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Selected Key Research Projects

 
 
Assessing Readiness for Nurse Implementation of Alcohol Screening, Brief Intervention, and Referral to Treatment [RN-SBIRT]
PI: Lauren Broyles, Ph.D.
Funding Source: MIRECC Pilot
Study Site: Pittsburgh
While hazardous alcohol consumption and alcohol-related disorders are common among hospital inpatients, routine alcohol Screening, Brief Intervention, and Referral to Treatment (SBIRT) are relatively uncommon in inpatient settings, thus leaving unhealthy alcohol use under-detected and under-managed. The inpatient general medical setting (IGMS) may provide an ideal opportunity for alcohol-related health promotion and intervention led by nurses. However, the extent to which inpatient nurses feel professionally prepared to conduct alcohol screening and intervention in this particular clinical context is unknown. The specific aims of this study are 1) to assess nurses’ readiness to screen and intervene for unhealthy alcohol use among inpatients, and 2) to identify facilitators and barriers to nurse-delivered SBIRT in IGMS.

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The Effectiveness of rTMS in Depressed Patients (CSP#556)
PI’s: Steven Forman, M.D., Ph.D. (Pittsburgh), Michael Thase, M.D. (Philadelphia)
Funding Source: VA Cooperative Studies Program (#556)
Study Sites: Pittsburgh and Philadelphia
The goal of this study is to evaluate the efficacy, safety, durability of benefits and cost-effectiveness of repetitive Transcranial Magnetic Stimulation (rTMS) in the resolution of Treatment-Resistant Major Depression (TRMD) with emphasis on the unique VA population of depressed patients that are commonly comorbid for substance abuse and/or Post-Traumatic Stress Disorder (PTSD).

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Insight and Neurocognitive Functioning in Veterans with Bipolar Disorder
PI: Gerald Goldstein, Ph.D.
Funding Source: MIRECC Core
Study Site: Pittsburgh
The aim of this study is to formally examine the relationship between deficits in insight and neurocognition in bipolar subjects. In addition, this study will examine the effects of excessive use of alcohol on insight in alcoholic versus non-alcoholic bipolar subjects. By use of magnetic resonance imaging (MRI), this study will also assess prefrontal and hippocampal volume in bipolar subjects with and without alcohol dependence.

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Computer-Based Cognitive Remediation for Individuals with Schizophrenia and Alcoholism
PI: Gretchen Haas, Ph.D.
Funding Source: MIRECC Core
Study Site: Pittsburgh
This study investigates the ability of individuals with schizophrenia to perform computerized cognitive remediation (‘training’) tasks and the generalizability of skills attained on these tasks to neurocognitive, social cognitive and social skills domains.

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Primary Prevention of Major Depressive Disorder in Old Age
PI: John Kasckow, M.D., Ph.D.
Philadelphia Site PI: David Oslin, M.D.
Funding Source: MIRECC Core
Study Site: Pittsburgh and Philadelphia
This qualitative study examines patient preferences for treatment of comorbid depressive and substance use disorders to help inform the development of more effective and acceptable interventions and treatment plans for dually or multiply diagnosed individuals. The specific goals are 1) to describe patient preferences for treatment of comorbid depression and substance use and 2) to compare preferences among individuals who have a) primary depression with substance abuse, b) primary substance abuse with depression and c) depression alone.

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Comorbid Depression and Substance Use: Understanding Veteran Treatment Preferences
PI: Morgen Kelly, Ph.D.
Funding Source: MIRECC Pilot
Study Site: Pittsburgh
This qualitative study examines patient preferences for treatment of comorbid depressive and substance use disorders to help inform the development of more effective and acceptable interventions and treatment plans for dually or multiply diagnosed individuals. The specific goals are 1) to describe patient preferences for treatment of comorbid depression and substance use and 2) to compare preferences among individuals who have a) primary depression with substance abuse, b) primary substance abuse with depression and c) depression alone.

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Health-Related Social Control among Veterans with Depression in Primary Care
PI: Shahrzad Mavandadi, Ph.D.
Funding source: VISN 4 Competitive Pilot Project Fund
Site: Philadelphia
Social control attempts, or attempts by social network members to influence and regulate a target person's behavior, have been shown to significantly predict participation in health behaviors and psychological wellbeing in both non-clinical and physically ill (e.g., diabetes) populations. However, despite the fact that depression is associated with compromised interpersonal functioning, maladaptive cognitive attributions, and poor health behaviors, social control processes have not been studied within the context of depression. Thus, the objectives of this pilot study are:
to explore differential vulnerability to various social control attempts among veterans with major and/or other depression vs. no depression,
examine the degree to which depression moderates the relationship between social control attempts and behavioral and affective responses to those attempts,
assess the degree to which attributions account for the relationship between depression and behavioral and affective responses, and
longitudinally examine whether baseline social control attempts and behavioral and affective responses predict subsequent health outcomes.

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Effectiveness of Extended Treatments for Drug Dependence
PI: James McKay, Ph.D.
Funding source: NIDA
Study site: Philadelphia
The goal of this project is to test an adaptive model of care for individuals with cocaine dependence who seek treatment in the VA and community-based, specialty care programs. Patients (N=300) who complete an intake at an Intensive Outpatient Program (IOP) will be randomized into two conditions, which use telephone-based Motivational Interviewing (MI) to increase rates of engagement in either standard IOP (MI-IOP), or in one of four treatment options selected by the patient (MI-PC). Patients are eligible for these interventions if they fail to attend IOP regularly in weeks 1-2 (the "Non-engaged" group), or if they achieve initial engagement (the "Engaged" group) but subsequently stop attending IOP at some point during weeks 3-12. The treatment options in MI-PC are IOP, telephone-based stepped care, individual CBT, or the combination of naltrexone and medication management (for patients who have co-occurring alcohol and cocaine dependence).

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Pharmacogenetic Response to Naltrexone for Alcohol Dependence
PI: David W. Oslin, M.D.
Pittsburgh Site PI: Adam Gordon, M.D.
Funding Source: NIAAA
Study Site: Philadelphia & Pittsburgh
The aims of the study are to test for treatment outcome differences in alcohol dependent subjects randomly assigned to 12 weeks of treatment with naltrexone (NTX; 50mg/day) or placebo among those with one or two copies of the Asp40 allele of the mu-opioid receptor compared to those homozygous for the Asn40 allele. The design of the study is a 2X2 cell double-blind randomization to NTX or placebo stratified by genotype. Up to 70 outpatient subjects of European or Asian descent who are at least age 18 with alcohol dependence are randomly assigned to one of the two treatment conditions based on their genotype (AA, AG, GG) in a double-blind fashion. All subjects also receive regularly scheduled manualized adherence enhancement therapy for alcoholism. The primary study outcome is alcohol use (5 or more drinks per day for men and 4 or more for women).

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Accessible Website Design for Cognitive Impairment, e.g. Schizophrenia
PI: Armando Rotondi, Ph.D.
Funding Source: VA - RR&D
Study Site: Pittsburgh
The overall goal of this project is to use a group of persons with cognitive impairments to explore website interface design effectiveness, and develop a set of empirically-based interface design guidelines to create accessible websites for a population of persons with cognitive impairments. Specifically, the project will focus on persons with schizophrenia/schizoaffective disorder.

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Treatment of OEF/OIF Neuropsychiatric Symptoms Following TBI
PI: Armando Rotondi, Ph.D.
Funding Source: VA - HSR&D
Study Site: Pittsburgh
The overall goal of this project is to develop and test the feasibility and acceptability of a web-based intervention for OEF/OIF veterans and their families to treat veteran and family stresses and in particular the neuropsychiatric/behavioral consequences of complicated-mild TBI (cm-TBI). The intervention will provide evidence-based family-centered psychoeducational therapy. To improve access and acceptability, it will incorporate a web-enhanced delivery method.

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Contact

Hank Kranzler, M.D.
Co-Associate Director for Research
Philadelphia VAMC
215-823-5800 Ext. 2224
kranzler@mail.med.upenn.edu

Robert Sweet, M.D.
Co-Associate Director for Research
VA Pittsburgh Healthcare System
412-954-5354
robert.sweet@va.gov