Sarah E Valentine

Boston University | BU · Department of Psychiatry

Background Successful implementation of evidence-based treatments (EBT) for posttraumatic stress disorder (PTSD) in primary care may address treatment access and quality gaps by providing care in novel and less stigmatized settings. Yet, PTSD treatments are largely unavailable in safety net primary care. We aimed to collect clinician stakeholder da...

Background: Posttraumatic stress disorder (PTSD) disproportionally affects low-income, racial and ethnic minoritized communities, where prevalence is high, yet access to evidence-based treatments (EBTs) is low. As such, there is a need to identify effective, feasible, and scalable interventions for PTSD. Stepped care approaches that include brief,...

Objective: Increasing prevalence of substance use in pregnancy presents a public health crisis that is compounded by posttraumatic stress disorder (PTSD) comorbidity. We aimed to detail the clinical complexities of PTSD treatment provision among pregnant women with substance use histories. Methods: We conducted a qualitative study using clinical...

Objective: This pilot open trial examined the feasibility, acceptability, and preliminary effectiveness of Written Exposure Therapy (WET), a 5-session evidence-based intervention for posttraumatic stress disorder (PTSD) during pregnancy. Participants were pregnant women with comorbid PTSD and substance use disorder (SUD) receiving prenatal care in...

Posttraumatic stress disorder (PTSD) assessment among transgender and gender diverse (TGD) adults is complex because the literature offers little guidance on affirming assessment that accurately captures both trauma- and discrimination-related distress. This study aimed to characterize threats to precise PTSD assessment that arose during the Clinic...

Objective: Transgender and gender diverse (TGD) people are at heightened risk of both Criterion A trauma exposure and other bias-related minority stressors (e.g., discrimination, rejection). In the absence of a unified trauma-minority stress theory, it remains unclear how to best conceptualize psychopathology for people who experience both trauma...

Objective We conducted a formative evaluation to understand the impact of the COVID-19 pandemic on the safety net integrated primary care setting and to identify (and respond to) new implementation barriers prior to a hybrid type I effectiveness-implementation trial of a posttraumatic stress disorder (PTSD) treatment. Method We used surveys and qu...

Background Successful implementation of evidence-based treatments (EBT) for posttraumatic stress disorder (PTSD) in primary care may address treatment access and quality gaps by providing care in novel and less stigmatized settings. Yet, PTSD treatments are largely unavailable in safety net primary care. We aimed to collect clinician stakeholder da...

PurposePeer providers represent a growing sector of the U.S. workforce, yet guidance is needed on best practices for adapting behavioral health interventions for peer delivery.Methods We utilized the Framework for Reporting Adaptations and Modifications to Evidence-based interventions (FRAME; Wiltsey Stirman et al. 2013, 2019) to describe how we sy...

Background Despite promising findings regarding the safety, fidelity, and effectiveness of peer-delivered behavioral health programs, there are training-related challenges to the integration of peers on health care teams. Specifically, there is a need to understand the elements of training and consultation that may be unique to peer-delivered inter...

Over 50% of young adults (defined as individuals aged 18-25 years) with substance use disorders (SUDs) have at least 1 co-occurring psychiatric disorder, and the presence of co-occurring disorders worsens SUD outcomes. Treatment of both co-occurring psychiatric disorders and SUDs in young adults is imperative for optimal treatment, yet many barrier...

Objective Posttraumatic stress disorder (PTSD) treatment delivery by peer specialist providers could increase access to and engagement with PTSD treatment in low resource settings. The current pilot study tested the feasibility, acceptability, and initial effectiveness of a peer‐delivered, brief cognitive‐behavioral therapy for PTSD. Method Four c...

Although there is small, but growing empirical evidence for the use of dialectical behavioral therapy (DBT) skills training as a stand-alone treatment, it is widely administered to an array of populations in various settings. Building upon a previous review, this systematic review identifies 31 additional studies testing the effect of DBT skills tr...

Objective: There is a robust literature base documenting gender differences and racial/ethnic differences in exposure to potentially traumatic events (PTEs) and posttraumatic stress disorder (PTSD) diagnosis. Yet, to the best of our knowledge, this is the first study to evaluate the risk of PTEs and PTSD between genders, stratified by race/ethnici...

Lesbian, gay, bisexual, and transgender (LGBT) populations face a range of health disparities that all health care systems must address. In response to known health disparities, the LGBT Health Program of the Veterans Health Administration (VHA) developed policies supporting the provision of affirming care to LGBT veterans. To support policy implem...

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...

The Handbook of Evidence-Based Mental Health Practice with Sexual and Gender Minorities represents the first compendium of evidence-based approaches to sexual and gender minority (SGM)-affirmative mental health practice. In the past several years, clinical researchers have begun developing and adapting evidence-based mental health treatment approac...

Psychosocial interventions for common emotional and behavioral difficulties have been developed for use in correctional facilities, yet these programs are largely unavailable upon community re-entry due to a shortage of trained mental health specialists. In this study, we developed and piloted a youth worker-delivered cognitive behavioral therapy (...

The science-practice gap in the treatment of mental health is most pronounced in community settings, where clients with the highest needs often receive their care. Implementation science and community-based participatory research (CBPR) strategies aim to effectively address this gap by establishing partnerships that focus on scientifically rigorous...

Transgender and gender non-conforming (TGNC) populations, including those who do not identify with gender binary constructs (man or woman) are increasingly recognized in health care settings. Research on the health of TGNC people is growing, and disparities are often noted. In this review, we examine 77 studies published between January 1, 1997 and...

Research on men who have sex with men (MSM) has uncovered psychosocial factors (syndemic indicators) that are associated additively with poor health. To test these relations in a sample of HIV-positive MSM, we enrolled 166 patients from two HIV clinics. We investigated relations between syndemic indicators and outcomes including medication nonadher...

The estimated prevalence of adult sexual assault among sexual minority men (SMM) is comparable to published estimates for women. Adult sexual assault is associated with low disclosure rates and poor physical and mental health in SMM. One potential negative consequence of disclosures is secondary victimization, whereby victims perceive disclosure re...

Purpose: We investigated the odds of intimate partner violence (IPV) among primary care patients across subgroups of transgender and gender nonconforming (TGNC) individuals relative to cisgender women, and cisgender sexual minority men and women relative to cisgender heterosexual men and women. Methods: Participants completed an IPV screener as...

Using a mixed-methods approach, we explored how college women’s lifetime experiences of physical or sexual gender-based violence (GBV) were associated with appraisals of GBV and their feminist beliefs or identity (N = 32). Women commented on their increased awareness of the prevalence of GBV, their desire to help other women, and their beliefs abou...

Objective: Posttraumatic stress disorder (PTSD) is a debilitating psychiatric illness that frequently remains undiagnosed and untreated. While extensive research has been conducted among veterans, little research has evaluated course of treatment for PTSD in a general hospital setting. Methods: We utilized data from the Partners HealthCare Resea...

Living with HIV can be both a precipitant and a consequence of partner abuse (PA) across populations, including male–male partnerships. However, overlapping experiences of living with HIV and experiencing PA are not well characterized. We conducted 24 qualitative interviews with urban HIV-positive sexual minority men (SMM) recruited from a public h...

Our study extends the literature on associations between posttraumatic stress disorder (PTSD) and chronic medical conditions by assessing differences in the magnitude of these relations by ethnicity. We examined group differences in the magnitude of the relation between PTSD and chronic medical conditions (cardiovascular disease [CVD], hypertension...

Background Among Latinos, living in a locality with greater Latino ethnic density may be protective for mental health, although findings vary by Latino subgroup, gender and birthplace. Although little studied, Latino residential segregation may capture different pathways linking risk and protective environmental factors to mental health than local...

Poster Presented at the 1st Annual Massachusetts General Hospital Chelsea Research Day, Chelsea, MA.

Objective: Posttraumatic stress disorder (PTSD) is a chronic psychiatric condition associated with significant disability that often remains untreated. Sociodemographic and family-level factors may serve as predictors of unmet treatment need, identifying groups that would most benefit from policies aimed at increasing access to the mental health c...

Objective: As part of a larger implementation trial for cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) in a community health center, we used formative evaluation to assess relations between iterative cultural adaption (for Spanish-speaking clients) and implementation outcomes (appropriateness and acceptability) for CPT...

This study aims to elucidate relations between provider perceptions of aspects of the consolidated framework for implementation research (Damschroder et al., 2009) and provider attitudes toward the implementation of evidence-based treatments (EBTs) in an ethnically diverse community health setting. Guided by directed content analysis, we analyzed 2...

Previous studies have demonstrated bidirectional associations between posttraumatric stress disorder (PTSD) and romantic relationship dissatisfaction. Most of these studies were focused at the level of the disorder, examining the association between relationship dissatisfaction and having a diagnosis of PTSD or the total of PTSD symptoms endorsed....

Objective: Bulimia nervosa (BN) and binge eating disorder (BED) are associated with significant health impairment. Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) comprise both psychological (disturbances in mood and affect) and physiological (bloating and changes in appetite) symptoms that may trigger binge eating and/or pu...

Objective: Non-Latino blacks experience a higher proportion of chronic illness and associated disabilities than non-Latino whites. Posttraumatic stress disorder (PTSD) is associated with a greater risk of chronic illness, although few studies have investigated whether the interaction of PTSD with racial disparities may lead to a greater risk of ch...

Objective: Relations between mental and physical health symptoms are well-established in the literature on recovery following motor vehicle collisions (MVCs). To understand the temporal sequencing and evolution of these relations, we examined the bidirectional association between mental and physical health symptoms at 4 and 16 weeks following a MV...

The present study aimed to describe associations between various types of mental health stigma and help-seeking behaviors among ethnically diverse clients with posttraumatic stress disorder (PTSD) served by an urban community health clinic. The present study draws qualitative data from a parent National Institute of Mental Health Study that aims to...

Previous studies documenting sexual minority women's disproportionate risk for a range of medical, mental health, and substance use disorders have not provided a predictive framework for understanding their interrelations and outcomes. The present study aimed to address this gap by testing the syndemic effect of co-occurring psychosocial problems o...

Men’s violence against women (MVAW) has been identified as a critical sociocultural problem. Gaining a better understanding of perspectives on the etiology of violence held by women with histories of male-perpetrated interpersonal violence provides insight into the processes of victimization and recovery. Furthermore, emerging research suggests tha...

Men who have sex with men (MSM) are the group most at risk for HIV and represent the majority of new infections in the United States. Rates of childhood sexual abuse (CSA) among MSM have been estimated as high as 46 %. CSA is associated with increased risk of HIV and greater likelihood of HIV sexual risk behavior. The purpose of this study was to i...

Despite the applicability of cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) to addressing sequelae of a range of traumatic events, few studies have evaluated whether the treatment itself is applicable across diverse populations. The present study examined differences and similarities among non-Latino, Latino Spanish-spe...

Abuse in childhood has been established as a predictor of adult abuse, with the strongest associations found between childhood sexual abuse (CSA) and adult sexual victimization. Revictimization has been demonstrated among women, and there is a growing literature on revictimization experiences among men who have sex with men (MSM). No studies have a...

Objective Dialectical behavior therapy (DBT) skills training is currently being administered as stand-alone treatment across a variety of clinical settings, serving diverse client populations. However, there is little empirical support for this use.Method In this systematic review, we identified 17 trials employing a treatment that included DBT ski...

Evidence suggests that smoking may have negative associations with HIV health outcomes. The smoking rate in our sample of people living with HIV (N = 333) was triple that of the general population (57 v. 19 %). Regression analyses revealed that (smokers v. non-smokers) reported lower medication adherence (unstandardized beta = 9.01) and were more l...

Objective: To examine correlates of compensatory weight control behaviors among women in transition between adolescence and adulthood. Participants: The authors recruited a sample of undergraduate women (N = 759) at a large northwestern university during the 2009-2010 academic year. Methods: Logistic regression was used to assess relations amo...

Interpersonal violence researchers have begun to focus on the role of perception of abuse experiences in post-abuse adjustment, and have posited that there may be something critical about a mismatch between having experienced abuse and actually labeling an experience as “abuse.” Utilizing cross-sectional data collected from outpatient HIV care sett...

Although links between partner abuse (PA) and substance abuse (SA) are well-documented in the literature, we know less about these relations among HIV-positive men who have sex with men (MSM). We conducted a qualitative study with this group (N = 28). Participants reported (1) social modeling of SA in childhood and in adult social networks, (2) ini...

We identified no empirical investigations of ways in which feminist beliefs might protect women from the effects of male-perpetrated abuse. Thus, we used a qualitative approach to explore this association. We conducted 32 interviews with women who reported prior experiences of male-perpetrated abuse. The results suggest that feminist beliefs have p...

Given the high rates of partner abuse (PA) among sexual minority men with HIV, it is surprising that this phenomenon remains largely understudied in this group. The extant literature reveals little about the lived experiences of the men who experience abuse in their primary relationships. Furthermore, the role of meaning making in recovery from PA...

High rates of partner abuse (PA) of all types-physical, sexual, and psychological-have been identified in studies of HIV-positive individuals. We examined both the prevalence and correlates of same-sex PA in HIV-positive men who have sex with men (MSM). Participants recruited from public outpatient HIV clinics (N = 168) completed CASI surveys about...

Background: MSM are at high-risk for STD infection in the United States. Identifying high-yield settings to screen MSM for STDs is necessary for cost-effectiveness and program planning purposes. Methods: As part of the CDC MSM Prevalence Monitoring Project, data were routinely collected from MSM who received STD testing at three Howard Brown Health...