VISN 19 MIRECC Staff: Dr. Nazanin Bahraini

Dr. Nazanin H. Bahraini

Title: Clinical/Research Psychologist
Contact:
303.399.8020 ext. 5642
nazanin.bahraini@va.gov

Dr. Nazanin H. Bahraini obtained a PhD in Counseling Psychology from the University of Denver in summer, 2008. Following completion of a Pre-Doctoral Internship at the Denver VA Medical Center Eastern Colorado Health Services Center, and a Post Doctoral Fellowship at the Denver VA Medical Center Mental Illness, Research, Education and Clinical Center (MIRECC), Dr. Bahraini became a licensed Psychologist in the state of Colorado.

Dr. Bahraini joined the VISN 19 MIRECC team as a full Research, Clinical Psychologist in 2010. Her many contributions encompass: investigatory research (Principal Investigator and Co-PI for multiple projects), consulting (expert input for mental health and medical providers on Veteran’s issues), and assessment (psychological and neuropsychological screening for a diverse Veteran population). Additionally, Dr. Bahraini supplies training opportunities for new professionals, such as clinical supervision and other activities facilitating growth of Post Doctoral Fellows, Psychology interns, etc. She is equally active in other educational activities that provide tools for Veterans, family members, and the community, through dissemination and implementation of educational products, presentations, and workshops. Dr. Bahraini also supplies key expertise for all MIRECC staff as Director of Regulatory Affairs, ensuring complete and timely compliance with all regulatory mandates. Finally, Dr. Bahraini shares her experience through a local academic appointment, as Assistant Professor at the University of Colorado Denver School of Medicine, Department of Psychiatry.

Areas of specialty are: Traumatic brain injury, posttraumatic stress disorder and other co-morbid psychiatric conditions that affect outcomes for returning Veterans. Specific research includes investigation on the effects of TBI and history of suicidal behavior on executive functioning, and an examination of cognitive processes that contribute to suicidality in OEF/OIF combat Veterans with PTSD. Dr. Bahraini has presented regionally as well as nationally on these and other topics, for prestigious events such as the National Mental Health Conference, American Association of Suicidology, and the American Psychiatric Association. For a comprehensive listing of her presentations, publications, workshops and educational products, please see below.

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Research Projects

Burden Belonging and Response to Pain in Veterans

Research Team: Peter M. Gutierrez PhD, Lisa A. Brenner PhD, Theresa D. Hernández PhD, Nazanin H. Bahraini PhD, Bridget B. Matarazzo PsyD, James Pease MSW, Jennifer Olson-Madden PhD

This study is designed to test the psychometric properties of the Interpersonal Needs Questionnaire (INQ-12) and the Acquired Capability for Suicide Scale (ACSS) in a sample of military veterans, something which has not been done. These measures were developed to assess the constructs of Joiner’s interpersonal psychological theory of suicide. Secondary goals of the study are to determine if values mediate the relationship between reasons for living and suicide risk, and whether participants’ suicidal wish can be categorized as either escaping their problems or influencing other people.

Keywords: Suicide Prevention

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Examining the relationship between personal values, interpersonal needs, and suicidal ideation in a Veteran population

Research Team: Nazanin H. Bahraini PhD, Lisa A. Brenner PhD, Patricia Alexander PhD, Jeri E.Forster PhD, Stephen Bensen PhD, Marie Devore MS

Through this research we hope to understand which values (e.g., power, achievement, security) and value dimensions (e.g., importance, success) have the strongest impact on suicidality in this population.

Keywords: Suicide Prevention

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Executive Dysfunction and Suicide in Psychiatric Inpatients and Outpatients

Research Team: Lisa A. Brenner PhD, Beeta Homaifar PhD, Nazanin H. Bahraini PhD, Joe Huggins MSW MSCIS, Jeri E. Forster PhD, Herbert Nagamoto MD, Shea A. Lott MA, Brooke Holliman MA

This study will assess decision making in the context of an interaction between suicide and TBI.

Keywords: Suicide Prevention, Seriously Mentally Ill (SMI), Traumatic Brain Injury (TBI)

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Experiential avoidance in combat Veterans with and without posttraumatic stress disorder (PTSD)

Research Team: Nazanin H. Bahraini PhD, Lisa A. Brenner PhD, Marie Devore MS

This study is designed to test a novel method of measuring avoidance of trauma-related material in combat Veterans with and without PTSD, and to compare this novel behavioral measure of avoidance with other traditional self report measures of avoidance.

Keywords: Suicide Prevention, Post Traumatic Stress Disorder (PTSD)

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Providing Mental Health Services to Operation Iraqi Freedom (OIF)/Operation Enduring Freedom (OEF) Veterans: Provider Perspectives

Research Team: Gina M Signoracci, PhD, Lisa A. Brenner PhD, Jennifer Olson-Madden, PhD, Nazanin H. Bahraini, PhD

The purpose of this study is to gather information from VISN 19 ECHCS Denver VA professionals regarding their perspectives of necessary resources to provide mental health service to Operation Iraqi Freedom (OIF)/ Operation Enduring Freedom (OEF) Veterans.

Keywords: OEF/OIF/OND

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Recent Presentations

Suicide Risk Assessment and Prevention in Military Personnel

6/13/11

Military Healthcare Convention & Conference in San Antonio, Texas

PowerPoint | PDF 

Keywords: Suicide Prevention, Evidence-Based Treatments
Also: Suicide risk assessment, Suicide risk factors military, Safety planning, Veteran suicide risk

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Recent Publications (since 2009)

Bahraini, N. H., Brenner, L. A., Harwood, J. E. F., Homaifar, B. Y., Ladley-O’Brien, S. E., Filley, C. M., et al. (Adler, L. E.). (2009). Utility of the Trauma Symptom Inventory for the assessment of posttraumatic stress symptoms in veterans with a history of psychological trauma and/or brain injury. Military Medicine, Oct;174(10):1005-9.

Correspondence of three core Trauma Symptom Inventory (TSI) posttraumatic stress disorder (PTSD) scales (Intrusive Experiences, Defensive Avoidance, and Anxious Arousal) and the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-IV) PTSD module were examined among 72 veterans with traumatic brain injury (TBI), PTSD, or both conditions. Subjects were classified into PTSD only, TBI only, or co-occurring PTSD and TBI groups based on TBI assessment and SCID-IV PTSD diagnosis. Linear regression was used to model TSI T-Scores as a function of group. Scores on all three scales significantly differed between the TBI and PTSD groups (PTSD only and co-occurring PTSD and TBI) in the expected direction. Study findings indicate that despite the potential overlap of symptoms between PTSD and TBI, the TSI appears to be a useful measure of trauma-related symptoms in veterans who may also have a TBI, particularly mild TBI. Limitations and areas for future research are discussed.

Keywords: PTSD, Traumatic Brain Injury (TBI)

Bahraini NH, Gutierrez PM, Harwood JEF, Huggins JA, Hedegaard H, Chase M, Brenner LA. (2012). The Colorado Violent Death Reporting System (COVDRS): Validity and Utility of the Veteran Status Variable. Public Health Rep., May/Jun;127(3):304-309.

Objective. Using the Veterans Affairs Beneficiary Identification Record Locator Subsystem (BIRLS) as the criterion database, we evaluated the sensitivity and specificity of the death certificate information in the Colorado Violent Death Reporting System (COVDRS) to determine Veteran status for those who died by suicide. Methods. The study sample consisted of 3,820 individuals aged 18 years and older who died by suicide in Colorado from January 1, 2004, through December 31, 2008. To determine agreement on Veteran status, COVDRS data were submitted to the Veterans Benefits Administration for linkage to the BIRLS using Social Security numbers. Results. Sensitivity and specificity of the Veteran status information on the death certificate were 93.1% (95% confidence interval [CI] 90.7, 95.2) and 91.7% (95% CI 90.5, 92.8), respectively. The overall agreement between the death certificate and the BIRLS on Veteran status was very good (kappa 5 0.76; 95% CI 0.74, 0.79). Conclusions. This study of 3,820 suicide deaths in Colorado demonstrated a high level of agreement between the COVDRS Veteran status variable and the BIRLS. Such findings offer support for using the COVDRS in studying factors associated with suicide in the Veteran population.

Keywords: Suicide

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Bates MJ, Bradley JC, Bahraini NH, Goldenberg MN. (2012). Clinical Management of Suicide Risk with Military and Veteran Personnel. Chapter in Textbook of Suicide Assessment and Management, 2nd Edition Edited by Simon RI and Hales RE. The American Pyschiatric Publishing, Washington DC, 405-441.

No abstract available

Keywords: Suicide

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Betthauser LM, Bahraini N, Krengel MH, Brenner LA. Self-Report Measures to Identify Post Traumatic Stress Disorder and/or Mild Traumatic Brain Injury and Associated Symptoms in Military Veterans of Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF). Neuropsychol Rev. 2012 Feb 19.

Individuals serving in Iraq and Afghanistan sustain injuries associated with physical and psychological trauma. Among such injuries, mild traumatic brain injury (mTBI) and post traumatic stress disorder (PTSD) are common. Self-report measures are frequently used to identify mTBI and/or PTSD and symptoms associated with these conditions. In addition to providing information regarding mTBI and PTSD, the goal of this literature review was to identify and present information on the psychometric properties of measures used to obtain information regarding these common conditions among Veterans who have returned from Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF). A comprehensive review of studies in which self-report measures were used to evaluate mTBI, PTSD, and associated symptoms among OEF/OIF Veterans is presented. Findings suggest that additional work is needed to identify psychometrically sound and clinically useful self-report measures that assess mTBI and PTSD and associated symptoms among OEF/OIF Veterans.

Keywords: OEF/OIF/OND, PTSD, Traumatic Brain Injury (TBI)

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Brenner L, Bahraini N and Hernández TD (2012). Perspectives on creating clinically relevant blast models for mild traumatic brain injury and post traumatic stress disorder symptoms. Front. Neur. 3:31.

Military personnel are returning from Iraq and Afghanistan and reporting non-specific physical (somatic), behavioral, psychological, and cognitive symptoms. Many of these symptoms are frequently associated with mild traumatic brain injury (mTBI) and/or post traumatic stress disorder (PTSD). Despite significant attention and advances in assessment and intervention for these two conditions, challenges persist. To address this, clinically relevant blast models are essential in the full characterization of this type of injury, as well as in the testing and identification of potential treatment strategies. In this publication, existing diagnostic challenges and current treatment practices for mTBI and/or PTSD will be summarized, along with suggestions regarding how what has been learned from existing models of PTSD and traditional mechanism (e.g., non-blast) TBI can be used to facilitate the development of clinically relevant blast models.

Keywords: PTSD, Traumatic Brain Injury (TBI)

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Homaifar, B. Y., Bahraini, N.H., Silverman, M.M., Brenner, L.A.. (2012). Executive Functioning as a Component of Suicide Risk Assessment: Clarifying its Role in Standard Clinical Applications. Journal of Mental Health Counseling, 34(2), 110-120.

Clinically, because executive dysfunction (e.g., impulsivity, insight, thinking process) is often thought of in the context of those with traumatic brain injuries and other neurologic conditions, its formal assessment has historically been seen as the domain of those who assess and treat patients with neurologic disease. However, mental health counselors (MHCs) could benefit from learning how executive functioning relates to suicide risk assessment and coping strategies. Assessment of executive functions can be incorporated in routine clinical practice without the need for formal neuropsychological measures or other time-consuming procedures. In fact, during standard clinical assessment, mental health professionals often informally assess components of executive functioning such as impulsivity, insight, and thinking processes. This article highlights aspects of executive functioning with which MHCs may already be familiar and demonstrates their clinical utility in enhancing assessment and management of suicide-related thoughts and behaviors.

Keywords: Assessment, Suicide Prevention, Traumatic Brain Injury

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