Aaron P Turner

Aaron P Turner
VA Puget Sound Health Care System · Department of Rehabilitation Medicine

PhD

About

124
Publications
19,877
Reads
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3,493
Citations
Additional affiliations
July 2016 - present
University of Washington Seattle
Position
  • Professor (Full)
July 2009 - present
VA Puget Sound Health Care System
Position
  • Managing Director
July 2009 - June 2015
University of Washington Seattle
Position
  • Professor (Associate)

Publications

Publications (124)
Article
Purpose/objective: While personality traits have been well-documented to be related to resilience in several populations, they have yet to be explored in people with multiple sclerosis (PwMS). As such, this study aimed to understand how personality traits are associated with MS-related resilience after considering the independent contributions of...
Article
Background The Multiple Sclerosis Resiliency Scale (MSRS) was designed to assess factors connected to resilience when facing MS-related challenges. Although the MSRS has demonstrated good internal consistency and construct validity, its test-retest reliability has yet to be established. Identifying the minimal detectable change (MDC) of the scale w...
Article
Full-text available
Background Women Veterans with amputation are a group with unique needs whose numbers have grown over the last 5 years, accounting for nearly 3% of all Veterans with amputation in 2019. Although identified as a national priority by the Veterans Health Administration, the needs of this population have remained largely underrepresented in amputation...
Article
Objectives: Difficulties with prospective memory (PM) are not routinely assessed in persons with multiple sclerosis (MS) even though they can impact daily functioning. This study aimed to examine the preliminary criterion and ecological validity of a highly abbreviated Memory for Intentions Test (MIST) intended to serve as an initial screening of P...
Article
Background: While comorbidities have been associated with all-cause hospitalizations among persons with multiple sclerosis (MS), there has been no examination of their role in all-cause emergency department (ED) utilization. As such, this study aimed to determine if the presence of comorbidities increases the odds of ED usage in a national sample o...
Article
Full-text available
Purpose There is limited qualitative research on the experience of patients undergoing lower limb amputation due to chronic limb threatening ischemia (CLTI) and their participation in amputation-level decisions. This study was performed to understand patient lived experiences related to amputation and patient involvement in shared decision making....
Article
Effective, rigorously evaluated nonpharmacological treatments for chronic pain are needed. This study compared the effectiveness of training in hypnosis (HYP) and mindfulness meditation (MM) to an active education control (ED). Veterans (N=328) were randomly assigned to 8 manualized, group-based, in-person sessions of HYP (n = 110), MM (n = 108), o...
Article
Objective: To examine the relationship between neuropsychological functioning and performance-based functional capacity in Veterans with a history of mild traumatic brain injury (mTBI), as well as the moderating effect of age and psychiatric symptoms on this relationship. Setting: Three VA medical centers. Participants: One hundred nineteen Iraq/Af...
Article
Objectives 1) To identify the rate of short-notice cancelled appointments in a large national sample of persons with multiple sclerosis (MS) and 2) examine the demographic and clinical factors associated with frequent cancellations. Design Retrospective cross-sectional cohort using electronic health records. Setting Veterans Health Administration...
Article
Background and purpose: Many persons with multiple sclerosis (PwMS) experience cognitive impairments, which may affect their ability to engage in physical therapy. There is limited information on how cognitive impairments are associated with PwMS' ability to participate and improve their functional outcomes. This study aimed to assess the relation...
Article
Fatigue is one of the most common and disabling symptoms of multiple sclerosis (MS). A recent randomized controlled trial comparing a fatigue self-management program and a general MS education program found that both programs improved fatigue in participants with MS. Participants were randomized to a self-management program (Fatigue: Take Control,...
Article
Background: Fatigue is one of the most prevalent and impactful symptoms for people with multiple sclerosis (MS). Yet, fatigue is less understood in progressive forms of MS, and few studies have explored the extent to which MS disease course is associated with fatigue. The current study aimed to (1) describe fatigue severity and fatigue interferenc...
Article
Objectives: To examine the biopsychosocial correlates of overall and individual self-management behaviors in persons with multiple sclerosis (PwMS), including demographics, co-occurring medical diagnoses, cognition, personality traits, and psychosocial and physical functioning as variables. Design: Prospective cross-sectional cohort study. Sett...
Article
Background Chronic pain in Veterans is a major problem compounded by comorbid posttraumatic stress disorder (PTSD) and depression. Adopting a transdiagnostic framework to understanding “shared territory” among these diagnoses has the potential to inform our understanding of the underlying cognitive processes and mechanisms that transverse diagnosti...
Article
Objective To describe pain intensity and interference in people with progressive multiple sclerosis (MS), compare these to people with relapsing-remitting MS (RRMS), and identify common and unique factors associated with pain intensity in people with progressive MS and RRMS. Design Observational, cross-sectional analysis using baseline data from a...
Article
Objective To: 1) evaluate the impact of a group-based self-management treatment intervention (VETPALS) on physical and psychosocial functioning (co-primary outcomes) and quality of life (secondary outcome) in individuals with amputation and 2) examine the feasibility and acceptability of the intervention in a large national health care system. Des...
Article
Objective: To examine associations among compensatory cognitive training (CCT), objective cognitive functioning, and self-reported cognitive symptoms. We examined whether change in objective cognitive functioning associated with participation in CCT at 10-week follow-up mediates change in self-reported cognitive symptoms associated with CCT at 15-...
Article
Objective: Psychological treatments for chronic low back pain (CLBP) are effective. However, limited research has investigated their neurophysiological mechanisms. This study examined electroencephalography- (EEG-) assessed brain oscillation changes as potential mechanisms of cognitive therapy (CT), mindfulness-meditation (MM), and mindfulness-bas...
Article
Full-text available
Objectives Persons with multiple sclerosis (MS) can face a number of potential healthcare-related barriers, for which mobile health (mHealth) technology can be potentially beneficial. This review aimed to understand the frequency, current uses, and potential barriers with mHealth usage among persons with MS. Methods A query string was used to iden...
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Full-text available
Purpose of Review Individuals undergoing amputations typically present with comorbid conditions that may adversely impact mortality, mobility, residual limb healing, mood, function, and participation. Understanding how to manage these individuals holistically is essential to optimize function and reduce complications. Recent Findings A review of r...
Article
Background Depression, fatigue, and pain commonly co-occur in multiple sclerosis (MS) and are positively associated with one another. However, it is unclear whether treatment-related improvement in one of these symptoms is associated with improvements in the other two symptoms. Purpose This study examined whether early improvements in depressive s...
Article
Objectives: To (1) describe depressive symptom severity and suicidal ideation (SI) in persons with progressive multiple sclerosis (MS); (2) compare depressive symptom severity and SI in persons with progressive MS and persons with relapsing-remitting MS (RRMS); and (3) identify common and unique risk factors for greater depressive symptom severity...
Article
Objective: Chronic pain rehabilitation warrants sensitivity to unique psychosocial factors, such as trauma history. In Veterans of the United States Armed Forces, military sexual trauma (MST) is a pervasive type of trauma associated with a host of physical and psychological sequelae. A growing literature suggests a relationship between history of...
Article
Objective: The purpose of the current study was to determine modifiable predictors of intervention adherence in a study of group-based Compensatory Cognitive Training (CCT) for Iraq/Afghanistan Veterans with a history of mild traumatic brain injury (mTBI). Methods: One hundred twenty-three Veterans enrolled in a randomized controlled trial of a 10-...
Article
Objective This study examined risk factors in the year prior to suicide in a national sample of Veterans with multiple sclerosis (MS) as well as means of suicide and receipt of mental health services prior to death Design Case control Study. Individuals in the VA MS National Data Repository were linked to the National Death Index Plus to obtain de...
Article
Importance: Multiple sclerosis (MS) is a complex and unpredictable neurologic disease affecting nearly 1 million people in the US. People with MS commonly experience multiple physical and psychological symptoms such as depression, anxiety, stress, fatigue, and pain that impact functioning and quality of life. Subsequently, living with MS requires...
Article
Purpose/objective: The objective of the study was to examine the BIS-BAS model of chronic pain. This model posits that 2 neurophysiological systems-the behavioral inhibition system (BIS) sensitized to and activated by punishment cues and the behavioral activation system (BAS) sensitized to and activated by reward cues-make independent and concurre...
Article
Objectives: To describe the protocol of a randomized controlled trial to evaluate the effectiveness and mechanisms of three behavioral interventions. Methods: Participants will include up to 343 Veterans with chronic pain due to a broad range of etiologies, randomly assigned to one of three 8-week manualized in-person group treatments: (1) Hypno...
Article
Objective: Aging with physical disability disrupts one’s ability to achieve valued goals due to changes in symptoms and function. It is unclear how to cope optimally in this context. This study examined whether two possible strategies—tenacious goal pursuit (TGP) and flexible goal adjustment (FGA)—were associated with reduced pain interference and...
Article
Objective To determine which factors are associated with suboptimal disease-modifying therapy (DMT) adherence, and to develop an explanatory model that could be used to identify individuals at risk and potentially inform interventions. Design Cross-sectional cohort study using electronic health records. Setting Veterans Health Administration (VA)...
Article
Background: Missed appointments can have negative effects on several facets of healthcare, including disruption of services, worse patient health outcomes, and increased costs. The influence of demographic and clinical factors on missed appointments has been studied in a number of chronic conditions, but not yet in multiple sclerosis (MS). Engagem...
Article
Background Patients undergoing amputation of the lower extremity for the complications of peripheral artery disease and/or diabetes are at risk of treatment failure and the need for reamputation at a higher level. The aim of this study was to develop a patient‐specific reamputation risk prediction model. Methods Patients with incident unilateral t...
Article
Self-management (SM) interventions improve pain, fatigue, and depression in individuals with chronic health conditions. However, little is known about the psychological mechanisms underlying symptom improvement. The current study sought to identify potential mechanisms that mediate the effect of participation in a cognitive-behavioral SM interventi...
Article
Background: Depression is a common comorbid condition among individuals with multiple sclerosis (MS) and is associated with greater overall disease burden and lower quality of life. Numerous clinical trials have supported physical activity interventions versus education, usual care, and attention control conditions for improving depressive symptom...
Article
Background Patients who undergo lower extremity amputation secondary to the complications of diabetes or peripheral artery disease have poor long‐term survival. Providing patients and surgeons with individual‐patient, rather than population, survival estimates provides them with important information to make individualized treatment decisions. Met...
Article
Objectives: Characterize the course of depressive symptoms during the first year after dysvascular amputation and identify factors that predict symptom trajectories. Design: Prospective cohort study of individuals undergoing lower extremity amputation (LEA), surveyed at 4 time points (perioperative period, 6 weeks, 4 months, and 12 months postam...
Article
Objective: Much is known about the associations between negative factors and adjustment to chronic pain. However, less is known about how positive factors (e.g., positive affect [PA], resilience) function in relation to disability and mood in individuals with multiple sclerosis (MS). To better understand how positive factors contribute to function...
Article
Objective: To examine the extent to which pain catastrophizing, fatigue catastrophizing, positive affect, and negative affect simultaneously mediated the associations between common symptoms of multiple sclerosis (MS; i.e., pain, fatigue) and impact on daily life, depressive symptoms, and resilience. Method: Participants were community-dwelling...
Article
Objective: To examine moderators of treatment effects in a randomized controlled trial comparing a telehealth self-management intervention to a telehealth MS education intervention for fatigue, pain, and mood in adults with multiple sclerosis (MS). Design: Secondary analysis of a single-blind randomized controlled trial. Setting: community. P...
Article
Background: Fatigue occurs in 75%-95% of people with multiple sclerosis (MS) and is frequently reported as the most disabling symptom. A multicomponent group program of six weekly 2-hour sessions, Fatigue: Take Control (FTC), was developed from an international MS fatigue management guideline. Objective: To determine whether FTC is associated wi...
Chapter
Multiple sclerosis (MS) is a chronic and progressive central nervous system disease characterized by immune-mediated demyelination and neuronal damage within the brain, spinal cord, and optic nerves. Individuals with MS experience a constellation of symptoms and co-occurring conditions, including sensory problems, cognitive difficulties, weakness,...
Chapter
Amputation (or limb loss) is the removal of a limb or portion of a limb. It can be the result of many causes including chronic disease (predominantly diabetes mellitus and peripheral vascular disease), infection, trauma, malignancy, or the surgical correction of congenital limb deficiency. Over 90 % of amputations affect lower limbs and over 75 % a...
Article
Objective: To describe the relationship between caregiver-specific support and conflict, and psychosocial outcomes among individuals experiencing their first lower extremity amputation (LEA). We hypothesized that caregiver-specific support would be associated with lower levels of depressive symptoms and higher levels of life satisfaction, and that...
Article
Full-text available
Objective: To examine the potential moderating effects of mental health symptoms on the efficacy of Compensatory Cognitive Training (CCT) for Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF)/Operation New Dawn (OND) Veterans with a history of mild traumatic brain injury (mTBI). Design: Secondary analysis of a randomized controlled...
Article
Objective: This study examined the moderating influence of perceived social support on the prospective relationship between baseline levels of activities of daily living (ADL) and depressive symptoms during the 1st year following amputation. Method: Participants included 73 veterans with new/first unilateral lower extremity amputation due to vas...
Article
Objective: This study examined patterns of social participation among individuals experiencing their first dysvascular lower extremity amputation. We identified the types of social participation valued by this population and explored factors that were associated with individuals' levels of participation and their subjective satisfaction with parti...
Article
Problems with sleep and cognitive impairment are common among people with multiple sclerosis (MS). The present study examined the relationship between self-reported sleep and both objective and perceived cognitive impairment in MS. Data were obtained from the baseline assessment of a multi-centre intervention trial (NCT00841321). Participants were...
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Full-text available
Among individuals with multiple sclerosis (MS), mental health comorbidities play a significant role in contributing to secondary disability and detracting from quality of life. This review examines current evidence surrounding three mental health issues of particular relevance to MS: depression, anxiety, and bipolar disorder. We review what is know...
Article
Objective: The objective of this study was the development of AMPREDICT-Mobility, a tool to predict the probability of independence in either basic or advanced (iBASIC or iADVANCED) mobility 1 year after dysvascular major lower extremity amputation. Methods: Two prospective cohort studies during consecutive 4-year periods (2005-2009 and 2010-201...
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Full-text available
Objective: This study describes the development and psychometric evaluation of a novel patient-reported single-item mobility measure. Design: Prospective cohort study. Setting: Four Veteran's Administration Medical Centers. Subjects: Individuals undergoing their first major unilateral lower extremity amputation; 198 met inclusion criteria; o...
Article
Objective: Information on prevalence and management of alcohol misuse among Afghanistan and Iraq veterans with traumatic brain injury (TBI) is limited. This study compared rates of alcohol misuse and follow-up care-brief intervention (BI) and addiction treatment-among Afghanistan and Iraq veterans with and without TBI receiving care from the Depar...
Article
Objective: This study examined the prevalence and correlates of sexual activity among individuals experiencing their first dysvascular lower extremity amputation. Design: A prospective cohort was recruited from 4 Veterans Affairs Medical Centers. Of 198 potential participants who met inclusion criteria, 113 (57%) agreed to participate within 7 d...
Article
Sleep problems are highly prevalent among individuals with multiple sclerosis (MS); however, the relationship between sleep problems and cognitive dysfunction is poorly understood in this population. In the present study, 163 individuals with MS and depression, fatigue, or pain completed self-report measures of sleep, cognitive dysfunction, and rel...
Article
Full-text available
Objective: The purpose of the study was to evaluate the efficacy of group-based compensatory cognitive training (CCT) for Operation Enduring Freedom (OEF)/Operation Iraqi Freedom(OIF)/Operation New Dawn (OND) Veterans with a history of mild traumatic brain injury. Method: One hundred nineteen OEF/OIF/OND Veterans with history of mild traumatic b...
Article
Full-text available
Objective: To evaluate the impact of a physical activity intervention consisting of telephone counseling with home-based monitoring to improve fatigue and depression in individuals with multiple sclerosis (MS). Method: Single-blind randomized controlled trial. Sixty-four individuals with MS received either telephone counseling (N = 31), or self-...
Article
Background: Poor medication adherence exerts a substantial negative impact on the health and well-being of individuals with multiple sclerosis (MS). Improving adherence rates requires a proactive approach of frequent and ongoing monitoring; however, this can be difficult to achieve within traditional, reactive health care systems that generally em...
Article
Examine estimated prevalence and correlates of suicidal ideation (SI) among individuals one year after first lower extremity amputation (LEA). Cohort survey. Four medical centers. Referred sample of primarily men experiencing their first LEA due to complications of Diabetes Mellitus or Peripheral Arterial Disease. Of 239 individuals screened betwee...
Article
Objectives: Pain is a significant problem for many individuals with multiple sclerosis (MS). Pain is often associated with other MS symptoms (eg, physical, sensorimotor, cognitive declines), and both pain and MS symptoms are hypothesized to contribute to psychosocial problems (eg, depression), other symptoms (eg, fatigue, sleep disturbance), and f...
Article
Multiple sclerosis (MS) is a chronic illness involving both controllable and uncontrollable stressors. The goodness-of-fit hypothesis posits that managing stressors effectively requires the use of different coping approaches in the face of controllable and uncontrollable stressors. To test the applicability of the goodness-of-fit model in a sample...
Article
Objectives: To determine whether self-efficacy longitudinally predicts 2 types of perceived cognitive impairment (PCI) in multiple sclerosis (MS): general cognitive functioning and executive functioning; and secondarily to assess whether self-efficacy mediates the relationships between depression, fatigue, and PCI. Design: Longitudinal analysis...
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Full-text available
Purpose/objectives: The aims of this study were to (1) identify the predictors of symptoms of anxiety, and (2) evaluate the differential association of somatic and nonsomatic symptoms of depression on anxiety over time in persons with multiple sclerosis (MS). Method/design: Participants were 513 persons with MS who previously enrolled in a study...
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Full-text available
Objective: This study describes the results of a multidisciplinary conference (the Baltimore Conference) that met to develop consensus guidelines for competency specification and measurement in postdoctoral training in rehabilitation psychology. Methods: Forty-six conference participants were chosen to include representatives of rehabilitation p...
Article
Objectives: To examine 2 modifiable health behaviors-smoking and physical activity-and their relationship to mortality among individuals with multiple sclerosis (MS). Design: Secondary analysis of Large Health Survey. Setting: Data were obtained from a linkage of the Veterans Affairs (VA) MS National Data Repository, containing information on...
Article
Objective: The aim of this study was to examine associations between a cognitive screen and four neuropsychologic tests administered at both 6 wks and 4 mos after amputation and five functional outcomes measured 12 mos after lower extremity amputation. Design: This study includes a prospective cohort from four medical centers. Participants were...
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Full-text available
Objective: The objective was to determine the relationship between pain expectations assessed prior to surgery and satisfaction with pain 4 and 12 months after major dysvascular lower extremity amputation. Research method: The study included a prospective cohort of male (n = 19) veterans experiencing their first lower extremity amputation due to...
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Full-text available
Purpose/objective: The primary aim of this study was to examine the relationship between perceived social support and depressive symptoms among family caregivers of veterans with multiple sclerosis (MS). A secondary aim of this study was to examine the relationship between caregiver perceived social support and caregiver demographic variables, vet...
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Full-text available
Objective: To evaluate the impact upon medication adherence of brief telephone-based counseling using principles of motivational interviewing and telehealth home monitoring. Design: Randomized controlled pilot trial of 19 veterans with multiple sclerosis (MS) currently prescribed disease modifying therapy (DMT) who endorsed missing doses. Follow...
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Full-text available
Background. Fatigue is the most common symptom in people with multiple sclerosis (MS). Poor sleep also occurs in this population. Objective. The objective of this study was to determine the relationship between fatigue and sleep quality in people with MS and cognitive impairment. Method. This cross-sectional study assessed relationships among fatig...
Article
The aim of this study was to describe prevalence of alcohol misuse and smoking among individuals with amputations as a result of peripheral arterial disease before surgery and 12 mos after surgery, changes in these behaviors over time, and factors associated with change. This is a prospective cohort study of 75 veterans experiencing their first maj...