seeks to better understand the relationship between these factors.

Keywords: Evidence-Based Treatments, Suicide Prevention, Substance Use Disorders (SUD), Traumatic Brain Injury (TBI)

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SAFE VET - A Brief Intervention to Reduce Suicide Risk in Military Service Members and Veterans

Research Team: Lisa A. Brenner PhD, Bridget B. Matarazzo PsyD, Patricia Alexander PhD, Kimberly Arne MSW, Parri Hinton BA, Melodi Billera MSW LSW

The purpose of this study is to compare the effectiveness of the SAFE VET (Suicide Assessment and Follow-up Engagement: Veteran Emergency Treatment) intervention versus enhanced usual care on Veterans’ suicide attempts, suicide ideation, outpatient mental health or substance abuse treatment, and suicide-related coping. SAFE VET uses a standardized intervention that is specifically adapted for use in the Emergency Department to mitigate suicide risk.

Keywords: Evidence-Based Treatment, Suicide Prevention

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TBI-4 Study

Research Team: Lisa A. Brenner PhD, Beeta Homaifar PhD, Jennifer Olson-Madden PhD, Bridget B. Matarazzo PsyD, Joe Huggins MSW MSCIS, Herbert Nagamoto MD, Jeri E.Forster PhD, Alexandra Schneider BA

Military personnel are returning from current conflicts with traumatic brain injury (TBI). Brief and sensitive screening measures are needed to assess TBI in this population.

Keywords: Evidence-Based Treatments, Traumatic Brain Injury (TBI)

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Traumatic Brain Injury Among Homeless Veterans

Research Team: Lisa A. Brenner PhD, Jennifer Olson-Madden PhD, Marie Devore, Leah Russell MA, Ann Elizabeth Montgomery PhD, Roger Casey PhD, John Schinka PhD, Joe Huggins MSW MSCIS

The National Center on Homelessness among Veterans was established, in part, to assist the Department of Veterans Affairs (VA) in programming efforts to provide care for Veterans who are homeless or at-risk for homelessness. An immediate goal of the Center is to enlist research and clinical expertise to increase understanding regarding traumatic brain injury (TBI) among the homeless Veteran population.

Keywords: Evidence-Based Treatments, Homeless Programs, Traumatic Brain Injury (TBI)

Using Complementary and Alternative Medicine (CAM) to Promote Stress Resilience in Those with Co-Occurring Mild TBI and PTSD

Research Team: Theresa D. Hernández PhD, Lisa A. Brenner PhD

The research team hypothesizes that, similar to other populations, active acupressure treatments will help promote stress resilience, improve cognition and sleep, helping to reduce suicidal ideation and ultimately suicidal behavior. In addition to these potential functional benefits in Veterans, active acupressure is an independent, portable, safe and no-cost (once learned) intervention that is non-pharmacological and therefore has no side effects. The study aims to address a need (reducing military/Veteran suicidality) that has to date gone largely unmet, a need that is also currently a Department of Defense priority.

Keywords: Complementary and Alternative Medicine, Evidence-Based Treatments, Suicide Prevention

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Window to Hope – Evaluating a Psychological Treatment for Hopelessness among Veterans with Traumatic Brain Injury

Research Team: Lisa A. Brenner PhD, Grahame Simpson PhD (Senior Research Fellow/ Research Team Leader, Brain Injury Rehabilitation Unit, Australia), Bridget B. Matarazzo PsyD, Jeri E. Forster PhD, Gina M. Signoracci PhD, Adam Hoffberg MHS

This proposed project will be the first to replicate a groundbreaking psychological treatment for suicide prevention among those with moderate or severe traumatic brain injury, Window to Hope (WtoH), developed by PI Simpson and colleagues in Sydney, Australia. WtoH has been successfully evaluated in a Randomized Controlled Trial (RCT), in which treated Australian civilians (n=17) with severe TBI recorded significant decreases in hopelessness. The current project aims to (i) undertake the cross-cultural adaptation of the WtoH program; (ii) establish the acceptability and feasibility of WtoH within the VAMC context; and (iii) conduct a RCT within the VAMC to replicate the results from the original trial (efficacy). Deliverables are expected to include an intervention suitable for a larger trial and broader dissemination.

Keywords: Complementary and Alternative Medicine, Evidence-Based Treatments, Suicide Prevention, Traumatic Brain Injury (TBI)

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Recent Presentations Related to Evidence Based Treatment

The Self-Directed Violence Classification System (SDVCS): How Learning to Use it will make you a Better Clinician

10/18/11

Peter M. Gutierrez PhD 

Appleton, WI CBOC

Keywords: Assessment, Evidence-Based Treatments, Suicide Prevention

PowerPoint | PDF 

Military Suicide Research Consortium

9/13/11

Peter M. Gutierrez PhD 

University of Utah National Center for Veterans Studies and American Psychological Association jointly sponsored Military and Veteran Suicide Prevention Clinical Best Practices Consensus Meeting in Washington, DC

Keywords: Evidence-Based Treatments, OEF/OIF/OND Veterans, Suicide Prevention

PowerPoint | PDF 

Suicide Risk Assessment and Prevention in Military Personnel

6/13/11

Nazanin H. Bahraini PhD 

Military Healthcare Convention & Conference in San Antonio, Texas

Keywords: Assessment, Evidence-Based Treatments, Suicide Prevention

PowerPoint | PDF 

Overview of Issues of Veterans and Suicide

5/23/11

Peter M. Gutierrez PhD

2011 Southeastern Arizona Suicide Prevention Seminar - Promoting Hope: Building a Stronger Community for Armed Forces Members and Their Families

Keywords: Evidence-Based Treatments, Suicide Prevention

PowerPoint | PDF 

Safety Planning with Suicidal Clients

5/23/11

Peter M. Gutierrez PhD

2011 Southeastern Arizona Suicide Prevention Seminar - Promoting Hope: Building a Stronger Community for Armed Forces Members and Their Families

Keywords: Assessment, Evidence-Based Treatments, TBI, Suicide Prevention

PowerPoint | PDF 

Suicide Risk Assessment: Tips & Tools

5/5/11

Bridget B. Matarazzo PsyD

Boulder Mental Health Center, Boulder, CO

Keywords: Assessment, Evidence-Based Treatments, Suicide Prevention

PowerPoint | PDF 

Traumatic Brain Injury and Suicidality: Assessment & Prevention

5/5/11

Gina M. Signoracci PhD

Boulder Mental Health Center, Boulder, CO

Keywords: Assessment, Evidence-Based Treatments, Suicide Prevention

PowerPoint | PDF 

Safety Planning: A Stand Alone Intervention

5/5/11

Patricia Alexander PhD and Bridget B. Matarazzo PsyD

Boulder Mental Health Center, Boulder, CO

Keywords: Evidence-Based Treatments, Suicide Prevention

PowerPoint | PDF 

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Recent Publications (since 2009)

Gutierrez, P.M., Brenner, L.A., Olson-Madden, J.H., Breshears, R., Homaifar, B.Y., Betthauser, L.M., et al. (Staves, P. J., & Adler, L.E.) (2009). Consultation as a means of veteran suicide prevention. Professional Psychology: Research and Practice, Vol 40(6), 586-592.

The development and implementation of a suicide consultation service being run by an interdisciplinary team in a metropolitan Veteran’s Administration (VA) medical center is described. This service is grounded in a collaborative theoretical framework. An overview of the consultation process and theoretical and empirical literature to support the framework used by the service are provided. Some of the interventions commonly recommended to referring clinicians to reduce client suicide risk are reviewed. Although there are many challenges to running a service such as this, the authors conclude that the model presented is flexible enough to be applied in a variety of settings.

Keywords: Suicide, Evidence Based Treatment

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Osman, A., Bagge, C. L., Freedenthal, S., Gutierrez, P.M., & Emmerich, A. (2011). Development and evaluation of the social anxiety and depression life interference-24 (SADLI-24) inventory. Journal of Clinical Psychology, 67(1), 82-98.

We describe the development of a new self-report instrument, the Social Anxiety and Depression Life Interference-24 (SADLI-24) inventory. We initially retained 30 content specific items for the instrument (Study 1). In Study 2 (N = 438), we established a 2-factor solution, Social Anxiety Life Interference-12 (SALI-12) and Depression Life Interference-12 (DLI-12). We also examined estimates of known-groups and concurrent validity. Confirmatory factor analysis in Study 3 (N = 430) provided support for the oblique two-factor structure. In Study 4 (N = 179), we provided additional support for estimates of known-groups validity. In Study 5 (N = 63), we evaluated estimates of test-retest reliability. Both SADLI-24 scale scores showed good estimates of internal consistency.

Keywords: Assessment, Evidence Based Treatment, Seriously Mentally Ill (SMI)

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Osman, A., Freedenthal, S., Fang, Q., Willis, J., Norizuki, T., & Gutierrez, P.M. (2011). The UTSA Future Disposition Inventory: Further analyses of reliability, validity, and potential correlates in non-clinical samples. In A. M. Columbus (Ed.) Advances in psychology research. Hauppauge, NY: Nova Science Publishers, Inc.

Abstract not available

Keywords: Assessment, Evidence Based Treatment, Seriously Mentally Ill (SMI)

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Osman, A., Freedenthal, S., Gutierrez, P.M., Wong, J. L., Emmerich, A., & Lozano, G. (2011). The Anxiety Depression Distress Inventory-27 (ADDI-27): A short version of the Mood and Anxiety Symptom Questionnaire-90. Journal of Clinical Psychology, 67(6), 591-608.

The authors conducted three studies to construct and examine the psychometric properties of a 27-item version of the Mood and Anxiety Symptom Questionnaire-90 (MASQ-90; Watson & Clark, 1991a). The Anxiety Depression Distress Inventory-27 (ADDI-27) contains three empirically derived scales: Positive Affect, Somatic Anxiety, and General Distress, which are relevant dimensions of the tripartite model of affect. Each scale is composed of nine items, and the estimate of scale reliability for each scale score was ≥ .80 across the three studies. Results of exploratory and confirmatory factor analyses provided adequate support for a 3-factor model. Additional estimates of concurrent validity documented the ADDI-27 scales' convergent and discriminant validity. We also identified three construct relevant correlates for each scale score. Overall, the ADDI-27 appears to be a content valid, reliable, and multidimensional measure of the tripartite model of affect.

Keywords: Assessment, Evidence Based Treatment, Seriously Mentally Ill (SMI)

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Osman, A., Gutierrez, P.M., Bagge, C. L., Fang, Q., & Emmerich, A. (2010). Reynolds adolescent depression scale-second edition: A reliable and useful instrument. Journal of Clinical Psychology, 66(12), 1324-1345.

The authors conducted two studies to address issues of the dimensionality, scale reliability, and psychometric properties of scores on the Reynolds Adolescent Depression Scale-Second Edition (RADS-2; Reynolds, 2002) in samples of adolescent psychiatric inpatients. In Study 1 (N=262), they used bifactor analysis to further evaluate the general and specific components of the RADS-2. In Study 2 (N=196), they used confirmatory factor analysis to evaluate the fit of a 1-factor model, the original 4-factor model, a second-order model, and a bifactor model to a new sample data. In both studies, the total RADS-2 and content-specific subscale scores showed acceptable estimates of reliability (i.e., scale reliability estimates >.80). Estimates of concurrent validity were also examined. Scores of the RADS-2 total and content-specific subscale scores were useful in differentiating between the responses of youth with mood disorder diagnoses and those with other primary psychiatric disorder diagnoses. The authors also conducted correlation analyses to identify potential correlates for the total RADS-2 scale and the proposed subscale scores.

Keywords: Assessment, Evidence Based Treatment, Seriously Mentally Ill (SMI)

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Osman, A., Gutierrez, P.M., Barrios, F., Wong, J. L., Freedenthal, S., & Lozano, G. (2010). Development and Initial Psychometric Properties of the UTSA Future Disposition Inventory. Journal of Clinical Psychology, 66(4), 1-20.

We describe the development and initial psychometric properties of a 24-item self-report measure, the University of Texas at San Antonio Future Disposition Inventory (UTSA FDI). This instrument is designed to evaluate future related thoughts and feelings that are associated with suicide-related risk behaviors: positive focus, suicide orientation, and negative focus. The items were generated by clinical and nonclinical samples. The structure of the instrument was defined in a sample of 350 university undergraduate students (Study 1). Using CFA, we confirmed the fit of the 3-factor solution in an independent sample of college age students (n=452; Study 2). Scale reliability estimates were good (all rho's>or=.80) in both studies. Known-groups validation analyses showed that scores on each scale were useful in differentiating the responses of the study groups. Correlates for the scales were identified when scores on measures of suicide-related risk and general psychological symptoms were included as validation self-report instruments.

Keywords: Assessment, Evidence Based Treatment, Seriously Mentally Ill (SMI)

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Osman, A., Gutierrez, P.M., Schweers, R., Fang, Q., Holguin-Mills, R. L., & Cashin, M. (2010). Psychometric Evaluation of the Body Investment Scale for Use with Adolescents. Journal of Clinical Psychology, 66(3), 259-276.

We conducted two studies to examine the psychometric properties of the Body Investment Scale (BIS; Orbach & Mikulincer, 1998) in U.S. adolescent samples. The BIS was designed to assess bodily experiences that are associated with suicide-related behaviors. In Study 1, confirmatory factor analysis (CFA) with data from a combined sample of 204 high school adolescents (83 boys, 121 girls) and 197 psychiatric inpatient (101 boys, 96 girls) adolescents provided moderate support for the oblique four-factor solution: Body Feelings (rho=.86, 95% CI=.83-.89), Body Touch (rho=.71, 95% CI=.65-.76), Body Care (rho=.78, 95% CI=.71-.81), and Body Protection (rho=.78, 95% CI=.73-.82); robust comparative fit index=.88 and the robust Tucker Lewis Index=.83. The second-order factor model also provided moderate fit to the data. In Study 2, results of the CFA with data from adolescent psychiatric inpatients (N=205; 101 boys, 104 girls) provided additional support for the four-factor solution. In addition, results of the receiver operating characteristic and logistic regression analyses showed that scores on the Body Feelings and Body Protection scales were most useful in differentiating the responses of suicidal and nonsuicidal adolescents, all Cohen's d values >.30. The study also examined associations between scores on the BIS scales and the validation self-report measures of hopelessness, suicide-related behavior, and reasons for living.

Keywords: Assessment, Evidence Based Treatment, Seriously Mentally Ill (SMI)

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Osman, A., Gutierrez, P.M., Smith, K., Fang, Q., Lozano, G., & Devine, A. (2010). The Anxiety Sensitivity Index-3: Analyses of Dimensions, Reliability Estimates, and Correlates in Nonclinical Samples. Journal of Personality Assessment, 92(1), 45-52.

We investigated the factor structure, reliability estimates, and correlates of the Anxiety Sensitivity Index-3 (ASI-3; Taylor et al., 2007) in 2 studies. We established a bifactor model in Study 1 as an alternative representation of the structure of the ASI-3. Analyses of gender differences on the total ASI-3 and subscale scores were not statistically significant (Study 1, N = 462). In Study 2 (N = 293), results of a series of confirmatory factor analyses provided stronger support for the fit of the bifactor model compared with 2 alternative models. Estimates of scale reliability were adequate (all rho values > or = .80) and not "p" (as in italic p for significance). in the 2 studies. In addition, using simultaneous regression analyses, we found anxiety-specific correlates for the total ASI-3 and subscale scores to include responses on self-report measures of interpersonal sensitivity, obsessive-compulsive anxiety, paranoid ideation, and phobic anxiety.

Keywords: Assessment, Evidence Based Treatment, Seriously Mentally Ill (SMI)

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Osman, A., Gutierrez, P.M., Wong, J. L., Freedenthal, S., Bagge, C. L., & Smith, K. D. (2010). Development and Psychometric Evaluation of the Suicide Anger Expression Inventory--28. Journal of Psychopathology and Behavior Assessment, 32, 595-608.

Abstract not available

Keywords: Assessment, Evidence Based Treatment, Seriously Mentally Ill (SMI)

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