MIRECC Presents Archive 2019-2020

MIRECC Presents Archive

June 3, 2020: Posttraumatic headaches: Current concepts in pathophysiology, diagnosis, and management
Cynthia Mayer, DO

Chronic headaches can occur after trauma and can co-exist with traumatic brain injury and chronic PTSD, causing significant discomfort for patients and impairing optimal functioning. This presentation will summarize the current status of clinical care and research related to posttraumatic headaches and discuss guidelines for assessment and treatment.

April 15, 2020: The role of religion/spirituality in mental health outcomes for PTSD
Zhen Cheng, PhD

Religion and spirituality have become increasingly important in psychiatric assessment and treatment. They can be an important part of cultural heritage, and they also can be important in healing and social supports. This presentation discussED the relevance of religion and spirituality in clinical outcomes for mental health conditions, including PTSD.

April 1, 2020: Treatment engagement and retention in patients with PTSD
Shannon Kehle-Forbes, PhD

Despite the development of evidence-based, effective treatments for PTSD within VA, treatment engagement and retention continue to be challenging, but they are essential for effective treatment. This presentation will explore some of the factors that influence engagement and retention and provide clinical suggestions for optimizing treatment engagement and retention.

March 18, 2020: Evidence for glymphatic dysfunction in Alzheimer’s Disease: Sleep, waste, and neurodegeneration at the crossroads of the Central Nervous System
Jeff Iliff, PhD

Alzheimer’s Disease continues to be an important contributor to morbidity and mortality among Veterans. The glymphatic system, a brain-wide network that facilitates the clearance of waste products, has been demonstrated to fail in the aging brain and in the young brain after traumatic brain injury. Impairment of glymphatic function may link brain trauma early in life with the development of dementia in later years. This clinically relevant presentation will explore the implications of impairment of glymphatic function for vulnerability to Alzheimer’s Disease.

March 4, 2020: Dialectical Behavioral Therapy (DBT) for treating PTSD
Melanie S. Harned, PhD, ABPP

Dialectical Behavior Therapy (DBT) was originally developed to treat chronically suicidal and self-injuring individuals with multiple mental disorders and pervasive emotion dysregulation. From its inception, DBT has highlighted the role of trauma as a common etiological factor and posttraumatic stress disorder (PTSD) as an important treatment target for many patients who receive this treatment. In this talk, the basic structure and procedures of the DBT Prolonged Exposure (DBT PE) protocol will be outlined and the clinical challenges encountered during its development will be discussed. In addition, research findings supporting the safety and effectiveness of the integrated DBT and DBT PE protocol treatment will be presented.

Outcome/Objectives:  

1. Understand the rationale for integrating PTSD treatment into DBT.
2. Outline the basic structure and procedures of the DBT Prolonged Exposure protocol for PTSD.
3. Review research findings evaluating the safety and effectiveness of the treatment.

February 19, 2020: Dissociation, Somatization, and Other Challenging Presentations of PTSD
Abigail Angkaw, PhD

Challenging presentations of PTSD, particularly dissociation and somatization trauma reactions, sometimes lead clinicians to hesitate offering evidence-based PTSD treatment. This course will help clinicians identify and understand dissociation and somatization presentations as trauma reactions within a PTSD case conceptualization framework, and will include reviewing clinical suggestions to support first-line evidence-based PTSD treatment for Veterans with these challenging presentations.

Outcome/Objectives:  
1. Describe how individuals with PTSD may present with dissociation and somatization;
2. Discuss the rationale for not immediately excluding individuals with PTSD and dissociation or somatization reactions from evidence-based treatments for PTSD;
3. Identify methods to address dissociation and somatization PTSD reactions within evidence-based PTSD treatment.

February 5, 2020: Clinical and administrative applications of the PTSD-Repository Clinical Trials Database
Maya O’Neil, Ph.D., Jessica Hamblen, PhD, Tamara Cheney, MD

The development and use of evidence-based treatments for PTSD remains an important VA mission. This requires PTSD research that can inform and positively impact patient care. This presentation will highlight the relevance and effective use of the national PTSD repository for VA clinicians, educators, and researchers.

Outcome/Objectives: 
1. Understand the rationale behind developing the PTSD-Repository;
2. Identify key patient, study, and outcome variables included in the PTSD-Repository;
3. Learn how to use the PTSD-Repository for clinical, administrative, educational, or research purposes.

January 15, 2020: Unconventional interventions for PTSD: State of the evidence
Paul Holtzheimer, MD, MSCR

Currently, several nonpharmacologic biological treatments are being investigated for the treatment of trauma. This presentation will explore the current evidence base for the use of these treatments, such as stellate ganglion block and hyperbaric oxygen, in PTSD treatment.

Outcome/Objectives: 
1. describe various proposed non-pharmacologic biological treatements for PTSD
2. discuss the regulatory processes that provide safety oversight for these interventions; and
3. identify the safety and efficay data for focal brain stimulation in PTSD treatment.

December 18, 2019: Focal Brain Stimulation for PTSD
Paul Holtzheimer, MD, MSCR

Currently, several nonpharmacologic biological treatments are being investigated for the treatment of PTSD. This presentation will focus on the current evidence base for a particularly promising clinical treatment, focal brain stimulation, including potential benefits and risks.

Outcome/Objectives: 
1. Describe the neural circuit paradigm that supports the use of focal brain stimulation for PTSD;
2. Summarize the rationale for using focal brain stimulation to treat PTSD; and
3. Identify the safety and efficay data for focal brain stimulation in PTSD treatment.

December 4, 2019: Lethal means safety: How clinicians can have the conversation
Bridget Matarazzo, PsyD

Lethal means safety is an important part of suicide prevention and risk assessment, one of the highest mental health priorities in VHA. This presentation will provide practical guidelines for clinicians for discussing lethal means safety with their patients in order to lower suicide risk.

Outcomes/Objectives:
1. Explain the importance of discussing lethal means safety with patients
2. Identify patients with whom providers should discuss lethal means safety
3. Discuss safe storage practices for firearms and medications

November, 2019: Quality of Care and Patient Outcomes Following Discontinuation of Long-Term Opioid Therapy in High-Risk Patients
Travis Lovejoy, PhD

The effective treatment of chronic pain is one of the greatest challenges for clinicians. Just as challenging is tapering and discontinuation of long-term opioids. This presentation will discuss these challenges that clinicians face with high-risk patients, and will offer perspectives on clinical outcomes and optimizing quality of care after opioid discontinuation.

Outcome/Objectives
1. Describe historical trends in opioid prescribing in the U.S.
2. Identify the consequences of opioid taper and discontinuation among long-term opioid users
3. Characterize changes in patients’ pain following discontinuation of long-term opioid therapy

November 6, 2019: Diagnosing ADHD in Adults, and Considering Treatment Options
Whitney Black, MD

One of the most challenging psychiatric illnesses to diagnose and treat is ADHD. Symptoms can overlap with several other conditions, and accurate diagnosis is dependent on an estimation of patient functioning going back to childhood and adolescence. Moreover, treatment options include the appropriate use of controlled substances with potential for misuse. This presentation will focus on these important clinical issues, and it will include considerations particularly relevant to the care of Veterans and healthcare teams.

Outcome/Objectives
1. Identify evidence-based screening measures when diagnosing ADHD
2. Describe strategies for psychostimulant titration trials in adult patients; and
3. Describe the role for non-stimulant medications in treatment of adults with ADHD.

October 16, 2019: The role of psychedelics in modern psychiatry: A review of the evidence base
Melissa Buboltz, MD, Aryan Sarparast, MD, Payton Sterba, MD, Jovo Vijanderan, MD

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