VISN 4 MIRECC Newsflash
Fall 2023
RESEARCH SPOTLIGHT |
Exploring Disparities in Alcohol-Related Care
In part, Precision Mental Health Care, the focus of our Center, entails deepening understanding of the diversity of patients as well as the differences in how they access and experience care. Tailoring care to individuals’ unique characteristics (“the right treatment, for the right patient, at the right time”) will require a clearer picture of the existing health care opportunity landscape. Take a look at some recent research from our Center on equity gaps in alcohol-related care:
➤ Big data reveals racial and ethnic biases in diagnosing alcohol use disorder
A study of the electronic health records of more than 700,000 Veterans enrolled in VA’s Million Veteran Program (MVP) found that among patients with similar levels of self-reported alcohol consumption and health issues associated with heavy drinking, there were significant discrepancies in the prevalence of alcohol use disorder (AUD) diagnoses. The difference was greatest between Black and White male Veterans, and significant differences were also seen in women and between Hispanic and White individuals. The findings lend support for future investigations examining the processes and factors that go into diagnostic decisions.
Read the Full Article
➤ Veterans with multiple health conditions less likely to receive brief intervention for unhealthy alcohol use
Researchers analyzed data for more than 280,000 Veterans in VHA primary care and found that those with multiple chronic health conditions and at high risk of hospitalization, despite endorsing more severe unhealthy alcohol use, were less likely to receive a brief intervention (BI) to help them set goals to reduce or abstain from drinking. The authors also found that higher-complexity patients with unhealthy alcohol use were more likely to be Black than lower-complexity patients. Future research is needed to study potential patient-level and clinic-level reasons for these disparities.
Read the Full Article
➤ Female patients with unhealthy alcohol use more likely to face cost barriers to care
Analyses of a national CDC survey of nearly 59,000 individuals with unhealthy alcohol use found that overall, health care access for Veterans is significantly better than for non-Veterans (regardless of where care is received). And while females with unhealthy alcohol use, regardless of Veteran status, are more likely than their male counterparts to report better access to care, females (between 15% and 18%, depending on Veteran status) are more likely to report facing cost barriers, highlighting the need for implementation research to help reduce barriers and gender gaps in alcohol-related care.
Read the Full Article
NEW ADVANCED FELLOW |
Christal Davis, Ph.D., who recently joined us in Philadelphia, is interested in using genetically informative approaches to advance our understanding of the development and outcomes of substance use. She is particularly focused on the application of statistical genetics to improve our prediction of trajectories and patterns of substance use disorders among Veterans, thereby allowing for more targeted prevention and intervention efforts.
Originally from Jackson, Miss., Dr. Davis holds a Ph.D. in clinical psychology from the University of Missouri and completed her clinical internship at the Charleston Consortium, which consists of the Medical University of South Carolina and the Ralph H. Johnson VA Medical Center. Her clinical training has focused on the treatment of substance use disorders and related comorbidities, including PTSD and chronic pain. She is especially interested in the use of mindfulness-based approaches and is passionate about advancing mental health care for women Veterans.
FUNDING UPDATE |
Henry Kranzler, M.D. and colleagues received an NIAAA grant for their project, Leveraging GWAS Findings to Map Variants and Identify Novel Effector Genes for Alcohol-Related Traits.
MIRECC Advanced Fellow Mark Thomas, Ph.D. received a Gerald Goldstein Early Career Mental Health Research Award for his project, Does Engagement in CBT for Insomnia Improve Multidimensional Sleep Health in Veterans with and without Obstructive Sleep Apnea? Dr. Thomas also received a MIRECC Pilot Project Award for his project, Effect of CPAP Adherence and MOVE! Participation on Depression and Weight Loss Using HER Data.
Subhajit Chakravorty, M.D. received CSR&D career development funding for his project, The Genetic Architecture of Co-Occurring Insomnia and Alcohol Use Disorder.
Adam Bramoweth, Ph.D., DBSM received pilot funding from the Center for Health Equity Research and Promotion (CHERP) for his quality improvement project, Treatment of Insomnia to Improve Burnout and Engagement among VAPHS Staff.
HONORS AND ACHIEVEMENTS |
Kyle Kampman, M.D. was inducted into the College of Physicians of Philadelphia. The College was started in 1787 “to advance the science of medicine and to thereby lessen human misery.”
Two posters presented by members of our MIRECC won Early Career Investigator Poster Contest Awards at 2023 VAPHS Research Week:
- Charles Bennett, Ph.D., Mary McShea, M.A., Benjamin Congedo, M.S., NCC, Elise Theodore, B.A., and Gretchen Haas, Ph.D.: Evaluation of a Novel Telehealth Methodology for Daily Monitoring of Suicidality: A Pilot Study
- Taylor Torres, B.S., Stuart Steinhauer, Ph.D., Steven Forman, M.D., Ph.D., and Sarah Forster, Ph.D.: Impact of Episodic Future Thinking on Delay Discounting in Cocaine Users with and without a History of Incarceration
Frederick Nardei, Jr., CPS-VF, CRS, CCIS was selected as VAPHS Peer Specialist of the Year for the second year in a row.
Steven Sayers, Ph.D. received the 2023 Psychologist of the Year Award from the Society for Couple and Family Psychology, Division 43 of the American Psychological Association.
Henry Kranzler, M.D. was installed as the endowed chair of the Karl E. Rickels Professorship of Psychiatry at the Perelman School of Medicine at the University of Pennsylvania.
David Oslin, M.D. received Penn Medicine’s Luigi Mastroianni, Jr. Clinical Innovator Award for his work on developing the Penn Integrated Care (PIC) program, which was modeled on the VA-developed Behavioral Health Laboratory PC-MHI program.
EDUCATIONAL ACTIVITIES |
Sarah Griffin, Ph.D. presented on “Pain, Depression, and Sleep Disturbance” for Behavioral Health Grand Rounds, presented by our Center, in July.
Steve Sayers, Ph.D. presented on “Coaching Into Care: Current Evidence and New Initiatives for Behavioral Health Grand Rounds in August.
As part of his research project, Enhancing Access to Insomnia Care (EASI Care): Implementing Brief Behavioral Treatment for Insomnia in Primary Care Mental Health Integration, Adam Bramoweth, Ph.D., DBSM and his team published a brief new patient education video on the VHA YouTube channel: “The 2 Processes that Regulate Sleep and the 4 Rules to Improve Your Sleep.” (Running Time: 2:24)
EXPERTS IN THE NEWS |
Michael Thase, M.D. spoke to SELF about ways people can talk to someone they are newly dating about their bipolar I diagnosis.
Beatrice Chakraborty, Ph.D., VAPHS site research coordinator for the Million Veteran Program (MVP), was interviewed by Erie News Now when Pittsburgh site team visited the Erie VA Medical Center to recruit Veterans to participate in MVP.
Faith Luyster, Ph.D. spoke to Verywell Health about the relationship between unhealthy sleep and asthma symptoms.
Research studies by Henry Kranzler, M.D., Amy Helstrom, Ph.D., and David Oslin, M.D. were discussed in an article about the use of naltrexone for alcohol use disorder in Filter magazine.
David Oslin, M.D. spoke to the Philadelphia Inquirer about a visit by a delegation of Ukrainian officials and doctors to the Corporal Michael J. Crescenz VA Medical Center in Philadelphia to learn about rebuilding their nation’s mental health system amid the trauma of war. One reason the group chose to consult with VA was because of its approach to integrating mental health care into the whole system of care.
Dr. Oslin’s Precision Medicine in Mental Health Care (PRIME) Care study was mentioned on a podcast discussing pharmacogenetic (PGx) testing in psychiatry from Inside Precision Medicine. The PRIME Care study and implementation aspects of PGx testing were also highlighted in an article in the summer issue HSR&D’s FORUM.
An article on which Dr. Oslin is a coauthor about a Million Veteran Program (MVP) study of suicide was highlighted in a news brief on the website of the Office of Research Development.
A systematic review authored by Gabriela Khazanov, Ph.D. of the Philadelphia Center for Substance Abuse Treatment and Education (CESATE) examining the effectiveness of financial incentives for COVID-19 vaccination was highlighted by Reason.
Henry Kranzler, M.D. spoke to Everyday Health about alcohol-related mortality deaths during the first years of COVID-19, which climbed most among minorities. He also spoke to WebMD for a story about treatments for alcohol use disorder.
A study coauthored by Caitlan Tighe, Ph.D. that explored why people who frequently experience discrimination have worse sleep was covered by WRIC ABC 8 News.
An article by Subhajit Chakravorty, M.D., Rachel Kember, Ph.D., Philip Gehrman, Ph.D., and Henry Kranzler, M.D. about the genetic risk factors of insomnia and alcohol use disorder was highlighted in a news brief on the website of the Office of Research and Development.
Philip Gehrman, Ph.D. spoke to Scientific American about research recently published in the Proceedings of the National Sciences of the USA on why sleep deprivation can sometimes improve mood. Dr. Gehrman, Elaine Boland, Ph.D., and Michael Thase, M.D. were also coauthors on the paper, which was also featured in the July issue of Penn Medicine’s Benchmarks.
Dr. Gehrman also joined WHYY’s Studio 2 to answer listener questions and talk about the latest research on sleep. He spoke to the New York Times and KCBS about cognitive behavioral therapy for insomnia (CBT-I) and to Spy.com about which trendy sleep tips are worthwhile.
An article by Isabella Soreca, M.D. about bright light therapy and its impact on sleep for people with sleep apnea was highlighted in a news brief on the website of the Office of Research and Development.
PUBLICATION HIGHLIGHTS |
Kember RL, Vickers-Smith R, Zhou H, Xu H, Jennings M, Dao C, Davis L, Sanchez-Roige S, Justice AC, Gelernter J, Vujkovic M, Kranzler HR. Genetic underpinnings of the transition from alcohol consumption to alcohol use disorder: shared and unique genetic architectures in a cross-ancestry sample. American Journal of Psychiatry. June 2023. [link]
Prasad KM, Muldoon B, Theis N, Iyengar S, Keshavan MS. Multipronged investigation of morphometry and connectivity of hippocampal network in relation to risk for psychosis using ultrahigh field MRI. Schizophrenia Research. June 2023. [link]
Goldschmied JR, Boland E, Palermo E, Barilla H, Dinges DF, Detre JA, Basner M, Sheline YI, Rao H, Gehrman P. Antidepressant effects of acute sleep deprivation are reduced in highly controlled environments. Journal of Affective Disorders. August 2023. [Link]
Vest BM, Wray LO, Thase ME, Brady LA, Chapman SR, Oslin DW. Providers' use of pharmacogenetic testing to inform antidepressant prescribing: results of qualitative interviews. Psychiatric Services. August 2023. [link]
Soreca I, Arnold N, Dombrovski AY. Bright light therapy for CPAP-resistant OSA symptoms. Journal of Clinical Sleep Medicine. September 2023. [link]
Forster SE, Torres TM, Steinhauer SR, Forman SD. Telehealth-based contingency management targeting stimulant abstinence: a case series from the COVID-19 pandemic. Journal of Studies on Alcohol and Drugs. October 2023. [link]
Chakravorty S, Kember RL, Mazzotti DR, Dashti HS, Toikumo S, Gehrman PR, Kranzler HR. The relationship between alcohol- and sleep-related traits: results from polygenic risk score and Mendelian randomization analyses. Drug and Alcohol Dependence. October 2023. [link]
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