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Rocky Mountain MIRECC for VA Suicide Prevention - Margaret D. Legarreta, PhD

Rocky Mountain MIRECC for Veteran Suicide Prevention

Updated: 5 February 2018

Biography

Margaret D. Legarreta, PhDMargaret D. Legarreta, PhD
Title: Clinical Research Psychologist
Contact:
801-582-1565 x2763
margaret.legarreta@va.gov
 
Biography: Dr. Margaret Legarreta received her M.S. and PhD in Clinical Psychology from Idaho State University. While a graduate student in a generalist program she worked with adults and children alike. Wishing to develop expertise working with adults, especially Veterans she complete a pre-doctoral internship at the Central Texas VA Health Care System in Temple Texas. While there she was able to develop specific skills in the assessment and treatment of PTSD, health related behavioral issues to include chronic illnesses, chronic pain, TBI, sleep disorders, and transplant psychology. Following her internship she completed a 2 year post-doctoral fellowship at the Salt Lake City VA through the Rocky Mountain MIRECC. She is currently a licensed clinical psychologist in the state of Utah and works as a full time research psychologist studying the association between chronic pain and suicide.

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Recent Publications

Legarreta M, Bueler E, DiMuzio J, McGlade E, Yurgelun-Todd D. Suicide Behavior and Chronic Pain: An Exploration of Pain-Related Catastrophic Thinking, Disability, and Descriptions of the Pain Experience. J Nerv Ment Dis. 2018 Feb 2. doi: 10.1097/NMD.0000000000000799. [Epub ahead of print] PubMed PMID: 29394193
This study examined differences in suicidal ideation (SI) and suicide attempts (SAs) among veterans with chronic pain. Pain-specific variables, including catastrophic thinking, disability, and sensory, affective, and evaluative pain descriptors, were a focus. Structured diagnostic and clinical interviews were conducted to examine SI/SA and mental health. Veterans completed the Structured Clinical Interview for DSM-IV and the Columbia-Suicide Severity Rating Scale to assess Axis I symptoms and suicidal behavior(s). Self-report questionnaires were used to evaluate the participants' subjective experience of chronic pain, which included the McGill Pain Questionnaire, Pain Catastrophizing Scale, and Pain Disability Index. The findings add to previous literature by suggesting pain-related catastrophic thinking specifically is related to elevated risk for SA, whereas affective and sensory pain are associated with SI. The study results support the need to assess pain from a multifaceted perspective and to examine the different experiences of pain, such as sensory and affective constructs, when discussing suicide risk in veterans.
Graham J, Legarreta M, North L, DiMuzio J, McGlade E, Yurgelun-Todd D. (2016). A Preliminary Study of DSM-5 PTSD symptom Patterns in Veterans by Trauma Type. Mil Psychol, 28(2),115-122.
Posttraumatic stress disorder (PTSD) has a primary etiology in experiencing psychological trauma and the subsequent psychological sequelae (American Psychiatric Association, 2013). There are multiple trauma types that may serve as the index trauma in PTSD. This exploratory study compared DSM–5 PTSD symptoms for 3 types of trauma in veterans: combat trauma (n 36), sexual trauma (n 21), and civilian trauma (n 21). Results indicated that veterans with combat trauma were likely to experience diminished interest and detachment and estrangement from others. Veterans with sexual trauma were likely to experience detachment and estrangement from others, sleep disturbances, and problems with concentration. Veterans with civilian traumas were less likely to meet criteria for PTSD and were less likely to experience a number of PTSD symptoms. Results of this preliminary study suggest that PTSD is not a unitary disorder, but a disorder characterized by different subtypes based on the precipitating trauma.
Keywords: PTSD, veterans, trauma type, symptom profile, DSM–5
Epstein DJ, Legarreta M, Bueler E, King J, McGlade E, Yurgelun-Todd D (2016). Orbitofrontal cortical thinning and aggression in mild traumatic brain injury patients. Brain Behav, 6(12): e00581
INTRODUCTION: Although mild traumatic brain injury (mTBI) comprises 80% of all TBI, the morphological examination of the orbitofrontal cortex (OFC) in relation to clinical symptoms such as aggression, anxiety and depression in a strictly mTBI sample has never before been performed. OBJECTIVES: The primary objective of the study was to determine if mTBI patients would show morphological differences in the OFC and if the morphology of this region would relate to clinical symptoms. METHODS: Using structural images acquired in a 3T MRI machine, the cortical thickness and cortical volume (corrected for total brain volume) of the OFC was collected for healthy control (N = 27) subjects and chronic mTBI (N = 55) patients at least one year post injury. Also, during clinical interviews, measures quantifying the severity of clinical symptoms, including aggression, anxiety, and depression, were collected. RESULTS: MTBI subjects displayed increased aggression, anxiety, and depression, and anxiety and depression measures showed a relationship with the number of mTBI in which the subject lost consciousness. The cortical thickness of the right lateral OFC displayed evidence of thinning in the mTBI group; however, after correction for multiple comparisons, this difference was no longer significant. Clinical measures were not significantly related with OFC morphometry. CONCLUSION: This study found increased aggression, anxiety, and depression, in the mTBI group as well as evidence of cortical thinning in the right lateral OFC. The association between clinical symptoms and the number of mTBI with loss of consciousness suggests the number and severity of mTBI may influence clinical symptoms long after injury. Future studies examining other brain regions involved in the production and regulation of affective processes and inclusion of subjects with well-characterized mood disorders could further elucidate the relationship between mTBI, brain morphology, and clinical symptoms.
Keywords: aggression; mild traumatic brain injury; morphometry; orbitofrontal cortex
 
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