Lisa Anne Brenner

Traumatic brain injury (TBI) is a common neurological condition, defined as a disruption to brain functioning caused by a blow, bump, jolt to the head, or a penetrating head injury. The damage caused by the primary insult is exacerbated by the secondary injury (e.g., metabolic changes, cranial bleeding, swelling). Military members, including those...

Objective: To examine racial and ethnic differences in suicide and drug and opioid-related overdose deaths among a population-based cohort of military service members who were diagnosed with a mild traumatic brain injury (mTBI) during military service. Design: Retrospective cohort. Setting: Military personnel receiving care within the Military...

The suicide rate in Guam, a United States (U.S.) territory, is markedly higher than the suicide rate within the U.S. There are also important differences in who is most at risk for suicide in Guam, relative to within the general U.S. Understanding these distinctions is important for implementing effective suicide prevention initiatives in this regi...

Objective: Synthesize data regarding barriers and facilitators of adoption (i.e., adoption determinants) of evidence-based occupational (OT) and physical therapy (PT) interventions within real-world practice. Whether evidence varied across disciplines, settings, and use of theoretical frameworks was also examined. Data sources: Literature publis...

Aims Firearm purchasing increased within the U.S. during the coronavirus disease 2019 pandemic. While rates of firearm ownership and suicide are elevated among women Veterans compared to women non-Veterans, no studies have examined if and how firearm beliefs and behaviors changed among women Veterans during the pandemic. We examined women Veterans’...

Background In the USA, deaths due to suicide, alcohol, or drug-related causes (e.g., alcohol-related liver disease, overdose) have doubled since 2002. Veterans appear disproportionately impacted by growing trends. Limited research has been conducted regarding the relationship between community-level factors (e.g., rurality, community distress resul...

Military sexual trauma (MST) is highly prevalent among women veterans. Research among MST survivors has focused on individuals receiving care in specific settings, such as mental health services. There is a dearth of knowledge regarding MST prevalence and associations in other settings commonly accessed by women veterans, including reproductive hea...

Objective: Risk for traumatic brain injury (TBI) within both the Veteran population and among individuals with a history of criminal justice involvement is notably high. Despite this, research examining TBI among Veterans with a history of criminal justice involvement (ie, justice-involved Veterans) remains limited. The sequelae of TBI can impact...

Compared to microbiomes on other skin sites, the microbiome of the human hand has been found to have greater variability across time. To increase understanding regarding the longitudinal transfer of the hand microbiome to objects in the built environment, and vice versa, twenty-two participants provided skin microbiome samples from their dominant h...

Efforts were focused on identifying differences in suicide rates and time-dependent hazard rate trends, overall and within age groups, by race and ethnicity among United States Army members who returned from an index deployment (October 2007 to September 2014). This retrospective cohort study was conducted using an existing longitudinal database, t...

Background To date, knowledge is limited regarding time-dependent suicide risk in the years following return from deployment and whether such rates vary by military rank (i.e., enlisted, officer) or component (i.e., active duty, National Guard, reserve). To address these gaps in knowledge, the objectives of this study were to determine and compare...

Knowledge regarding deaths due to suicide, alcohol-related, or drug-related causes may be limited by inconsistent and/or restrictive case definitions, resulting in concerns regarding validity of findings and underestimates of burden. In this proof-of-concept study, we assessed varying case definitions (suicide, alcohol-related, drug-related mortali...

Background Independently, veterans and individuals with Parkinson's Disease (PD) are at increased risk for suicide. To our knowledge, the risk of suicide among veterans with PD has yet to be evaluated. This study aimed to examine the associations between PD and risk of suicide, as well as suicide means among those using Veteran Health Administratio...

Introduction Among women Veterans, firearms are the leading suicide means. This has prompted efforts to elucidate factors associated with women Veterans’ firearm ownership. This cross-sectional study examined if deployment experiences were associated with firearm ownership among women Veterans and if safety-related beliefs mediated these associatio...

Objective: A systematic review of the literature was conducted to identify measures used to evaluate developmental outcomes after abusive head trauma (AHT), as well as describe outcomes among those with AHT, and explore factors and interventions influencing such outcomes. Design: This systematic review adheres to the Preferred Reporting Items fo...

Objective: There have been no systematic studies of pregnancy outcomes among women with traumatic brain injury (TBI), potentially limiting informed clinical care for women with such injuries. The purpose of this exploratory study was to evaluate pregnancy and fetal/neonatal outcomes among women with a TBI diagnosis recorded during their delivery h...

Background Sleep problems are common among Veterans with mild traumatic brain injury (mTBI) and may contribute to participation restrictions. However, explanatory mechanisms underlying this relationship are poorly understood. Sleep problems are associated with post-concussive symptoms (e.g., headaches). In turn, post-concussive symptoms contribute...

Objective: Challenges associated with case ascertainment of traumatic brain injuries (TBIs) sustained during the Afghanistan/Iraq military operations have been widespread. This study was designed to examine how the prevalence and severity of TBI among military members who served during the conflicts were impacted when a more precise classification...

US Military Veterans experience higher rates of food insecurity compared to civilians, but the impact of the COVID-19 pandemic on Veterans is unclear. We conducted a nationwide survey of injured post-9/11 Veterans’ food security, Coronavirus exposure, and nutrition habits. Of 193 Veterans, 63 (32.6%) were food insecure. Food insecurity was associat...

The U.S. Veterans Health Administration developed a suicide prediction statistical model and implemented a novel clinical program, Recovery Engagement and Coordination for Health-Veterans Enhanced Treatment (REACH VET). This high-value suicide prevention program aims to efficiently identify patients at risk and connect them with care. Starting in A...

Background Suicide rates have increased among women Veterans, with increased use of firearms as the method. Addressing suicide risk in this population requires understanding the prevalence and correlates of firearm access in healthcare settings frequented by women Veterans. Objectives Characterize the prevalence and correlates of firearm ownership...

Objective: Bayesian meta-analyses offer several advantages over traditional approaches, including improved accuracy when using a small number of studies and enhanced estimation of heterogeneity. However, psychological trauma research has yet to see widespread adoption of these statistical methods, potentially due to researchers' unfamiliarity with...

Purpose of review An evaluation of the most comprehensive review of literature on the Clubhouse model to date was conducted, with the goal of characterizing the ways in which social determinants of health (SDoH) were examined within studies of the Clubhouse model and evaluating the composition of Clubhouse samples with respect to characteristics th...

Importance: Selecting effective antidepressants for the treatment of major depressive disorder (MDD) is an imprecise practice, with remission rates of about 30% at the initial treatment. Objective: To determine whether pharmacogenomic testing affects antidepressant medication selection and whether such testing leads to better clinical outcomes....

Objective: Kibler et al. (2009) reported that hypertension was related to PTSD independent of depression. These two conditions have significant diagnostic overlap. The present study sought to conceptually replicate this work with a veteran sample, using Bayesian estimation to directly update past results, as well as examine symptom severity scores...

Date Presented 04/01/2022 We present results of a latent variable path analysis indicating that postconcussive symptoms may heighten risk for suicidal thoughts among Veterans by limiting successful participation. We discuss implications of results with respect to OT’s role in suicide prevention efforts. Primary Author and Speaker: Adam Kinney Contr...

Background Homeless Veterans are at substantially elevated risk for suicide mortality; however, understanding of drivers of suicide in this population remains limited. Method Building upon prior work, we conducted a retrospective chart review, comprised of a latent class analysis of 724,752 Veterans with use of Veterans Health Administration (VHA)...

Background United States military Veterans from recent conflicts are experiencing symptoms related to posttraumatic stress disorder (PTSD). Many Veterans are resistant to conventional health and mental health interventions (e.g., medication, psychotherapy). Alternative treatment approaches are needed. An underlying feature of PTSD is exaggerated in...

Importance: Veterans with mild traumatic brain injury (mTBI) and associated symptoms are at risk for suicide. Postconcussive symptoms (PCS) may heighten risk for suicidal thoughts by limiting veterans’ participation. Objective: To investigate whether participation mediates the relationship between PCS and suicidal ideation. Design: Cross-sectional,...

Background Immune activation or high levels of stress may lead to increased metabolism of tryptophan during pregnancy. Porphyromonas gingivalis (Pg), the “keystone” periodontal pathogen, induces immune and indoleamine 2,3-dioxygenase (IDO) activation. Thus, we hypothesized that larger gestational decreases in tryptophan and elevations in neopterin...

Importance: Understanding the extent to which population-level suicide risk screening facilities follow-up and engagement in mental health treatment is important as engaging at-risk individuals in treatment is critical to reducing suicidal behaviors. Objective: To evaluate mental health follow-up and treatment engagement in the Veterans Health A...

The brain maintains homeostasis of neural excitation in part through the receptor-mediated signaling of Glutamate (Glu) and Gamma Amino Butyric Acid (GABA), but localized injuries cause cellular release of excess Glu leading to neurotoxicity. The literature strongly supports the role of Insulin-like growth factor-1 (IGF-1) in adult brain neuroprote...

Background Women veterans of reproductive age experience a suicide rate more than double their civilian peers. Developing effective suicide prevention strategies for women veterans requires identifying settings frequented by women veterans where acceptable prevention initiatives can be implemented. Reproductive healthcare (RHC) settings may provide...

Context: Suicide is a public health crisis within the United States. Individuals with spinal cord injury (SCI) are vulnerable to negative outcomes such as suicide. Objective: This systematic review describes frequency of suicidal ideation (SI) and behaviors (suicide attempt [SA] and deaths) among samples of adults living with SCI. Associated ris...

Mild traumatic brain injury (mTBI) is one of the most common injuries experienced by Veterans and can frequently result in a variety of post-concussive symptoms. Post-concussive headaches (PCH), one of the most common symptoms, can persist for years after the injury occurred. The long-lasting impacts of PCH can be extremely distressing for Veterans...

Objective Understand barriers and facilitators to the implementation of recommended practices for post-concussive sleep disturbance and headache, as outlined in the VA/DoD 2016 Clinical Practice Guideline (CPG) for mild traumatic brain injury (mTBI). Design Convergent parallel mixed methods. Setting 10 national Veteran Health Administration (VHA)...

Objective: Psychosocial factors, including combat-related distress (e.g., posttraumatic stress disorder [PTSD]), contribute to postconcussive symptoms (PCS) among veterans with mild traumatic brain injury (mTBI). However, research on risk factors for PCS has focused solely on life-threatening combat experiences, neglecting the morally injurious di...

To validate the Computerized Adaptive Test Suicide Scale (CAT-SS), Veterans completed measures at baseline (n = 305), and 6- (n = 249), and 12-months (n = 185), including the CAT-SS (median items 11, duration of administration 107 seconds) and the Columbia-Suicide Severity Rating Scale (C-SSRS). Logistic regression was used to relate CAT-SS scores...

Social and political policy, human activities, and environmental change affect the ways in which microbial communities assemble and interact with people. These factors determine how different social groups are exposed to beneficial and/ or harmful microorganisms, meaning microbial exposure has an important socio-ecological justice context. Therefor...

Medical leaders have warned of the potential public health burden of a “parallel pandemic” faced by healthcare workers during the COVID-19 pandemic. These individuals may have experienced scenarios in which their moral code was violated resulting in potentially morally injurious events (PMIEs). In the present study, hierarchical linear modeling was...

Enrollment in the Home-Based Mental Health Evaluation (HOME) Program is associated with higher rates of treatment engagement following psychiatric hospitalization discharge, as compared to enhanced care as usual. We aim to describe feasibility and acceptability data related to implementation of the HOME Program at two Department of Veterans Affairs...

Objectives: To illustrate the use of machine learning methods to search for heterogeneous effects of a target modifiable risk factor on suicide in observational studies. The illustration focuses on secondary analysis of a matched case-control study of vitamin D deficiency predicting subsequent suicide. Methods: We describe a variety of machine l...

Purpose of ReviewWe present biological and psychological factors implicated in psychiatric manifestations of SARS-CoV-2, as well as its neuroinvasive capability and immune pathophysiology.Recent FindingsPreexisting mental illness leads to worse clinical outcomes in COVID-19. The presence of the virus was reported in the cerebrospinal fluid (CSF) an...

Objective Estimate the probability of met and unmet post-acute rehabilitative needs among pediatric patients with moderate to severe traumatic brain injury (TBI). Participants One hundred and thirty children who received acute and post-acute rehabilitative services at a hospital for children. Methods Prospective, observational study. Recommended...

The gut microbiome is impacted by environmental exposures and has been implicated in many physical and mental health conditions, including anxiety disorders, affective disorders, and trauma- and stressor-related disorders such as posttraumatic stress disorder (PTSD). United States (US) military Veterans are a unique population in that their militar...

Importance Veterans from recent and past conflicts have high rates of posttraumatic stress disorder (PTSD). Adaptive testing strategies can increase accuracy of diagnostic screening and symptom severity measurement while decreasing patient and clinician burden. Objective To develop and validate a computerized adaptive diagnostic (CAD) screener and...

BACKGROUND Computerized cognitive behavioral therapies (cCBT) have been developed to deliver efficient, evidence-informed treatment for depression and other mental health conditions. One of the most empirically supported cCBTs for depression is Beating the Blues (BtB), which is often administered with the support of a care provider or peer. This in...

Background: Computerized cognitive behavioral therapies (cCBTs) have been developed to deliver efficient, evidence-based treatment for depression and other mental health conditions. Beating the Blues (BtB) is one of the most empirically supported cCBTs for depression. The previous trial of BtB with veterans included regular guidance by health care...

Within the general literature on infections and suicidal behavior, studies on Toxoplasma gondii ( T. gondii ) occupy a central position. This is related to the parasite's neurotropism, high prevalence of chronic infection, as well as specific and non-specific behavioral alterations in rodents that lead to increased risk taking, which are recapitula...

Introduction Sleep problems and periodontal disease have a bidirectional relationship and are independently linked with depression, dementia, and metabolic disease. Inadequate sleep can worsen inflammation, a hallmark of periodontal disease, and the activation of the immune system can alter sleep/wake cycles. A key player in periodontal disease is...

Dietary patterns influence gut microbiota composition. To date, there has not been an assessment of diet and gut microbiota in Veterans, who have a history of unique environmental exposures, including military deployment, that may influence associations between diet and gut microbiota. Our aim was to characterise Veteran habitual dietary intake and...

Background Mild traumatic brain injury (mTBI) is a signature injury sustained by Veterans during recent conflicts. For some, mTBI/concussion is associated with disabling symptoms, including post-concussive headaches (PCH). However, there are limited evidence-based treatments for persistent PCH. Objective Investigators assessed the feasibility of d...

Despite the fact that millions of individuals living in the United States are coping with disabilities associated with traumatic brain injury (TBI), limited work has explored strategies for patient engagement in research among those with such injuries. The Coalition for Recovery and Innovation in Traumatic Brain Injury Care Across the Lifespan (CRI...

Objective To evaluate risk for suicide among Veterans with a history of stroke, seeking care within the Veterans Health Administration (VHA), we analyzed existing clinical data. Design This retrospective cohort study was approved and performed in accordance with the local Institutional Review Board. Veterans were identified via the VHA's Corporate...

Background: Suicide rates for women veterans are increasing faster than for nonveterans. The 2017 suicide rate for women veterans was more than double that for women nonveterans. However, research to inform improved suicide prevention for women veterans is scant. Objectives: To accelerate research on women veterans' unique risks and resiliencies...

Introduction The purpose of this study was to estimate the risk of death by suicide for those with amyotrophic lateral sclerosis (ALS) seeking care within the Veteran Health Administration (VHA). Methods This was a retrospective, cohort study. Extended Cox regression models were used to compare the hazard of suicide between the ALS and the unexpos...

Objective: Anxiety sensitivity (AS) is a transdiagnostic risk factor for persistent physical and psychological symptoms relevant to veterans, such as postconcussive symptoms following mild traumatic brain injury (mTBI). The Cognitive Anxiety Sensitivity Treatment (CAST) computerized intervention has been shown to reduce AS but has not been widely...

Background Post-traumatic headaches are a common sequela of mild traumatic brain injury (concussion). It is unclear whether or how these headaches differ phenotypically from primary headaches. Objective Determine whether there is an overarching unobserved latent trait that drives the expression of observed features of post-traumatic headache and o...

Recently published exploratory studies based on exposure to outdoor fine particulates, defined as particles with a nominal mean diameter less than or equal to 2.5 μm (PM2.5) indicate that the pollutant may play a role in mental health conditions, such as major depressive disorder. This paper details a model that can estimate the United States (US)...

Importance In 2018, the Veterans Health Administration (VHA) implemented the Veterans Affairs (VA) Suicide Risk Identification Strategy to improve the identification and management of suicide risk among veterans receiving VHA care. Objectives To examine the prevalence of positive suicide screening results among veterans in ambulatory care and emer...

Background: US military Veterans returned from Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) with symptoms associated with mild traumatic brain injury [mTBI; i.e., persistent post-concussive (PPC) symptoms] and posttraumatic stress disorder (PTSD). Interventions aimed at addressing symptoms associated with both...

Objective: To evaluate the association between distal moderate/severe traumatic brain injury (TBI) history and the human gut microbiome. Setting: Veterans Affairs Medical Center. Participants: Veterans from the United States-Veteran Microbiome Project (US-VMP). Veterans with moderate/severe TBI (n = 34) were compared with (1) Veterans with a h...