Scholars@Duke
Harold S Kudler

Harold S Kudler

Medical Associate Professor in the Department of Psychiatry and Behavioral Sciences
Psychiatry & Behavioral Sciences, Adult Psychiatry & Psychology
kudle001@duke.edu
VA Medical Center 116A, Durham, NC
VA Med Ctr, 508 Fulton St, Durham, NC

Selected Publications

Well-being domains in U.S. military veterans: identifying modifiable factors to promote whole health.

Journal Article Int Psychogeriatr · October 2024 The U.S. Department of Veterans Affairs is actively transitioning away from a disease-centric model of healthcare to one that prioritizes disease prevention and the promotion of overall health and well-being. Described as Whole Health, this initiative aims ... Full text Link to item Cite

Well-Being of US Military Veterans.

Journal Article JAMA Netw Open · December 1, 2023 Full text Link to item Cite

Rethinking Health and Health Care: How Clinicians and Practice Groups Can Better Promote Whole Health and Well-Being for People and Communities.

Journal Article Med Clin North Am · November 2023 A new National Academies of Sciences, Engineering, and Medicine report, "Achieving Whole Health: A New Approach for Veterans and the Nation," redefines what it means to be healthy and creates a roadmap for health systems, including the Veterans Health Admi ... Full text Link to item Cite

Preventing Firearm-Related Deaths Among Service Members and Veterans

Journal Article North Carolina Medical Journal · July 1, 2023 Heightened risk of death by suicide among military service members and veterans reflects employment of firearms as a favored means. This commentary offers a practical preventive approach employing lethal means reduction, addressing upstream factors, identi ... Full text Cite

Clinical practice guidelines for posttraumatic stress disorder: Are they still clinical?

Journal Article Psychotherapy (Chic) · September 2019 This article traces the evolution of clinical practice guidelines (CPGs) for the treatment of Posttraumatic Stress Disorder (PTSD) to illustrate how their construction and use have become intertwined and often conflated with other pressing clinical and sci ... Full text Link to item Cite

Barriers to the use of Veterans Affairs health care services among female veterans who served in Iraq and Afghanistan.

Journal Article Psychol Serv · August 2019 The study investigated barriers to the utilization of Veterans Affairs (VA) health care services among female veterans who served in served in Iraq and Afghanistan, including reasons for not choosing VA health care, reasons for not seeking mental health tr ... Full text Link to item Cite

The Association Between Military Sexual Trauma and Use of VA and Non-VA Health Care Services Among Female Veterans With Military Service in Iraq or Afghanistan.

Journal Article J Interpers Violence · August 2018 Military sexual trauma (MST) has been linked with increased rates of mental health disorders among veterans. Few studies have addressed how MST is related to use of VA and non-VA health care. The purpose of the current study was to (a) examine the associat ... Full text Link to item Cite

The association of alcohol consumption patterns with self-rated physical health and psychiatric distress among Afghanistan- and Iraq-era U.S. veterans.

Journal Article Psychiatry Res · January 2018 Alcohol misuse is associated with negative mental and physical health outcomes, which presents a public health concern in veterans. However, less is known regarding outcomes among veterans with low to moderate alcohol consumption. This study included veter ... Full text Link to item Cite

Cigarette Smoking and Musculoskeletal Pain Severity Among Male and Female Afghanistan/Iraq Era Veterans.

Journal Article Pain Med · September 1, 2017 OBJECTIVE: Cigarette smoking and musculoskeletal pain are prevalent among Department of Veterans Affairs (VA) health care system users. These conditions frequently co-occur; however, there is limited empirical information specific to Afghanistan/Iraq era v ... Full text Link to item Cite

The Post-Deployment Mental Health (PDMH) study and repository: A multi-site study of US Afghanistan and Iraq era veterans.

Journal Article Int J Methods Psychiatr Res · September 2017 The United States (US) Department of Veterans Affairs (VA) Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC) Post-Deployment Mental Health (PDMH) multi-site study examines post-deployment mental health in US military Afghanistan ... Full text Link to item Cite

Measuring the Quality of VA Care.

Journal Article Psychiatr Serv · March 1, 2017 Full text Link to item Cite

An Investigation of Treatment Engagement Among Returning Veterans With Problematic Anger.

Journal Article J Nerv Ment Dis · February 2017 Anger is a commonly reported problem among returning veterans, yet little attention has been devoted to studying treatment engagement among veterans who report anger problems but do not have posttraumatic stress disorder (PTSD). This study compares Iraq-Af ... Full text Link to item Cite

The prevalence of binge drinking and receipt of provider drinking advice among US veterans with military service in Iraq or Afghanistan.

Journal Article Am J Drug Alcohol Abuse · May 2016 BACKGROUND: Binge drinking is a significant public health concern linked to a number of health and psychosocial problems. Military service in Afghanistan (OEF) and Iraq (OIF) has been associated with posttraumatic stress disorder (PTSD) and increased hazar ... Full text Link to item Cite

Veterans' Preferences for Receiving Information About VA Services: Is Getting the Information You Want Related to Increased Health Care Utilization?

Journal Article Mil Med · February 2016 Although the current cohort of returning veterans has engaged more fully with care from the Department of Veterans Affairs (VA) than have veterans from previous eras, concern remains regarding low engagement with VA services, particularly for specialty ser ... Full text Link to item Cite

Allopregnanolone Levels Are Inversely Associated with Self-Reported Pain Symptoms in U.S. Iraq and Afghanistan-Era Veterans: Implications for Biomarkers and Therapeutics.

Journal Article Pain Med · January 2016 BACKGROUND AND OBJECTIVES: Pain symptoms are common among Iraq/Afghanistan-era veterans, many of whom continue to experience persistent pain symptoms despite multiple pharmacological interventions. Preclinical data suggest that neurosteroids such as allopr ... Full text Open Access Link to item Cite

Nature and Treatment of Comorbid Alcohol Problems and Post Traumatic Stress Disorder Among American Military Personnel and Veterans.

Journal Article Alcohol Res · 2016 Many service members and veterans seeking treatment for alcohol problems also have post-traumatic stress disorder (PTSD). This article considers the effectiveness of treating alcohol problems and PTSD simultaneously. The authors begin by summarizing the ex ... Link to item Cite

An exploratory pilot investigation of neurosteroids and self-reported pain in female Iraq/Afghanistan-era Veterans.

Journal Article J Rehabil Res Dev · 2016 Female Veterans are the most rapidly growing segment of new users of the Veterans Health Administration (VHA), and a significant proportion of female Veterans receiving treatment from VHA primary care providers report persistent pain symptoms. Currently, a ... Full text Link to item Cite

Functional correlates of military sexual assault in male veterans.

Journal Article Psychol Serv · November 2015 Despite research findings that similar numbers of male and female veterans are affected by military sexual trauma (MST), there has been considerably less research on the effects of MST specific to male veterans. The aim of the present study was to provide ... Full text Link to item Cite

Surveying treatment preferences in U.S. Iraq-Afghanistan Veterans with PTSD symptoms: a step toward veteran-centered care.

Journal Article J Trauma Stress · April 2015 This study examined health care barriers and preferences among a self-selected sample of returning U.S. veterans drawn from a representative, randomly selected frame surveyed about posttraumatic stress disorder (PTSD) symptomatology and mental health utili ... Full text Link to item Cite

The Relationship Between Posttraumatic Stress Symptoms and Physical Health in a Survey of U.S. Veterans of the Iraq and Afghanistan Era.

Journal Article Psychosomatics · 2015 BACKGROUND: Although a large body of literature has linked posttraumatic stress disorder (PTSD) with poor physical health among older veterans, less is known regarding the association between PTSD and health among relatively younger cohorts of veterans. OB ... Full text Link to item Cite

Mental Health Among Military Personnel and Veterans.

Journal Article N C Med J · 2015 This commentary describes the prevalence of mental health problems affecting military service members and veterans in North Carolina and the rest of the nation, with a special emphasis on those who served in the recent wars in Iraq and Afghanistan. Approxi ... Full text Link to item Cite

DSM-5 posttraumatic stress disorder: factor structure and rates of diagnosis.

Journal Article J Psychiatr Res · December 2014 Posttraumatic stress disorder (PTSD) is a significant problem among Iraq/Afghanistan-era veterans. To date, however, there has been only limited research on how the recent changes in DSM-5 influence the prevalence and factor structure of PTSD. To address t ... Full text Link to item Cite

The impact of social support on psychological distress for U.S. Afghanistan/Iraq era veterans with PTSD and other psychiatric diagnoses.

Journal Article Psychiatry Res · June 30, 2014 This study aimed to examine the degree to which posttraumatic stress disorder (PTSD) affects the relationship between social support and psychological distress for U.S. Afghanistan/Iraq era veterans with and without co-occurring psychiatric disorders. Vete ... Full text Link to item Cite

Altered resting-state functional connectivity of basolateral and centromedial amygdala complexes in posttraumatic stress disorder.

Journal Article Neuropsychopharmacology · January 2014 The amygdala is a major structure that orchestrates defensive reactions to environmental threats and is implicated in hypervigilance and symptoms of heightened arousal in posttraumatic stress disorder (PTSD). The basolateral and centromedial amygdala (CMA) ... Full text Open Access Link to item Cite

Effects of chronic mild traumatic brain injury on white matter integrity in Iraq and Afghanistan war veterans.

Journal Article Hum Brain Mapp · November 2013 Mild traumatic brain injury (TBI) is a common source of morbidity from the wars in Iraq and Afghanistan. With no overt lesions on structural MRI, diagnosis of chronic mild TBI in military veterans relies on obtaining an accurate history and assessment of b ... Full text Open Access Link to item Cite

Building communities of care for military children and families.

Journal Article Future Child · 2013 Military children don't exist in a vacuum; rather, they are embedded in and deeply influenced by their families, neighborhoods, schools, the military itself, and many other interacting systems. To minimize the risks that military children face and maximize ... Full text Link to item Cite

PSYCHODYNAMIC THERAPY, ADULT

Chapter · January 1, 2012 Cite

TRAUMATIC NEUROSIS

Chapter · January 1, 2012 Cite

FREUD, SIGMUND

Chapter · January 1, 2012 Cite

Developing community capacity to treat post-deployment mental health problems: A public health initiative

Journal Article Psychological Trauma Theory Research Practice and Policy · September 1, 2011 Meeting the mental health needs of Veterans returning from recent deployment requires the coordinated effort of partnerships across Department of Defense (DoD), Department of Veterans Affairs (VA), and state and local communities. Although the proportion o ... Full text Cite

Behavioral health conditions among military personnel and veterans: prevalence and best practices for treatment.

Journal Article N C Med J · 2011 The Department of Defense and the Department of Veterans Affairs place a high priority on behavioral health assessment, treatment, and research. We present the national and regional prevalence of the most-common behavioral health problems experienced by Op ... Link to item Cite

Initiatives to improve access to behavioral health services in the Veterans Affairs Health System.

Journal Article N C Med J · 2011 In response to veterans' needs in the context of recent deployments, the Veterans Affairs (VA) health system has increased the number of its facilities and caregivers and has pioneered changes in policy and programs. We review significant recent initiative ... Link to item Cite

A guide to guidelines for the treatment of PTSD and related conditions.

Journal Article J Trauma Stress · October 2010 In recent years, several practice guidelines have appeared to inform clinical work in the assessment and treatment of posttraumatic stress disorder. Although there is a high level of consensus across these documents, there are also areas of apparent differ ... Full text Link to item Cite

Correlates of anger and hostility in Iraq and Afghanistan war veterans.

Journal Article Am J Psychiatry · September 2010 OBJECTIVE: As troops return from Iraq and Afghanistan to civilian life, clinicians are starting to grapple with how best to detect those at risk of postdeployment adjustment problems. Data reveal the presence of mental health problems in these soldiers, in ... Full text Link to item Cite

Partnering in support of war zone veterans and their families

Journal Article Psychiatric Annals · February 1, 2009 Full text Cite

Hazardous alcohol use and receipt of risk-reduction counseling among U.S. veterans of the wars in Iraq and Afghanistan.

Journal Article J Clin Psychiatry · November 2008 OBJECTIVE: Military service in Afghanistan (Operation Enduring Freedom [OEF]) and Iraq (Operation Iraqi Freedom [OIF]) has been associated with high rates of mental health problems. Relatively little is known, however, about the prevalence of risky drinkin ... Full text Link to item Cite

The need for psychodynamic principles in outreach to new combat veterans and their families.

Journal Article J Am Acad Psychoanal Dyn Psychiatry · 2007 Although Posttraumatic Stress Disorder (PTSD) has come to be understood in primarily biological terms, the problems of returning combat veterans from Iraq and Afghanistan (and indeed, of their families) are best understood in psychodynamic terms. Their nee ... Full text Link to item Cite

Chronic stress and adaptation.

Journal Article Am J Psychiatry · March 2006 Full text Link to item Cite

The primary care health system as a core resource in response to terrorism

Journal Article Journal of Aggression Maltreatment and Trauma · May 31, 2005 Living through a terrorist event or under threat of attack affects both mental and physical health. A nation's primary care system plays a critical role under such circumstances. This article reviews the American experience after September 11, 2001 and adv ... Full text Cite

The primary care health system as a core resource in response to terrorism

Chapter · January 1, 2005 Living through a terrorist event or under threat of attack affects both mental and physical health. A nation’s primary care system plays a critical role under such circumstances. This article reviews the American experience after September 11, 2001 and adv ... Cite

Guidelines for treatment of PTSD.

Journal Article J Trauma Stress · October 2000 Full text Link to item Cite

Lack of efficacy for fluoxetine in PTSD: a placebo controlled trial in combat veterans.

Journal Article Ann Clin Psychiatry · June 2000 BACKGROUND: Fluoxetine and placebo were studied in a population of combat veterans with severe, chronic PTSD. METHODS: Twelve male veterans with PTSD were enrolled in a 12 week double-blind evaluation of fluoxetine and placebo. Mean fluoxetine dose at endp ... Full text Link to item Cite

Minnesota Multiphasic Personality Inventory profiles of Vietnam combat veterans with posttraumatic stress disorder and their children.

Journal Article J Clin Psychol · December 1997 Forty children of 28 fathers who are Vietnam veterans with posttraumatic stress disorder (PTSD) completed the Minnesota Multiphasic Personality Inventory. Each of the fathers had at least one elevated clinical scale. Fathers averaged eight elevated clinica ... Full text Link to item Cite

Minor depression in hospitalized elderly veterans

Journal Article JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · September 1, 1996 Link to item Cite

Interpersonal and self-reported hostility among combat veterans with and without posttraumatic stress disorder.

Journal Article J Trauma Stress · April 1996 The present study investigated self-reported and interpersonal hostility in 70 Vietnam combat veterans with and without posttraumatic stress disorder (PTSD) and 60 comparison community volunteer subjects. Veterans were 50 help-seeking, male Vietnam combat ... Full text Link to item Cite

Smoking in Vietnam combat veterans with post-traumatic stress disorder.

Journal Article J Trauma Stress · July 1995 The present study investigated smoking prevalence, smoking motives, demographic variables and psychological symptoms in 124 help-seeking, male Vietnam combat veterans with post-traumatic stress disorder (PTSD). A high percentage of these veterans smoked (6 ... Full text Link to item Cite

Religious coping and cognitive symptoms of depression in elderly medical patients.

Journal Article Psychosomatics · 1995 The investigators examined associations between depressive symptom type and religious coping in 832 consecutively admitted older medical inpatients. Cognitive symptoms of depression, but not somatic symptoms, were related to religious coping. Boredom, loss ... Full text Link to item Cite

Borderline personality disorder and PTSD.

Journal Article Am J Psychiatry · December 1993 Full text Link to item Cite

Predicting response to amitriptyline in posttraumatic stress disorder.

Journal Article Am J Psychiatry · July 1993 OBJECTIVE: This study evaluated the relation between baseline clinical phenomena and response to amitriptyline in patients with posttraumatic stress disorder (PTSD). METHOD: Data were obtained from an 8-week placebo-controlled, double-blind study of combat ... Full text Link to item Cite

Spectral and topographic analysis of EEG in schizophrenic patients.

Journal Article Biol Psychiatry · February 15, 1993 The authors performed spectral analysis of electroencephalograms (EEG), recorded awake, with eyes closed, in 13 patients with schizophrenia and 9 age-matched individuals without psychiatric diagnosis. We tested several possible parameterizations of the dat ... Full text Link to item Cite

Major depression in hospitalized medically ill older men: Documentation, management, and outcome

Journal Article International Journal of Geriatric Psychiatry · January 1, 1992 Fifty‐three hospitalized elderly men with medical illness were diagnosed with major depressive disorder and followed up for a mean of 2.3 months. Documentation and management of the depression by medical housestaff during the followup period were examined. ... Full text Cite

Cultivating Freud's Garden in France

Journal Article American Journal of Psychiatry · June 1990 Full text Cite

Treatment of posttraumatic stress disorder with amitriptyline and placebo.

Journal Article Arch Gen Psychiatry · March 1990 Amitriptyline hydrochloride was compared with placebo in 46 veterans with chronic posttraumatic stress disorder. Treatment continued up to 8 weeks, and efficacy was measured by five observer and two self-rated scales. Percent recovery rates were higher for ... Full text Link to item Cite

Symptom and comorbidity patterns in World War II and Vietnam veterans with posttraumatic stress disorder.

Journal Article Compr Psychiatry · 1990 Forty-four veterans with posttraumatic stress disorder (PTSD) from World War II and Vietnam were compared. The groups were comparable on many socioeconomic and combat measures and age at onset of PTSD. Vietnam veterans exhibited more severe PTSD symptoms, ... Full text Link to item Cite

ASSESSMENT AND PHARMACOTHERAPY OF POSTTRAUMATIC-STRESS-DISORDER

Conference BIOLOGICAL ASSESSMENT AND TREATMENT OF POSTTRAUMATIC STRESS DISORDER · January 1, 1990 Link to item Cite

The tension between psychoanalysis and neuroscience: A perspective on dream theory in psychiatry

Journal Article Psychoanalysis and Contemporary Thought · December 1, 1989 Cite

Measuring results of treatment of PTSD.

Journal Article Am J Psychiatry · December 1989 Full text Link to item Cite

The corticotropin-releasing hormone test in patients with posttraumatic stress disorder.

Journal Article Biol Psychiatry · August 1989 To evaluate the hypothalamic-pituitary-adrenal (HPA) axis in patients with posttraumatic stress disorder (PTSD), we measured adrenocorticotropin hormone (ACTH) and cortisol responses following administration of corticotropin-releasing hormone (CRH) in 8 co ... Full text Link to item Cite

Validity and reliability of the DSM-III criteria for posttraumatic stress disorder. Experience with a structured interview.

Journal Article J Nerv Ment Dis · June 1989 The DSM-III criteria for posttraumatic stress disorder (PTSD) were operationally defined for use in a structured interview. Acceptable interrater and test-retest reliabilities were shown; diagnostic validity was demonstrated relative to a standard diagnost ... Full text Link to item Cite

Antidepressant use in elderly medical inpatients: lessons from an attempted clinical trial.

Journal Article J Gen Intern Med · 1989 The authors conducted a clinical trial to examine the efficacy and safety of nortriptyline in the treatment of major depression in elderly medical inpatients. The diagnosis of major depression was made by a psychiatrist in 41 of 680 patients 65 years of ag ... Full text Link to item Cite

Familial psychiatric illness in chronic posttraumatic stress disorder.

Journal Article Compr Psychiatry · 1989 One hundred and eight veterans with posttraumatic stress disorder (PTSD) were compared with 60 age-matched controls with regard to family history of psychiatric illness. Depressed controls had a higher morbidity risk (MR) for depression and generalized anx ... Full text Link to item Cite

Tribulin in post-traumatic stress disorder.

Journal Article Psychol Med · November 1988 Tribulin (endogenous monoamine oxidase inhibitor/benzodiazepine receptor binding inhibitor) output was measured in the urine of 18 patients with post-traumatic stress disorder (PTSD) and 13 controls. The level of the two inhibitory activities was highly si ... Full text Link to item Cite

The DST and posttraumatic stress disorder.

Journal Article Am J Psychiatry · August 1987 The dexamethasone suppression test (DST) was administered to 28 male combat veterans with posttraumatic stress disorder. Six subjects (21%) were nonsuppressors. The nonsuppression rates for the subgroups with and without major depressive disorder according ... Full text Link to item Cite

Personality in chronic post-traumatic stress disorder:. A study of the eysenck inventory

Journal Article Journal of Anxiety Disorders · January 1, 1987 Personality variables were assessed in 30 patients with chronic post-traumatic stress disorder (PTSD). World War II/Korean War (WWII/K) veterans with PTSD were significantly more introverted and neurotic than age-matched non-psychiatric controls, whether o ... Full text Cite

Symptom exacerbation in psychotically depressed adolescents due to high desipramine plasma concentrations.

Journal Article J Clin Psychopharmacol · June 1986 The pharmacological treatment of two female adolescent patients meeting DSM-III criteria for psychotic depression is described. A combined antipsychotic and tricyclic antidepressant regimen led to clinical remission. However, a recrudescence in both psycho ... Link to item Cite

The Lives and Legends of Jacques Lacan

Journal Article American Journal of Psychiatry · June 1985 Full text Cite

Disclosing diagnosis, continued.

Journal Article Hosp Community Psychiatry · July 1984 Full text Link to item Cite