Kevin E Kip

University of South Florida, Tampa, Florida, United States

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Publications (214)1387.19 Total impact

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    ABSTRACT: Rationale: Lower forced expiratory volume in one-second (FEV1) is associated with increased prevalence of atherosclerosis, however, causal mechanisms remain elusive. Objective: To determine if systemic endothelial dysfunction mediates the association between reduced FEV1 and increased atherosclerosis. Methods and measurements: Brachial artery endothelial function, pulmonary function, coronary artery calcium, and carotid plaque were assessed in 231 SCCOR study participants, while peripheral arterial endothelial function, pulmonary function, and coronary artery calcium were assessed in 328 HeartSCORE study participants. Results: Lower FEV1 was independently associated with increased atherosclerosis in both cohorts (per 25% lower % predicted FEV1: OR=1.76, 95% CI 1.30-2.40, p<0.001 for carotid plaque in SCCOR participants and OR=1.35, 95% CI 1.02-1.77, p=0.03 for coronary artery calcium in HeartSCORE participants). Similarly, reduced endothelial function was independently associated with increased atherosclerosis in both cohorts (per standard-deviation lower endothelial function: OR=1.30, 95% CI 1.01-1.67, p=0.04 for carotid plaque in SCCOR participants; and OR=1.38, 95% CI 1.09-1.76, p=0.008 and OR=1.41, 95% CI 1.07-1.86, p=0.01 for coronary artery calcium in SCCOR and HeartSCORE participants, respectively). However, there was no association between endothelial dysfunction and FEV1, FEV1/FVC, low-attenuation area/visual emphysema, and diffusing capacity in SCCOR participants, and between endothelial dysfunction and FEV1 or FEV1/FVC in HeartSCORE participants (all p>0.05). Adjusting the association between FEV1 and atherosclerosis for endothelial dysfunction had no impact. Conclusions: Endothelial dysfunction does not mediate the association between airflow limitation and atherosclerosis. Instead, airflow limitation and endothelial dysfunction appear to be unrelated and mutually independent predictors of atherosclerosis.
    No preview · Article · Jan 2016 · American Journal of Respiratory and Critical Care Medicine
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    ABSTRACT: In both civilian and military settings, emerging therapies for post-traumatic stress disorder (PTSD) are an area of intense scientific interest and need. Accelerated Resolution Therapy (ART) is an emerging, innovative exposure-based treatment for symptoms of PTSD that is delivered in just one to five sessions and requires no homework or skills practice, thereby reducing patient's commitment time and practi-tioner's intervention time to approximately one-fifth of the time required for traditional first-line evidence-based therapies for PTSD. The ART protocol uses the evidence-based components of imaginal exposure, imagery rescripting, and smooth pursuit eye movements. ART addresses the cardinal PTSD features of distressing emotions, thoughts, sensations, and images in particular, by viewing the development and maintenance of PTSD symptoms as a consequence of a failure of a traumatized individual to exhibit extinction of the affective component of the memory. As of this publication date, there are two completed empirical studies of ART and multiple other studies are in progress. The two empirical studies of ART completed among both civilians and military personnel with symptoms of PTSD provide strong indications of efficacy. However, controlled trials against current first-line evidence-based therapies have not been conducted and long-term post-treatment empirical research data do not exist for ART. These data are considered essential in fully evaluating and quantifying the potential benefit of ART as a first-line treatment option for civilian and military PTSD.
    Full-text · Chapter · Nov 2015
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    ABSTRACT: Many breast cancer survivors continue to experience residual symptoms including anxiety, cognitive impairment, depression, fatigue, and pain. In this study, the cost-effectiveness of a Mindfulness-Based Stress Reduction intervention for breast cancer survivors was examined. The cost of the program was assessed from the societal perspective, accounting for both direct medical and patient opportunity costs. The cost per quality-adjusted life year was relatively low compared to the cost-utility findings of other published breast cancer interventions. The program appears to provide for significantly improved health-related quality of life at a comparativelv low cost.
    No preview · Article · Oct 2015 · Nursing economic$
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    ABSTRACT: First-line psychotherapies for post-traumatic stress disorder (PTSD) were principally validated in civilian populations. We compared treatment of symptoms of psychological trauma between civilian and military adults by use of Accelerated Resolution Therapy (ART), an emerging, brief exposure-based therapy. We pooled individual patient data from two recently completed studies of ART. Treatment response for symptoms of PTSD was compared by civilian versus military status, stratified by gender and history of sexual trauma. Mean age was 40.7 years in civilians (n = 62) vs. 42.2 years in military participants (n = 51). Mean PCL (PTSD) scores before/after treatment with ART were 53.2/30.2 among civilians compared with 56.0/40.5 among military participants (adjusted p = 0.25). Over follow-up (n = 91), there was an apparent greater reduction among civilians in Intrusive (p = 0.03) and Numbing symptoms (p = 0.01), but not in Arousal (p = 0.99) or Avoidance (p = 0.19) symptoms. Among females with sexual trauma, mean reductions on the PCL were substantial in civilian (-22.5 ± 16.7) and military (-21.2 ± 12.7) participants (p = 0.87). In an average of <4 treatment sessions, treatment with ART results in meaningful reductions in symptoms of PTSD in civilian and military patients. The suggestion of stronger response among civilians may owe to differential clinical presentation and trauma exposure history among military personnel. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.
    No preview · Article · Sep 2015

  • No preview · Article · Aug 2015 · International journal of cardiology
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    ABSTRACT: Background and purpose: The longitudinal invariance of the Center for Epidemiologic Studies-Depression (CES-D) scale among middle-aged and older adults is unknown. This study examined the factorial invariance of the CES-D scale in a large cohort of community-based adults longitudinally. Methods: 1,204 participants completed the 20-item CES-D scale at 4 time points 1 year apart. Structural equation modeling was used to identify best fitting model using longitudinal data at baseline and at 1-, 2-, and 3-year follow-up. Results: The 4-factor model showed partial invariance over 3 years. Two of the 6 noninvariant items were consistently noninvariant at the 3 follow-up points. Conclusion: Special consideration should be given to these 2 items when using the CES-D scale in healthy adults (45-75 years old).
    Full-text · Article · Aug 2015 · Journal of Nursing Measurement
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    ABSTRACT: Post-traumatic stress disorder (PTSD) is a disabling trauma and stress-related disorder that may occur after a person experiences a traumatic event, and evokes a combination of intrusion and avoidance symptoms, negative alterations in cognitions and mood, and alterations in arousal and reactivity. Accelerated resolution therapy (ART) is an emerging psychotherapy that provides fast and lasting resolution for mental health problems such as PTSD. ART has been shown to achieve a positive result in one to five sessions, typically over a 2-week period, and requires no homework, skills practice or repeated exposure to targeted events. Initial research, including one randomised control trial, has demonstrated that ART interventions can significantly reduce symptoms of psychological trauma in both civilians and US service members and veterans. These results suggest that ART be considered as either a primary treatment option or for refractory PTSD in those with a suboptimal response to endorsed first-line therapies. Conservative estimates indicate substantial potential cost savings in PTSD treatment. Despite the need for more definitive clinical trials, there is increasing interest in ART in the USA, including in the US Army. The growing positive empirical evidence is compelling, and there appears to be sufficient evidence to warrant UK researchers undertaking ART research. The armed forces offer the potential for comparative international trials. However, equally important are veterans, emergency services personnel and those subjected to violence. ART appears to also have application in other conditions, including depression, anxiety disorders, and alcohol or drug misuse. ART can potentially help personnel traumatised by the unique challenges of war and conflict zones by providing brief psychotherapy in a readily accessible and culturally competent manner. ART facilitates the provision of interventions and resolutions in theatre, thus enhancing forces' fighting capability.
    Full-text · Article · Jul 2015 · Journal of the Royal Army Medical Corps
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    ABSTRACT: We present the results of a randomized controlled trial evaluating the efficacy of vertebroplasty versus kyphoplasty in treating vertebral body compression fractures. Patients with vertebral body compression fractures were randomly assigned to treatment with kyphoplasty or vertebroplasty. Primary endpoints were pain (0-10 scale) and disability assessed using the Roland-Morris Disability Questionnaire (RMDQ). Outcomes were assessed at 3 days, 1 month, 6 months, and 1 year following the procedure. 115 subjects were enrolled in the trial with 59 (51.3%) randomly assigned to kyphoplasty and 56 (48.7%) assigned to vertebroplasty. Mean (SD) pain scores at baseline, 3 days, 30 days, and 1 year for kyphoplasty versus vertebroplasty were 7.4 (1.9) vs 7.9 (2.0), 4.1 (2.8) vs 3.7 (3.0), 3.4 (2.5) vs 3.6 (2.9), and 3.0 (2.8) vs 2.3 (2.6), respectively (p>0.05 at all time points). Mean (SD) RMDQ scores at baseline, 3 days, 30 days, 180 days, and 1 year were 17.3 (6.6) vs 16.3 (7.4), 11.8 (7.9) vs 10.9 (8.2), 8.6 (7.2) vs 8.8 (8.5), 7.9 (7.4) vs 7.3 (7.7), 7.5 (7.2) vs 6.7 (8.0), respectively (p>0.05 at all time points). For baseline to 12-month assessment in average pain and RMDQ scores, the standardized effect size between kyphoplasty and vertebroplasty was small at -0.36 (95% CI -1.02 to 0.31) and -0.04 (95% CI -1.68 to 1.60), respectively. Our study indicates that vertebroplasty and kyphoplasty appear to be equally effective in substantially reducing pain and disability in patients with vertebral body compression fractures. NCT00279877. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
    No preview · Article · Jun 2015 · Journal of Neurointerventional Surgery
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    ABSTRACT: Abstract Sexual risk taking and potential sequelae such as sexually transmitted diseases, including HIV, may be related to music videos that display suggestive imagery and lyrics. The purpose of this pilot study was to explore characteristics of music lyrics and imagery that might have implications on sexual arousal in Black college students. For four consecutive weeks, the top 20 Hip Hop/R&B music tracks from the official Billboard Charts website were selected. A convenience sample of 27 self-identified Black college students aged 18 to 24 were asked to rate the sexually explicit content in each video. There was a modest association between visual sexual explicitness scores for each video and scores on the Sexual Arousal and Desire Inventory (SADI) for females, and a strong association between visual sexual explicitness for each video and scores on the SADI for males.
    Full-text · Article · Jun 2015 · Journal of Black Studies
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    ABSTRACT: Body image is a complex issue with the potential to impact many aspects of cancer survivorship, particularly for the younger breast cancer survivor. The purpose of this review is to synthesize the current state of the science for body image in younger women with breast cancer. Combinations of the terms "body image," "sexuality intervention," "women," "younger women," and "breast cancer" were searched in the PubMed, PsycINFO, CINAHL, Web of Knowledge, and Science Direct databases through January 2014. Inclusion criteria for this review were (1) original research, (2) published in English from the year 2000 forward, (3) measuring body image as an outcome variable, and (4) results included reporting of age-related outcomes. Thirty-six articles met the inclusion criteria. The majority of studies were cross-sectional, with extensive variation in body image assessment tools. Age and treatment type had a significant impact on body image, and poorer body image was related to physical and psychological distress, sex and intimacy, and the partnered relationship among younger women. Only 1 intervention study found a significant improvement in body image after intervention. Findings suggest body image is a complex posttreatment concern for breast cancer survivors, particularly younger women. The findings of this review are limited by the high level of variation in the methods for assessing body image. Further research of interventions to address body image concerns following treatment for breast cancer is warranted. Improvement of body image may improve the quality of life of younger breast cancer survivors.
    No preview · Article · Apr 2015 · Cancer nursing
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    ABSTRACT: Breast cancer (BC) survivors often report cognitive impairment, which may be influenced by single-nucleotide polymorphisms (SNPs). The purpose of this study was to test whether particular SNPs were associated with changes in cognitive function in BC survivors and whether these polymorphisms moderated cognitive improvement resulting from the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR[BC]) program. BC survivors recruited from Moffitt Cancer Center and the University of South Florida's Breast Health Program, who had completed adjuvant radiation and/or chemotherapy treatment, were randomized to either the 6-week MBSR(BC) program (n = 37) or usual care (UC; n = 35) group. Measures of cognitive function and demographic and clinical history data were attained at baseline and at 6 and 12 weeks. A total of 10 SNPs from eight genes known to be related to cognitive function were analyzed using blood samples. Results showed that SNPs in four genes (ankyrin repeat and kinase domain containing 1 [ANKK1], apolipoprotein E [APOE], methylenetetrahydrofolate reductase [MTHFR], and solute carrier family 6 member 4 [SLC6A4]) were associated with cognitive impairment. Further, rs1800497 in ANKK1 was significantly associated with improvements in cognitive impairment in response to MBSR(BC). These results may help to identify individuals who would be better served by MBSR(BC) or other interventions. © The Author(s) 2015.
    Full-text · Article · Apr 2015 · Biological Research for Nursing
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    ABSTRACT: Sleep disturbances are recognized as a side effect of cancer treatment, affecting physiological and psychological functioning. Sleep disturbances can persist through treatment and survivorship, and are increasingly prevalent among breast cancer survivors (BCSs). The purpose of this review is to summarize current research on subjective and objective measures of sleep disturbances, the association between subjective and objective measures, and interventions used to manage sleep disturbances among BCSs after the completion of treatment. Articles published from 2003-2013 were retrieved using PubMed, Web of Science, and ScienceDirect. Key search terms included breast cancer, sleep actigraphy, and sleep disturbances. Articles assessing sleep subjectively and objectively in the post-treatment period were included. Twelve studies met the inclusion criteria.
    Preview · Article · Apr 2015 · Clinical Journal of Oncology Nursing
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    ABSTRACT: The objective of this study was to investigate the effectiveness of a web-based educational intervention for reducing postconcussion symptoms. 158 participants with self-reported symptomatic mild traumatic brain injury were randomized to intervention versus control. There was no effect of intervention on symptom severity or attributions. Subgroup analyses suggested benefit of the web-based intervention in those receiving concurrent mental health treatment and in those participants with the greatest time since injury (>1 year after mild traumatic brain injury). Web-based educational intervention was not effective overall in this sample. However, there is some suggestion of promise in those receiving concurrent mental health treatment and with more chronic symptoms. Findings also suggest potential benefit of interventions targeting self-efficacy. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.
    No preview · Article · Feb 2015 · Military medicine
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    ABSTRACT: Our aim was to compare the biopsychosocial characteristics of young women with those of older women who were enrolled in cardiac rehabilitation (CR). The baseline characteristics of women who prematurely terminated CR participation were also explored. Baseline physiological and psychosocial indices of women ≤ 55 years compared with older women eligible for CR were evaluated 1 week before enrolling in either a traditional CR or a gender-specific, motivationally enhanced CR. A greater proportion of young women (n = 65) compared with their older counterparts (n = 187) were diagnosed with acute myocardial infarction during their index hospitalization. They demonstrated lower high-density lipoprotein cholesterol, higher total cholesterol/high-density lipoprotein cholesterol ratios, and greater body weight compared with older women and were more likely to be active smokers. Young women compared with older women reported significantly worse health perceptions, quality of life, optimism, hope, social support, and stress and significantly more symptoms of depression and anxiety. Women who prematurely terminated CR participation were younger, more obese, with worse quality of life, and greater symptoms of depression and anxiety compared with women completing CR. Notable differences in physiological and psychosocial profiles of young women compared with older women enrolled in CR were evident, placing them at high risk for nonadherence to secondary prevention interventions as well as increased risk for disease progression and subsequent cardiac adverse events. Continued existence of these health differentials represents an important public health problem and warrants further research to address these age-related and sex-specific health disparities among women with coronary heart disease.
    No preview · Article · Nov 2014 · Journal of cardiopulmonary rehabilitation and prevention
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    S Erqou · K E Kip · S R Mulukutla · A N Aiyer · S E Reis
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    ABSTRACT: Background Identification of racial differences in the burden and correlates of carotid intima media thickness (CIMT) and coronary artery calcium (CAC) may provide the basis for the development of race-specific cardiovascular disease (CVD) risk prediction algorithms. Methods In the Heart Strategies Concentrating on Risk Evaluation (Heart SCORE) study, CIMT was measured by carotid ultrasonography in 792 individuals (35 % Black). CIMT >1 mm was considered significant. CAC was quantified by electron beam computed tomography in 776 individuals (46 % Black). CAC was considered significant if the Agatston score was >100. Cross-sectional associations between race, CIMT and CAC were assessed using logistic regression models. Results Blacks had greater CIMT (mean difference 0.033 mm, 95 % CI 0.005-0.06 mm; p=0.02) and 1.5-fold (95 % CI 1.0-2.3) higher odds of having significant CIMT than Whites. Blacks had less CAC than Whites (mean Agatston score difference 66, [11-122]; p=0.02) and 50 % lower odds of a significant CAC score compared with Whites (0.5 [0.3-0.7]). These associations were virtually unchanged after adjustment for CVD risk factors. Of the novel CVD risk markers assessed, small-dense low-density lipoprotein was independently associated with increased odds of significant CIMT, with the association being similar among Blacks and Whites (odds ratio [95 % CI]: 1.7 [1.2-2.5] and 1.4 [1.0-1.8] per 1-SD higher level, respectively). Interleukin-6 was significantly associated with CAC among Blacks (1.4 [1.0-2.0]). Conclusion Black race is independently associated with greater CIMT but less CAC than White race. CVD risk stratification strategies that incorporate these measures of subclinical atherosclerosis should consider race-specific algorithms.
    Preview · Article · Oct 2014 · Netherlands heart journal: monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation
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    ABSTRACT: Sleep apnea and obesity are strongly associated, and both increase the risk for coronary artery disease. Several cross-sectional studies have reported discrepant results regarding the role obesity plays in the relation between sleep apnea and coronary artery calcium (CAC), a marker of subclinical coronary disease. The aim of the present study was to investigate the association between sleep apnea and the presence of CAC in a community cohort of middle-aged men and women without preexisting cardiovascular disease, stratified by body mass index (<30 vs ≥30 kg/m(2)). Participants underwent electron-beam computed tomography to measure CAC and underwent home sleep testing for sleep apnea. The presence of CAC was defined as an Agatston score >0. Sleep apnea was analyzed categorically using the apnea-hypopnea index. The sample was composed of primarily men (61%) and Caucasians (56%), with a mean age of 61 years. The prevalence of CAC was 76%. In participants with body mass indexes <30 kg/m(2) (n = 139), apnea-hypopnea index ≥15 (vs <5) was associated with 2.7-fold odds of having CAC, but the effect only approached significance. Conversely, in participants with body mass indexes ≥30 kg/m(2), sleep apnea was not independently associated with CAC. In conclusion, sleep apnea is independently associated with early atherosclerotic plaque burden in nonobese patients.
    Full-text · Article · Sep 2014 · The American Journal of Cardiology
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    ABSTRACT: . Limited research has been conducted on the moderating effect of race/ethnicity on objective sleep disturbances in breast cancer survivors (BCSs). Objective . To explore racial/ethnic differences in objective sleep disturbances among BCSs and their relationship with self-reported symptoms. Intervention/Methods . Sleep disturbance and symptoms were measured using actigraphy for 72 hours and self-reported questionnaires, respectively, among 79 BCSs. Analysis of covariance, Pearson’s correlation, and multivariate regression were used to analyze data. Results . Sixty (75.9%) participants listed their ethnicity as white, non-Hispanic and 19 (24.1%) as minority. Total sleep time was 395.9 minutes for white BCSs compared to 330.4 minutes for minority BCSs. Significant correlations were seen between sleep onset latency (SOL) and depression, SOL and fatigue, and sleep efficiency (SE) and fatigue among minority BCSs. Among white BCSs, significant correlations were seen between SE and pain and wake after sleep onset (WASO) and pain. The association between depression and SOL and fatigue and SOL appeared to be stronger in minority BCSs than white BCSs. Conclusions . Results indicate that white BCSs slept longer than minority BCSs, and race/ethnicity modified the effect of depression and fatigue on SOL, respectively. Implications for Practice . As part of survivorship care, race/ethnicity should be included as an essential component of comprehensive symptom assessments.
    Full-text · Article · Jul 2014
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    ABSTRACT: Objective The purpose of this study was to investigate the effects of mindfulness-based stress reduction for breast cancer survivors (MBSR(BC)) on multiple measures of objective and subjective sleep parameters among breast cancer survivors (BCS).Methods Data were collected using a two-armed randomized controlled design among BCS enrolled in either a 6-week MBSR(BC) program or a usual care (UC) group with a 12-week follow-up. The present analysis is a subset of the larger parent trial (ClinicalTrials.gov Identifier: NCT01177124). Seventy-nine BCS participants (mean age 57 years), stages 0-III, were randomly assigned to either the formal (in-class) 6-week MBSR(BC) program or UC. Subjective sleep parameters (SSP) (i.e., sleep diaries and the Pittsburgh Sleep Quality Index (PSQI)) and objective sleep parameters (OSP) (i.e., actigraphy) were measured at baseline, 6 weeks, and 12 weeks after completing the MBSR(BC) or UC program.ResultsResults showed indications of a positive effect of MBSR(BC) on OSP at 12 weeks on sleep efficiency (78.2% MBSR(BC) group versus 74.6% UC group, p = 0.04), percent of sleep time (81.0% MBSR(BC) group versus 77.4% UC group, p = 0.02), and less number waking bouts (93.5 in MBSR(BC) group versus 118.6 in the UC group, p < 0.01). Small nonsignificant improvements were found in SSP in the MBSR(BC) group from baseline to 6 weeks (PSQI total score, p = 0.09). No significant relationship was observed between minutes of MBSR(BC) practice and SSP or OSP.Conclusions These data suggest that MBSR(BC) may be an efficacious treatment to improve objective and subjective sleep parameters in BCS.Copyright © 2014 John Wiley & Sons, Ltd.
    Full-text · Article · Jun 2014 · Psycho-Oncology
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    Full-text · Article · May 2014
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    ABSTRACT: Background As many as 70% of veterans with chronic pain treated within the US Veterans Administration (VA) system may have posttraumatic stress disorder (PTSD), and conversely, up to 80% of those with PTSD may have pain. We describe pain experienced by US service members and veterans with symptoms of PTSD, and report on the effect of Accelerated Resolution Therapy (ART), a new, brief exposure-based therapy, on acute pain reduction secondary to treatment of symptoms of PTSD. Methods A randomized controlled trial of ART versus an attention control (AC) regimen was conducted among 45 US service members/veterans with symptoms of combat-related PTSD. Participants received a mean of 3.7 sessions of ART. Results Mean age was 41.0 + 12.4 years and 20% were female. Most veterans (93%) reported pain. The majority (78%) used descriptive terms indicative of neuropathic pain, with 29% reporting symptoms of a concussion or feeling dazed. Mean pre-/post-change on the Pain Outcomes Questionnaire (POQ) was −16.9±16.6 in the ART group versus −0.7±14.2 in the AC group (p=0.0006). Among POQ subscales, treatment effects with ART were reported for pain intensity (effect size = 1.81, p=0.006), pain-related impairment in mobility (effect size = 0.69, p=0.01), and negative affect (effect size = 1.01, p=0.001). Conclusions Veterans with symptoms of combat-related PTSD have a high prevalence of significant pain, including neuropathic pain. Brief treatment of symptoms of combat-related PTSD among veterans by use of ART appears to acutely reduce concomitant pain.
    Full-text · Article · May 2014 · European Journal of Psychotraumatology

Publication Stats

7k Citations
1,387.19 Total Impact Points

Institutions

  • 2001-2015
    • University of South Florida
      • • College of Nursing
      • • Department of Cardiology
      Tampa, Florida, United States
    • University of Texas Southwestern Medical Center
      • Department of Ophthalmology
      Dallas, TX, United States
  • 1998-2012
    • University of Pittsburgh
      • • Department of Medicine
      • • Department of Epidemiology
      Pittsburgh, Pennsylvania, United States
  • 2006
    • Magee-Womens Hospital
      Pittsburgh, Pennsylvania, United States
  • 2004
    • Rhode Island Hospital
      Providence, Rhode Island, United States
  • 2000-2001
    • Jaeb Center for Health Research
      Tampa, Florida, United States