Scholars@Duke
Jennifer Leigh Strauss

Jennifer Leigh Strauss

Associate Professor in Psychiatry and Behavioral Sciences
Psychiatry, Child & Family Mental Health & Community Psychiatry
jennifer.strauss@duke.edu
N/A, Bldg 6, 508 Fulton Street, Durham, NC 27705
VA Hospital, Durham, NC

Selected Publications

Sex differences in predictors of recurrent major depression among current-era military veterans.

Journal Article Psychol Serv · May 2021 Although major depressive disorder (MDD) is a frequent diagnosis among women seeking care in the Veterans Health Administration, little is known about its course. For example, recurrence of MDD and its predictors have been investigated in civilians, but no ... Full text Link to item Cite

Lifetime Smoking Patterns and Preferences for Smoking Cessation Among Women Veterans Receiving Veterans Health Administration Care.

Journal Article Qual Health Res · December 2019 The objective of this study was to identify common themes among women veterans who smoke or recently quit and had used smoking cessation treatment within the Veterans Health Administration (VHA). The study built upon previous research by utilizing in-depth ... Full text Link to item Cite

Timely access to mental health care among women veterans.

Journal Article Psychol Serv · August 2019 Using survey data on (N = 419) patients at Department of Veterans Affairs (VA) clinics we analyzed women veterans' reports of timely access to VA mental health care. We evaluated problems that patients might face in obtaining care, and examined subjective ... Full text Link to item Cite

Pain Intensity and Pain Interference in Male and Female Iraq/Afghanistan-era Veterans.

Journal Article Womens Health Issues · June 25, 2019 BACKGROUND: Chronic pain conditions are common among both male and female Iraq/Afghanistan-era veterans and can have substantial negative impacts on quality of life and function. Although in general women tend to report higher levels of pain intensity than ... Full text Link to item Cite

Gender Differences in Response to Acceptance and Commitment Therapy Among Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn Veterans.

Journal Article Womens Health Issues · 2019 BACKGROUND: Most of our knowledge base regarding treatment response among veterans comes from predominantly male samples. Evidence suggests, however, that women and men use different coping strategies, which may impact how effective treatments are for peop ... Full text Link to item Cite

Self-Reported Pain in Male and Female Iraq/Afghanistan-Era Veterans: Associations with Psychiatric Symptoms and Functioning.

Journal Article Pain Med · September 1, 2017 OBJECTIVE: To examine pain symptoms and co-occurring psychiatric and functional indices in male and female Iraq/Afghanistan-era veterans. DESIGN: Self-reported data collection and interviews of Iraq/Afghanistan-era veterans who participated in a multisite ... Full text Link to item Cite

Randomized controlled trial of acceptance and commitment therapy for distress and impairment in OEF/OIF/OND veterans.

Journal Article Psychol Trauma · August 2017 OBJECTIVE: Acceptance and commitment therapy (ACT) is a widely utilized psychotherapeutic approach, but randomized, controlled studies are lacking in veterans. This study evaluated the efficacy of ACT for emotional distress among veterans of the conflicts ... Full text Link to item Cite

Patient, Provider, and Combined Interventions for Managing Osteoarthritis in Primary Care: A Cluster Randomized Trial.

Journal Article Ann Intern Med · March 21, 2017 BACKGROUND: A single-site study showed that a combined patient and provider intervention improved outcomes for patients with knee osteoarthritis, but it did not assess separate effects of the interventions. OBJECTIVE: To examine whether patient-based, prov ... Full text Open Access Link to item Cite

Differences in Depression Care for Men and Women among Veterans with and without Psychiatric Comorbidities.

Journal Article Womens Health Issues · 2017 BACKGROUND: Depression is common among primary care patients, affecting more women than men. Women veterans are an extreme but growing minority among patients seeking care from the Department of Veterans Affairs (VA), an organization historically designed ... Full text Link to item Cite

Yoga as an Intervention for PTSD: a Theoretical Rationale and Review of the Literature

Journal Article Current Treatment Options in Psychiatry · March 1, 2016 There is evidence to suggest that yoga may reduce PTSD symptoms. It is unclear at this point, however, whether or not yoga reduces PTSD symptoms any more than a non-specific intervention given inconsistent findings and methodological limitations. Nonethele ... Full text Cite

A Combined Patient and Provider Intervention for Management of Osteoarthritis in Veterans: A Randomized Clinical Trial.

Journal Article Ann Intern Med · January 19, 2016 BACKGROUND: Management of osteoarthritis requires both medical and behavioral strategies, but some recommended therapies are underused. OBJECTIVE: To examine the effectiveness of a combined patient and provider intervention for improving osteoarthritis out ... Full text Open Access 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

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

Drug use and childhood-, military- and post-military trauma exposure among women and men veterans.

Journal Article Drug Alcohol Depend · July 1, 2015 BACKGROUND: The current study was undertaken to examine whether posttraumatic stress symptoms (PTSS) and depressive symptoms mediated the association between trauma exposure (combat-related trauma and non-combat traumas occurring before, during, and after ... Full text Link to item Cite

A pilot randomized placebo-controlled trial of adjunctive aripiprazole for chronic PTSD in US military Veterans resistant to antidepressant treatment.

Journal Article Int Clin Psychopharmacol · May 2015 Many individuals with post-traumatic stress disorder (PTSD) experience persistent symptoms despite pharmacological treatment with antidepressants. Several open-label monotherapy and adjunctive studies have suggested that aripiprazole (a second-generation a ... Full text Link to item Cite

Exploratory investigation of biomarker candidates for suicide in schizophrenia and bipolar disorder.

Journal Article Crisis · 2015 BACKGROUND: Clozapine and lithium increase neurosteroids in rodents, and both drugs demonstrate antisuicidal actions. We therefore hypothesized that neurosteroid levels may be reduced in patients with schizophrenia or bipolar disorder who completed suicide ... Full text Link to item Cite

Study design and protocol for a theory-based behavioral intervention focusing on maintenance of weight loss: the Maintenance After Initiation of Nutrition TrAINing (MAINTAIN) study.

Journal Article Contemp Clin Trials · September 2014 BACKGROUND: Obesity is a significant public health problem. Although various lifestyle approaches are effective for inducing significant weight loss, few effective behavioral weight maintenance strategies have been identified. It has been proposed that beh ... 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

Differentiating Behavior Initiation and Maintenance: Theoretical Framework and Proof of Concept.

Journal Article Health Educ Behav · June 2014 Although many interventions are effective for health behavior initiation, maintenance has proven elusive. Interventions targeting maintenance often extend the duration with which initiation content is delivered or the duration of follow-up without interven ... Full text Link to item Cite

Amino acids as biomarker candidates for suicidality in male OEF/OIF Veterans: relevance to NMDA receptor modulation and nitric oxide signaling.

Journal Article Mil Med · May 2014 Veteran populations are exposed to multiple stressful events, and suicidality among veterans is a serious problem. Identifying biomarkers of suicidality may enhance detection, prevention, and treatment. Multiple neurotransmitter systems are implicated in t ... Full text Link to item Cite

Acute effects of trauma-focused research procedures on participant safety and distress.

Journal Article Psychiatry Res · January 30, 2014 The ethical conduct of research on posttraumatic stress disorder (PTSD) requires assessing the risks to study participants. Some previous findings suggest that patients with PTSD report higher distress compared to non-PTSD participants after trauma-focused ... Full text Open Access Link to item Cite

Systematic review of women veterans' mental health.

Journal Article Womens Health Issues · 2014 BACKGROUND: Given recent, rapid growth in the field of women veterans' mental health, the goal of this review was to update the status of women veterans' mental health research and to identify current themes in this literature. The scope of this review inc ... Full text 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

Adverse impact of coercive treatments on psychiatric inpatients' satisfaction with care.

Journal Article Community Ment Health J · August 2013 Consumers' satisfaction with inpatient mental health care is recognized as a key quality indicator that prospectively predicts functional and clinical outcomes. Coercive treatment experience is a frequently cited source of dissatisfaction with inpatient ca ... Full text Link to item Cite

Multifamily group treatment for veterans with traumatic brain injury: what is the value to participants?

Journal Article Psychiatr Serv · June 2013 OBJECTIVE: This study evaluated the feasibility, acceptability, and helpfulness of implementation of multifamily group treatment for traumatic brain injury (TBI) among veterans who sustained a TBI during the wars in Iraq and Afghanistan and their families ... Full text Link to item Cite

Implementation of multifamily group treatment for veterans with traumatic brain injury.

Journal Article Psychiatr Serv · June 2013 OBJECTIVE: This study evaluated the initial efficacy and feasibility of implementing multifamily group treatment for veterans with traumatic brain injury (TBI). METHODS: Veterans at two Veterans Affairs medical centers were prescreened by their providers f ... Full text Link to item Cite

A pilot randomized controlled trial with paroxetine for subthreshold PTSD in Operation Enduring Freedom/Operation Iraqi Freedom era veterans.

Journal Article Psychiatry Res · April 30, 2013 Subthreshold posttraumatic stress disorder (PTSD) is associated with increased risk for suicidality, depression, and functional impairment. We thus conducted a small (N=12) pilot randomized controlled trial (RCT) with paroxetine for subthreshold PTSD in Op ... Full text Open Access Link to item Cite

The theoretical and empirical basis for meditation as an intervention for PTSD.

Journal Article Behav Modif · November 2012 In spite of the existence of good empirically supported treatments for posttraumatic stress disorder (PTSD), consumers and providers continue to ask for more options for managing this common and often chronic condition. Meditation-based approaches are bein ... Full text Link to item Cite

An open-label pilot study of aripiprazole for male and female veterans with chronic post-traumatic stress disorder who respond suboptimally to antidepressants.

Journal Article Int Clin Psychopharmacol · July 2012 Emerging data suggest that second-generation antipsychotics such as aripiprazole may be effective in the treatment of post-traumatic stress disorder (PTSD). However, few clinical trials have used aripiprazole in PTSD, and data are limited on its use in Vet ... Full text Link to item Cite

Patient and provider interventions for managing osteoarthritis in primary care: protocols for two randomized controlled trials.

Journal Article BMC Musculoskelet Disord · April 24, 2012 BACKGROUND: Osteoarthritis (OA) of the hip and knee are among the most common chronic conditions, resulting in substantial pain and functional limitations. Adequate management of OA requires a combination of medical and behavioral strategies. However, some ... Full text Open Access Link to item Cite

Pregnenolone as a novel therapeutic candidate in schizophrenia: emerging preclinical and clinical evidence.

Journal Article Neuroscience · September 15, 2011 Emerging preclinical and clinical evidence suggests that pregnenolone may be a promising novel therapeutic candidate in schizophrenia. Pregnenolone is a neurosteroid with pleiotropic actions in rodents that include the enhancement of learning and memory, n ... Full text Link to item Cite

Is obstructive sleep apnea associated with ADHD?

Journal Article Ann Clin Psychiatry · August 2011 BACKGROUND: It has been suggested that obstructive sleep apnea (OSA) may result in symptoms similar to those experienced in attention-deficit/hyperactivity disorder (ADHD). Because this may have important public health implications, we reviewed the literat ... Link to item Cite

Multifamily Group Treatment for Veterans With Traumatic Brain Injury

Journal Article Professional Psychology: Research and Practice · February 1, 2011 A common clinical problem encountered by clinicians treating veterans who incurred traumatic brain injury (TBI) while serving in Afghanistan in support of Operation Enduring Freedom (OEF) or in Iraq in support of Operation Iraqi Freedom (OIF) is lack of kn ... Full text Cite

Is military sexual trauma associated with trading sex among women veterans seeking outpatient mental health care?

Journal Article J Trauma Dissociation · 2011 A robust association between sexual trauma and trading sex has been documented in civilian samples but has not been examined in veterans. Women veterans experience high rates of sexual victimization across the lifespan, including during military service (m ... Full text Link to item Cite

Adherence and psychotherapy

Journal Article · December 1, 2010 Psychotherapists target a wide range of clinical disorders, adopt diverse theoretical approaches, and operate within multiple treatment settings. As such, a unifying definition of adherence in the field of psychotherapy is not yet tenable. We therefore lim ... Full text Cite

Adherence and substance use

Journal Article · December 1, 2010 As reported in other chapters of this volume, the misuse of alcohol and other substances can contribute to treatment non-adherence across a range of medical and mental health service settings. In this chapter, our focus is specific to non-adherence in the ... Full text Cite

How should we implement psychiatric advance directives? Views of consumers, caregivers, mental health providers and researchers.

Journal Article Adm Policy Ment Health · November 2010 The aim of this study was to measure expert consensus on the implementation of Psychiatric Advance Directives (PADs) within the Veterans Health Administration. We conducted a two-round Delphi study with 55 panelists including consumers, caregivers, mental ... Full text Link to item Cite

Neurosteroids and self-reported pain in veterans who served in the U.S. Military after September 11, 2001.

Journal Article Pain Med · October 2010 OBJECTIVE: Nearly half of Operation Enduring Freedom/Operation Iraqi Freedom veterans experience continued pain post-deployment. Several investigations report analgesic effects of allopregnanolone and other neurosteroids in animal models, but few data are ... 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

Allopregnanolone levels are reduced in temporal cortex in patients with Alzheimer's disease compared to cognitively intact control subjects.

Journal Article Biochim Biophys Acta · August 2010 The neurosteroid allopregnanolone has pronounced neuroprotective actions, increases myelination, and enhances neurogenesis. Evidence suggests that allopregnanolone dysregulation may play a role in the pathophysiology of Alzheimer's disease (AD) and other n ... Full text Link to item Cite

Guided imagery as a therapeutic tool in post-traumatic stress disorder

Journal Article · December 1, 2009 Guided imagery is a behavioral technique used to direct individuals to effectively create and manipulate mental representations to produce therapeutic changes. A growing empirical literature supports the use of these techniques in a variety of physical and ... Full text Cite

Proof-of-concept trial with the neurosteroid pregnenolone targeting cognitive and negative symptoms in schizophrenia.

Journal Article Neuropsychopharmacology · July 2009 The neurosteroid pregnenolone and its sulfated derivative enhance learning and memory in rodents. Pregnenolone sulfate also positively modulates NMDA receptors and could thus ameliorate hypothesized NMDA receptor hypofunction in schizophrenia. Furthermore, ... Full text Link to item Cite

NEUROSTEROIDS AS NOVEL THERAPEUTIC AGENTS IN SCHIZOPHRENIA AND PTSD

Journal Article SCHIZOPHRENIA BULLETIN · March 1, 2009 Link to item Cite

Allopregnanolone and pregnenolone alterations following pharmacological agents in rodents and clinic populations

Journal Article · December 1, 2008 Recent research has revealed potential roles for neuroactive steroids in the pathophysiology and treatment of a number of psychiatric and neurological disorders. A wide array of preclinical investigations also reports neuroactive steroid actions in areas r ... Full text Cite

Cerebrospinal fluid dehydroepiandrosterone levels are correlated with brain dehydroepiandrosterone levels, elevated in Alzheimer's disease, and related to neuropathological disease stage.

Journal Article J Clin Endocrinol Metab · August 2008 OBJECTIVE: It is currently unknown whether cerebrospinal fluid (CSF) neurosteroid levels are related to brain neurosteroid levels in humans. CSF and brain dehydroepiandrosterone (DHEA) levels are elevated in patients with Alzheimer's disease (AD), but it i ... Full text Link to item Cite

Change is not always linear: the study of nonlinear and discontinuous patterns of change in psychotherapy.

Journal Article Clin Psychol Rev · July 2007 The study of discontinuities and nonlinear change has been a fruitful endeavor across the sciences, as these shifts can provide a window into the organization of complex systems and the processes that are associated with transition. A common assumption in ... Full text Link to item Cite

Interpersonal trauma, war zone exposure, and posttraumatic stress disorder among veterans with schizophrenia.

Journal Article Schizophr Res · March 2007 The present study examined the prevalence of war zone exposure, interpersonal trauma and post-traumatic stress disorder (PTSD) in veterans with primary schizophrenia hospitalized on a VA inpatient psychiatric unit. Data were collected on a sample of male v ... Full text Link to item Cite

Previous involuntary commitment is associated with current perceptions of coercion in voluntarily hospitalized patients

Journal Article International Journal of Forensic Mental Health · January 1, 2007 Involuntary psychiatric treatment is sometimes necessary and beneficial, but may also exert negative effects. The impact of involuntary commitment on subsequent mental health treatment experience is poorly understood. We examined whether history of involun ... Full text Cite

Role of treatment alliance in the clinical management of bipolar disorder: stronger alliances prospectively predict fewer manic symptoms.

Journal Article Psychiatry Res · December 7, 2006 The strength of the treatment alliance between patients and their clinicians may play a unique role in the management of bipolar disorder. However, few empirical studies have examined the alliance in bipolar disorder or its effects on patient outcomes. Thi ... Full text Link to item Cite

The impact of posttraumatic stress disorder on quality of life and health service utilization among veterans who have schizophrenia.

Journal Article J Trauma Stress · June 2006 The present study examined the impact of comorbid posttraumatic stress disorder (PTSD) on health-related quality of life and objective measures of health service utilization in 165 male veterans who have primary schizophrenia. Comorbid PTSD was assessed wi ... Full text Link to item Cite

Comorbid posttraumatic stress disorder is associated with suicidality in male veterans with schizophrenia or schizoaffective disorder.

Journal Article Schizophr Res · May 2006 The purpose of this study was to determine if patients with schizophrenia or schizoaffective disorders and comorbid posttraumatic stress disorder (PTSD) are at higher risk for suicidality than patients without comorbid PTSD. Participants were 165 male vete ... Full text Link to item Cite

Knowledge and risks of human immunodeficiency virus transmission among veterans with severe mental illness.

Journal Article Mil Med · April 2006 This study is among the first to examine knowledge about human immunodeficiency virus (HIV) and behavioral risks for HIV transmission among veterans with severe mental illness (SMI), a group at high risk for HIV infection. This study examined associations ... Full text Link to item Cite

Early alliance, alliance ruptures, and symptom change in a nonrandomized trial of cognitive therapy for avoidant and obsessive-compulsive personality disorders.

Journal Article J Consult Clin Psychol · April 2006 Participants were 30 adult outpatients diagnosed with avoidant personality disorder or obsessive-compulsive personality disorder who enrolled in an open trial of cognitive therapy for personality disorders. Treatment consisted of up to 52 weekly sessions. ... Full text Link to item Cite

Lifetime sexual and physical victimization among male veterans with combat-related post-traumatic stress disorder.

Journal Article Mil Med · September 2005 Because of the high prevalence of post-traumatic stress disorder (PTSD) among veteran men and the limited research on victimization in this group, we recruited 133 male veterans with combat-related PTSD from a psychiatric inpatient unit and assessed them f ... Full text Link to item Cite

Erectile dysfunction in early, middle, and late adulthood: symptom patterns and psychosocial correlates.

Journal Article J Sex Marital Ther · 2003 The prevalence of erectile dysfunction (ED) increases with age. However, it may emerge at any time during the adult years, and may bear a close relationship to ongoing psychosocial issues affecting the patient and his partner. The present study examined ED ... Full text Link to item Cite

When Clients Are Untruthful: Implications for the Therapeutic Alliance, Case Conceptualization, and Intervention

Journal Article Journal of Cognitive Psychotherapy: An International Quarterly · January 1, 2003 Therapists endeavor to be genuine and trustworthy with clients, thus facilitating the establishment and maintenance of a positive therapeutic relationship. Unfortunately, clients sometimes knowingly give false or misleading information, maintain counter th ... Full text Cite

Comparison of two treatments for traumatic stress: a community-based study of EMDR and prolonged exposure.

Journal Article J Clin Psychol · January 2002 This pilot study compared the efficacy of two treatments for postraumatic stress disorder (PTSD): Eye Movement Desensitization and Reprocessing (EMDR) and Prolonged Exposure (PE). Data were analyzed for 22 patients from a university-based clinic serving th ... Full text Link to item Cite

Dynamic systems theory as a paradigm for the study of change in psychotherapy: an application to cognitive therapy for depression.

Journal Article J Consult Clin Psychol · December 1998 Dynamic systems theory provides a conceptual framework for the study of change in psychotherapy that is consistent with that used in other sciences. A dynamic systems model of change was proposed and evaluated in the context of cognitive therapy for depres ... Full text Link to item Cite