Areas of interest: Suicidality, Women Veterans, Military Sexual Trauma, Interpersonal-Psychological Risk Factors for Suicide, Cognitive Behavioral Therapy, Posttraumatic Stress Disorder, Stigma.
Through this research we hope to understand which values (e.g., power, achievement, security) and value dimensions (e.g., importance, success) have the strongest impact on suicidality in this population.
This study is designed to test a novel method of measuring avoidance of trauma-related material in combat Veterans with and without PTSD, and to compare this novel behavioral measure of avoidance with other traditional self report measures of avoidance.
While there is a dearth of evidence-based treatment for co-occurring PTSD and mTBI, it has been suggested that best practices entail treating presenting symptoms (hyperarousal, hypoarousal, emotional reactivity, irritability, depression, anxiety, concentration problems). Yoga may be particularly well-suited to treating returning servicemen as data suggests that core symptoms that develop with a history of trauma exposure, are physiologically based, somatically experienced and often not amenable to change through talking alone. Research suggests that that moment-to-moment awareness of present experience may decrease emotional reactivity and anxiety, and increase the capacity for self-regulation. Mindfulness skills have also been associated with: building resilience in the midst of stress; allowing one to better cope with physical discomfort; decreasing anxiety and depression; decreasing reactivity. An 8-week, 16-session, hatha yoga intervention will be conducted with Veterans to assess the acceptability and feasibility of an intervention in this population. Veterans will be screened and assessed for mental and physical health prior to enrolling in the intervention. Weekly sessions, out of session practice, and weekly assessments will track possible changes in the Veterans quality of life, mental and physical health.
The purpose of this study is to examine the effect of PTSD on perceptions and beliefs about injury in Veterans with a history of combat mTBI or non-TBI injury.
"We want to know about your experiences as a woman Vet!" A qualitative analysis of women's voices about perceptions of VA care and the quality of services
July 2010
Poster presented at the VA Women’s Health Services Research Conference on Using Research to Build the Evidence Base for Improving the Quality of Care for Women Veterans, Washington, D.C.
Menefee, D.S., Smitherman, W., LeMaire, A., El Serag, R., & Monteith, L.L.
Examining change in PTSD and perceived coping among women veterans: Preliminary analyses of clinical outcomes following multimodal, evidence-based, inpatient treatment
July 2010
Poster presented at the VA Women’s Health Services Research Conference on Using Research to Build the Evidence Base for Improving the Quality of Care for Women Veterans, Washington, D.C.
Menefee, D.S., Smitherman, W., Monteith, L.L., Hiatt, E., & Grout, K.
“WISER” veterans recover: Preliminary analyses of the effectiveness of a multimodal, evidence-based inpatient treatment program for women veterans in affective symptom reduction and suicide risk factors.
July 2010
Poster presented at the VA Women’s Health Services Research Conference on Using Research to Build the Evidence Base for Improving the Quality of Care for Women Veterans, Washington, D.C.
Monteith, L.L., Green, K.L., Mathew, A.R., & Pettit, J.W. (2009). The interpersonal-psychological theory of suicidal behaviors as an explanation of suicide among war veterans. In L. Sher & A. Vilens (Eds.), War and Suicide. Hauppauge, NY: Nova Publishers.
Grover, K.E., Green, K. L., Pettit, J.W., Monteith, L.L., Garza, M. J., & Venta, A. (2009). Problem solving moderates the effects of life event stress and chronic stress on suicidal behavior in adolescence. Journal of Clinical Psychology, 65(12), 1281 - 1290.
The present study examined the unique and interactive effects of stress and problem-solving skills on suicidal behaviors among 102 inpatient adolescents. As expected, life event stress and chronic stress each significantly predicted suicidal ideation and suicide attempt. Problem solving significantly predicted suicidal ideation, but not suicide attempt. Problem solving moderated the associations between life event stress and suicidal behaviors, as well as between chronic stress and suicidal ideation, but not chronic stress and suicide attempt. At high levels of stress, adolescents with poor problem-solving skills experienced elevated suicidal ideation and were at greater risk of making a nonfatal suicide attempt. The interactive effects decreased to non-significance after controlling for depressive symptoms and hopelessness. Clinical implications are discussed.
Pettit, J.W., Lewinsohn, P.M., Roberts, R.E., Seeley, J.R., & Monteith, L.L. (2009). The long-term course of depression: Development of an empirical index and identification of early adult outcomes. Psychological Medicine, 39(3), 403-412.
BACKGROUND: Research on the long-term course of major depressive disorder (MDD) is hindered by the absence of established course criteria and by idiosyncratic definitions of chronicity. The aims of this study were to derive an empirical index of MDD course, to examine its predictive validity, and to identify the adulthood outcomes associated with a chronic course. METHOD: Indicators for a MDD course factor were rationally selected and subjected to principal components (PCA) and confirmatory factor analyses (CFA) among 426 subjects with a lifetime history of MDD by age 30. Scores on the index prior to age 19 were examined as predictors of course from age 19 to 30. Associations between the index and outcomes of interest at age 30 were examined. RESULTS: Three indicators loaded highly on a chronic course index and displayed adequate internal consistency: early onset age, number of episodes, and duration of ill time. Predictive validity of the index was supported. A more chronic course was associated with greater symptom severity, greater likelihood of treatment utilization, and greater psychosocial impairment in multiple domains. Treatment utilization interacted with chronicity to predict relatively few outcomes and did not reduce the negative impact of a chronic course. CONCLUSIONS: The course of MDD through early adulthood is best represented by a composite of early onset age, number of episodes, and duration of ill time. A chronic course through early adulthood is associated with numerous indicators of psychosocial impairment. Mental health treatment utilization in a naturalistic setting does not appear to reduce the negative impact of chronic MDD.
Pettit, J.W., Green, K.L., Monteith, L.L., Mathew, A.R., & (2011). Conceptualizing the Long-term Course of Unipolar Depression. In A. Columbus (Ed.), Advances in Psychology Research, Volume 74. Hauppauge, NY: Nova Science Publishers.
The long-term course of unipolar depression has received considerable attention in etiological and theoretical models, empirical investigations, and diagnostic nomenclatures. Unipolar depression is generally recognized as an enduring condition that begins in adolescence or early adulthood, and then waxes and wanes throughout the lifespan. Nevertheless, debate exists about how best to understand and classify the course of unipolar depression. This chapter discusses recent advances in the understanding of the long-term course of unipolar depression. Key concepts relevant to the course of depression are discussed, including onset age, episode duration, recurrence of episodes, and the presence of subthreshold depressive symptoms between episodes. Empirical findings germane to each of these concepts – and the overlap between them – are reviewed, as are the history, validity, and limitations of the DSM approach to classifying the course of depression. Recent conceptualizations of the long-term course are discussed, and suggestions for refining the current nomenclature are provided. The chapter concludes with suggestions for future research that will inform our understanding of the phenomenology, predictors, and outcomes of the long-term course of unipolar depression.
Monteith, L.L., & Pettit, J.W. (2011). Implicit and explicit stigmatizing attitudes and stereotypes about depression. Journal of Social and Clinical Psychology, 30(5), 484-505.
Prior research examining stigma toward depression has relied exclusively upon explicit measures, to the exclusion of implicit measures. Focusing exclusively on explicit stigma may provide an incomplete perspective, be subject to social desirability biases, and underestimate the extent of stigma towards depression. Including implicit measures in depression stigma research may provide valuable information on automatic attitudes and stereotypes, which may be more accurate predictors of automatic behaviors toward depressed persons. The present study examined implicit and explicit attitudes and stereotypes regarding the stability controllability, and etiology of depression in an undergraduate sample, using physical illness as a comparison condition. Depression was hypothesized to be rated as more negative, temporary, controllable, and psychologically-caused than physical illness on both implicit and explicit measures. Differences were expected to be especially pronounced when measured implicitly. Participants (n = 135) completed a series of implicit association tasks (IATs) and explicit semantic differential scales. Results demonstrated more negative attitudes about depression, compared to physical illness on implicit, but not explicit, measures. Explicit and implicit views of the etiology of depression were more supportive of psychological causes than biological causes, and this was more pronounced when measured implicitly. Depression was explicitly viewed as more controllable than physical illness; however, this difference was not observed implicitly. Whereas explicit ratings of stability were similar for depression and physical illness, participants implicitly rated depression as less stable than physical illness. The current study highlights the importance of including implicit measures in stigma research.
