Debra Kaysen

Debra Kaysen
Stanford University | SU · Department of Psychiatry and Behavioral Sciences

Ph.D.

About

192
Publications
28,376
Reads
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10,786
Citations
Citations since 2017
78 Research Items
4155 Citations
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Introduction
Dr. Kaysen's research is at the interface of posttraumatic stress disorder (PTSD) and addictions, and includes both etiologic and prevention/treatment-oriented studies. Dr. Kaysen conducts research across trauma exposed populations. She has also collaborated with faculty at JHSPH to adapt therapies for PTSD for low and medium resource settings (Iraq & Democratic Republic of the Congo). She is currently conducting an RCT evaluating treatments for PTSD and alcohol misuse.
Additional affiliations
April 2013 - present
University of Washington Seattle
Position
  • Depression Therapy Research Endowed Professorship
January 2006 - present
University of Washington Seattle
January 2003 - December 2008
University of Missouri - St. Louis
Education
May 1997 - June 2003
University of Missouri - St. Louis
Field of study
  • Clinical Psychology
August 1995 - May 1997
University of Missouri - St. Louis
Field of study
  • Clinical Psychology
September 1987 - June 1991
Tufts University
Field of study
  • Psychology

Publications

Publications (192)
Article
Objective: Adolescents are at risk for substance use, sexual assault, and sexual risk behaviours; however, to date no integrated prevention programmes address all three risk behaviours. The goal of this study was to evaluate the usability and acceptability of Teen Well Check, an e-health prevention programme targeting substance use, sexual assault,...
Article
Nearly all people in prison have experienced trauma, and many meet the criteria for posttraumatic stress disorder (PTSD). Untreated PTSD increases the risk of substance use problems after release contributing to a well‐documented cycle of trauma, addiction, and incarceration. However, evidence‐based, trauma‐focused therapy for PTSD is rarely offere...
Article
Full-text available
Background Trauma exposure and drug addiction go hand-in-hand for the 2.17 million people who are incarcerated in US prisons; prevalence of both exceed 80% among this population. This manuscript describes the rationale and methods for a participant-randomized effectiveness-implementation hybrid type II pilot trial designed to: 1) examine the effect...
Article
Full-text available
Objective: This study evaluated implicit associations (i.e., associations in memory that are automatically activated and difficult to control consciously) related to trauma and one's self in the context of a clinical trial for active duty service members seeking treatment for posttraumatic stress disorder (PTSD). Previous studies with nontreatment...
Article
Identifying potential mechanisms underlying the association between posttraumatic stress (PTS) and problematic alcohol use is an important target among college women who have experienced sexual assault. This study examined the role of posttraumatic cognitions in this association among college women (N = 530) who experienced either an alcohol‐involv...
Article
Objective: Posttraumatic stress disorder (PTSD) with comorbid substance use disorders (SUDs) has been associated with poorer treatment outcomes. The present study examined associations between provisional PTSD at baseline and 3 months with 6-month treatment outcomes from either a one-session motivational enhancement therapy (MET) or education inte...
Article
Accessible, brief, and self-directed intervention are needed to improve treatment access for individuals with co-occuring PTSD and alcohol misuse. This pilot study tests the feasibility, acceptability, and preliminary efficacy of a brief text message intervention based on cognitive behavioral therapy plus message framing (CBT + Framing) compared to...
Article
Objective A movement of parents refusing vaccines for their children has contributed to increasingly large outbreaks of diseases that are preventable by vaccines. Research has identified multiple factors that relate to parents' vaccination behaviors (i.e., whether not they vaccinate their children), including their beliefs about vaccines' safety an...
Article
Full-text available
Background Despite the growth of psychotherapy trials in low- and middle-income countries, there have been limited follow-up studies of more than 2 years. This study follows up female sexual violence survivors approximately 6 years after completing a 12-session group cognitive processing therapy (CPT) program in the eastern Democratic Republic of C...
Article
Background Alcohol use and sexual assault are common on college campuses in the United States, and the rates of occurrence differ based on gender identity and sexual orientation. Objective We aimed to provide an assessment of the usability and preliminary outcomes of Positive Change (+Change), a program that provides integrated personalized feedba...
Article
Purpose: This study examined differences in mental health and health risk behaviors across sexual orientation and gender identity among U.S. veterans. Methods: Veterans were recruited through targeted social media advertising, community organizations, and listservs to complete an online survey (N = 1062). Generalized linear regression was used to e...
Article
Background Sexual minority women and gender diverse individuals (SMWGD) are at heightened risk for alcohol and cannabis use disorders compared to heterosexual and cisgender individuals, and their heightened risk has been attributed to minority stress. However, few longitudinal studies have examined mechanisms through which minority stress may impac...
Article
Full-text available
Background Rates of PTSD in active-duty military are high relative to the general population. Although efficacious treatments exist, they are underutilized. Many service members with PTSD do not present for treatment and, of those who do, many do not receive sufficient doses of the interventions to receive full benefits. Motivational Enhancement Th...
Article
Cross-sectional studies have demonstrated associations between COVID news exposure, anxiety, and depression. However, longitudinal research examining the directionality of these associations is extremely limited. Further, most studies have focused on the general population and neglected sexual and gender minority individuals (SGM), a population dis...
Article
Objective: American Indian (AI) individuals are at increased risk for present-day trauma exposure and associated negative outcomes, as well as ongoing effects of intergenerational trauma exposure and adversity. However, few empirically supported treatments exist that are specifically tailored and/or tested with AI communities. This study describes...
Article
Full-text available
Adult sexual assault (ASA) in college remains a concern. Consequently, many college-aged women experience negative emotions surrounding sexual activity (sex-related distress). Consistent with self-medication theory, some drink to cope with sex-related distress, which may reduce distress, but lead to greater drinking quantity before sex and negative...
Article
Posttraumatic stress disorder (PTSD) treatments are increasingly delivered in massed formats and have shown comparable results to standard, weekly treatment. To date, massed cognitive processing therapy (CPT), delivered daily, has been delivered primarily in combination with adjunctive services and among veteran populations, but it has not been rig...
Article
Background Sexual minority populations are at heightened risk for alcohol use disorders compared to heterosexual populations, and these disparities are particularly pronounced for sexual minority women (SMW). Little research has examined the diversity of drinking trajectories among sexual minorities, despite evidence that such trajectories have hig...
Article
Full-text available
Over the past 20 years, numerous treatments addressing comorbid Posttraumatic Stress Disorder (PTSD) and Substance Use Disorder (SUD) have been developed and tested. The current meta-analysis examined the efficacy and acceptability of the two central treatment types– trauma-focused and non-trauma-focused – compared with all comparators and with cog...
Article
Despite calls forincreased mental health programming in low-resource and humanitarian contexts and effectiveness trials of psychotherapy in these settings, little research exists on the extent to which providers and recipients continue to practice skills learned during trials of these programs. To understand if and how providers continued to use me...
Article
Background Problematic substance use (SU) has increased substantially during the COVID-19 pandemic. While studies have identified risk factors for problematic SU during the pandemic (e.g., anxiety, depression, using substances to cope), these studies have been predominately cross-sectional, rarely examined changes in SU contexts during the pandemic...
Article
Full-text available
Importance Only one-third of patients with complex psychiatric disorders engage in specialty mental health care, and only one-tenth receive adequate treatment in primary care. Scalable approaches are critically needed to improve access to effective mental health treatments in underserved primary care settings. Objective To compare 2 clinic-to-clin...
Article
Full-text available
Objective: College women with sexual assault histories report greater heavy drinking relative to those without histories of assault. Moreover, individuals with sexual assault histories often have difficulty regulating emotions and tolerating distress, which can lead to a problematic pattern of drinking to cope. Thus, we evaluated the initial effic...
Article
Objective: Alcohol-related sexual consequences are common among young adults, yet there is no standard measure to comprehensively assess this construct. To fill this gap, the current study evaluated a 41-item measure of alcohol-related sexual consequences in a sample of at-risk young adults. Method: A subsample (n = 318; 54% female; 71% White; m...
Article
Full-text available
Introduction The complex relationship between intimate partner violence and psychological distress warrants an integrated intervention approach. In this study we examined the relevance, acceptability, and feasibility of evaluating a multi-sectoral integrated violence- and mental health-focused intervention (Nguvu). Methods We enrolled 311 Congoles...
Article
Full-text available
Hooking up, which refers to a sexual encounter (ranging from kissing to penetrative sex) between individuals who are not in a committed relationship, is an increasingly normative form of sexual exploration among emerging adults. Past research has focused on hookups within a heteronormative context, and some of this work has examined hookups as a wa...
Article
Sexual assault (SA) often occurs in the context of substances, which can impair the trauma memory and contribute to negative cognitions like self‐blame. Although these factors may affect posttraumatic stress disorder (PTSD) treatment, outcomes for substance‐involved SA have not been evaluated or compared with other types of SA. As such, we conducte...
Article
Full-text available
Objective: Sexual assault (SA) among college women is widespread and is associated with negative consequences including heavy drinking. However, women with SA histories are rarely the target of alcohol interventions, and existing alcohol interventions do not address the distal factors that contribute to heavy drinking in this group, such as emotio...
Article
Full-text available
Background: While evidence is growing for the efficacy of trauma-focused mental health interventions in low- and middle-income countries, concerns have been raised about whether these types of interventions can be effectively delivered in contexts with ongoing conflict and violence. Cognitive Processing Therapy (CPT) has been shown to be effective...
Article
Sexual minority women (SMW; individuals who identify as women and as lesbian, bisexual, or with another sexual minority identity) are at increased risk for problematic alcohol use compared to their heterosexual counterparts. This increased risk has been attributed to minority stress. However, longitudinal research examining associations between min...
Article
Full-text available
Sexual minority women (SMW), including lesbian and bisexual women, are at greater risk for heavy drinking and sexual victimization than heterosexual women. Risk factors for alcohol-related sexual victimization, such as incapacitated rape (IR), include frequent heavy drinking and hookups among heterosexual women, but it is less clear whether these r...
Preprint
BACKGROUND Alcohol use and sexual assault are common on college campuses in the United States, and the rates of occurrence differ based on gender identity and sexual orientation. OBJECTIVE We aimed to provide an assessment of the usability and preliminary outcomes of Positive Change ( +Change) , a program that provides integrated personalized feed...
Article
Full-text available
The COVID‐19 pandemic presents major challenges for mental health care providers. In particular, providers who treat posttraumatic stress disorder (PTSD) are now tasked with determining whether to initiate trauma‐focused therapy during the pandemic and, if so, whether and how to adapt treatment. The purpose of this communication is to identify and...
Article
Objective: Sexual minority women (SMW) evidence elevated rates of trauma exposure, posttraumatic stress (PTS), and alcohol consumption. Self-medication models of drinking suggest that individuals may drink to cope with symptoms of PTS, but this possibility remains untested among SMW. Method: The current study used data from drinking days collected...
Article
Native Americans (NA) experience interrelated risks of trauma exposure, substance use, and HIV risk behaviors that put them at increased risk for HIV infection. Despite these known risk factors, there are very few published randomized trials testing interventions to reduce trauma-related symptoms and substance misuse among NA. Methods The Healing...
Article
The impact of changes to posttraumatic stress disorder (PTSD) diagnostic criteria from Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) to Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) within diverse communities is unclear. Young adult sexual minority women are at high risk for interpersonal violence...
Article
Experiencing a sexual assault can have long-lasting negative consequences including development of posttraumatic stress disorder (PTSD) and alcohol misuse. Intervention provided in the initial weeks following assault can reduce the development of these chronic problems. This study describes the iterative treatment development process for refining a...
Article
Objective: Sexual minority women report more problematic alcohol use and depression than heterosexual women. Despite evidence that sexual identity can change over time, most studies treat it as a static construct. As a result, little is known about the extent to which changes in sexual identity influence alcohol use and depression. The current stu...
Article
Sexual minority women are at elevated risk for exposure to stressors (both traumatic and discriminatory) and have higher rates of alcohol consumption and problems. The psychological mediation framework (Hatzenbuehler, 2009) suggests that both general (e.g., traumatic events to which minorities and nonminorities may be exposed) and minority-group-sp...
Article
Objective: Managing complex psychiatric disorders like PTSD and bipolar disorder is challenging in Federally Qualified Health Centers (FQHCs) delivering care to U.S residents living in underserved rural areas. This protocol paper describes SPIRIT, a pragmatic comparative effectiveness trial designed to compare two approaches to managing PTSD and b...
Article
Full-text available
Hookups are uncommitted sexual encounters that range from kissing to intercourse and occur between individuals in whom there is no current dating relationship and no expressed or acknowledged expectations of a relationship following the hookup. Research over the last decade has begun to focus on hooking up among adolescents and young adults with si...
Article
Full-text available
Background: Multi-sectoral, integrated interventions have long been recommended for addressing mental health and its social determinants (e.g., gender-based violence) in settings of ongoing adversity. We developed an integrated health and protection intervention to reduce psychological distress and intimate partner violence (IPV), and tested its d...
Article
Full-text available
Background: Sexual assault (SA) frequently occurs under the influence of alcohol, and is often followed by both drinking and posttraumatic stress symptoms, including intrusive memories. Although many theories attempt to explain the co-occurrence of alcohol use and posttraumatic stress, one possibility not yet considered is that SA memories may be m...
Article
Objective: Evidence-based therapies for posttraumatic stress disorder are underutilized and at times unavailable in specialty settings. We reviewed the literature on interventions to treat PTSD within primary care to make recommendations on their effectiveness as treatment modalities or ways to improve engagement in specialty care. Method: We se...
Article
Objective: The purpose of this study is to examine associations between therapist adherence, competence, and modifications of an evidence-based protocol (EBP) delivered in routine clinical care and client outcomes. Method: Data were derived from a NIMH-funded implementation-effectiveness hybrid study of Cognitive Processing Therapy (CPT) for PTS...
Article
Co-occurring post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) are costly and consequential public health problems that negatively affect the health and well-being of U.S. military service members and veterans. The disproportionate burden of comorbid PTSD and AUD among U.S. military service members and veterans may be due to uniq...
Article
Full-text available
An overlooked sequela of HIV risk is trauma exposure, yet few HIV interventions address trauma exposure, mental health, and substance misuse. In a two-arm randomized controlled trial 73 Native American women were randomized to a culturally-adapted Cognitive Processing Therapy (CPT) or 6-weeks waitlist. Outcomes assessed: PTSD symptom severity, alco...
Article
This chapter describes the prevalence of trauma exposure and related mental health disorders among sexual minority women (SMW). It reviews theoretical models that explain the ways in which trauma exposure among SMW may lead to mental health concerns, including minority stress, insidious trauma, and psychological mediation theoretical frameworks, as...
Article
Aims To compare individuals with comorbid lifetime Posttraumatic Stress Disorder (PTSD) and alcohol use disorders (AUD; i.e., no drug use disorders [DUD]) with to those with comorbid PTSD and DUD on past‐year prevalence of these disorders, social functioning, lifetime psychiatric comorbidities, and treatment receipt. The comorbid groups were also c...
Article
Full-text available
The high levels of problematic drinking in college students make clear the need for improvement in the prediction of problematic drinking. We conducted a laboratory-based experiment that investigated whether implicit measures of alcohol-related associations, self-control, and their interaction predicted drinking. Although a few studies have evaluat...
Data
Additional measures administered during computer-based baseline assessment. (DOCX)
Article
For deployed veterans from the wars in Iraq and Afghanistan, the estimated costs of posttraumatic stress disorder (PTSD) and depression were between $4.0 billion and $6.2 billion in the first 2 years after they returned home.¹ A number of efficacious treatments for PTSD exist, including pharmacotherapy and psychotherapies, although the gap between...
Article
OBJECTIVE: Sexual minority women (SMW; e.g., lesbians, bisexual women) are at increased risk for alcohol use disorders and related problems compared with heterosexual women. However, little is known about the social context in which drinking occurs in this high-risk population. This study used latent class analysis to identify subgroups of SMW base...
Article
Objective: Sexual minority women (SMW; e.g., lesbians, bisexual women) are at increased risk for alcohol use disorders and related problems compared with heterosexual women. However, little is known about the social context in which drinking occurs in this high-risk population. This study used latent class analysis to identify subgroups of SMW bas...
Article
Research has indicated that sexual minority women (SMW) drink more than do their heterosexual counterparts. Minority stress theory postulates that this increased drinking is motivated by efforts to modulate distress related to minority status, highlighting the potential importance of coping and enhancement drinking motives. Social learning theory p...
Article
Multiple studies indicate that implicit alcohol-related associations (i.e., indices of relatively fast, spontaneous processes) predict drinking. An important next step is to investigate moderators of the implicit association-drinking relationship. Mood state has been proposed as a moderator of this relationship: implicit associations have been theo...
Article
Sexual minority women (SMW) are at high risk of trauma exposure and, subsequently, the development of posttraumatic stress disorder (PTSD). The authors extended a theoretical model explaining the higher risk of mental disorders in minority populations to the maintenance and exacerbation of PTSD symptoms among young adult SMW specifically. This stud...
Article
The purpose of this study was to evaluate personalized feedback intervention (PFI) framing with two web-delivered PFIs aimed to reduce young adult alcohol-related risky sexual behavior (RSB). Combined PFIs typically use an additive approach whereby independent components on drinking and components on RSB are presented without the discussion of the...
Article
Objectives: To describe our partnership and research infrastructure development strategies and discuss steps in developing a culturally grounded framework to obtain data and identify a trauma-informed evidence-based intervention. Method: We present funding strategies that develop and maintain the partnership and tools that guided research develo...
Article
Aims: Implicit measures of alcohol associations (i.e. measures designed to assess associations that are fast/reflexive/impulsive) have received substantial research attention. Alcohol associations related to the self (drinking identity), the effects of alcohol (alcohol excite) and appetitive inclinations (alcohol approach) have been found to predi...
Article
Full-text available
Objective: Hooking up is common in college, and has been linked to heavy drinking. Hookups have positive as well as negative consequences, and thus the motivations for hooking up are complex. Yet, little research has focused on these motivations. The present study examined the role that gender and drinking patterns play in the relationship between...
Article
Full-text available
Background Sexual violence is associated with a multitude of poor physical, emotional, and social outcomes. Despite reports of stigma by sexual violence survivors, limited evidence exists on effective strategies to reduce stigma, particularly in conflict-affected settings. We sought to assess the effect of group Cognitive Processing Therapy (CPT) o...
Poster
Full-text available
Background: After sexual assault, many college women develop symptoms of posttraumatic stress disorder (PTSD), and those who engage in substance use coping are at heightened risk for this outcome. Social support has been identified as an important protective factor against the development of PTSD, although it remains unclear for whom social support...
Poster
Full-text available
Background: In cross-sectional studies, social support and posttraumatic stress disorder (PTSD) symptoms appear related in that higher levels of PTSD are associated with lower social support, and vice versa. Theoretical models of the causal direction of this relationship differ. Most longitudinal studies suggest that PTSD symptoms erode social supp...
Article
In India, reported rates of domestic violence rise as high as 31%. Abuse against pregnant women in India is associated with depressive and PTSD symptoms, and poor birth outcomes, yet no evidence-based interventions have been tested on this population. In this cross-sectional qualitative study, we sought perspective on South Indian women's concerns...
Article
Full-text available
Background: In cross-sectional studies, social support and posttraumatic stress disorder (PTSD) symptoms appear related, in that higher severity of PTSD is associated with lower social support and vice versa. Theoretical models of the causal direction of this relationship differ. Most longitudinal studies suggest that PTSD symptoms erode social su...
Article
Objective: Sexual minority women (lesbians, bisexual women, and women who partner with women) experience high rates of trauma exposure, are more likely to develop posttraumatic stress disorder (PTSD), and have high rates of physical health problems compared with heterosexual women. The present study tested whether PTSD may be the mechanism through...
Article
Purpose: Sexual minority women (SMW) are at increased risk for alcohol use disorders and related problems. Social context (e.g., where and with whom one drinks) has been identified as an important factor associated with drinking behavior, but little is known about social context among SMW. An improved understanding of social context among SMW has...
Poster
Full-text available
As a group, sexual minority women (SMW) drink more than their heterosexual counterparts. There is evidence that context-specific drinking motives affect drinking behavior, as well as evidence that SMW consume more alcohol when drinking with other sexual minorities. However, daily variation in drinking motives has been minimally examined, and, to ou...
Article
Introduction: Sexual minority women have elevated trauma exposure and prevalence of posttraumatic stress disorder (PTSD) compared to heterosexual women and they are also more likely to use cannabis, although no research has examined relationships between PTSD and cannabis use in this population. Daily-level methodologies are necessary to examine p...
Article
Objective: The purpose of this study was to examine effects of sexual assault victimization on later typical alcohol use and alcohol-related consequences among young sexual minority women (SMW). Method: Data were collected over 4 annual assessments from a national sample of 1,057 women who identified as lesbian or bisexual and were 18- to 25-yea...
Article
Full-text available
Objective: Sexual-minority women are at elevated risk for obesity, as well as exposure to traumatic events. Rates of obesity are elevated in individuals with posttraumatic stress disorder (PTSD), but little is known about why this relationship exists. Behavioral mechanisms, such as eating patterns and alcohol use, are possible explanations that wo...
Article
In recent years, the implementation of trauma-focused treatments has expanded across settings that vary widely in the availability of resources, infrastructure, and personnel. The present review aims to inform researchers, policy makers, trainers, and administrators about this diverse range of research. Taking a global health perspective, this revi...