Publications by Type: Journal Article

In Press
Pebole, M. M., SantaBarbara, N. J., Nosrat, S., & Whitworth, J. W. (In Press). Effects of Resistance Training on Mental Health and Sleep Outcomes among Women with PTSD. Practice Innovations.
2023
Fortier, C. B., Kim, S., & Kenna, A. (2023). Assessment of IPV related brain injury: What do we know and where do we go? Brain Injury Professional , 19, 14-16.
Aul, C., Brau, J. B., Sugarman, A., DeGutis, J. M., Germine, L. T., Esterman, M., McGlinchey, R. E., et al. (2023). The functional relevance of visuospatial processing speed across the lifespan. Cognitive Research: Principles and Implications. , 8.Abstract
Visuospatial processing speed underlies several cognitive functions critical for successful completion of everyday tasks, including driving and walking. While it is widely accepted that visuospatial processing speed peaks in early adulthood, performance across the lifespan remains incompletely characterized. Additionally, there remains a lack of paradigms available to assess visuospatial processing speed in unsupervised web-based testing environments. To address these gaps, we developed a novel visuospatial processing speed (VIPS) task adapted from two tests sensitive to visuospatial processing speed declines in older adults, the Useful Field of View paradigm and the PERformance CEntered Portable Test. The VIPS task requires participants to make a central orientation discrimination and complete a simultaneous peripheral visual search task. Data were collected from 86 in-lab volunteers (18–30 years) to compare performance to traditional neuropsychological measures. Consistent with previous literature, performance on the novel VIPS task significantly correlated with measures of selective attention, executive functioning, visual speed, and working memory. An additional 4395 volunteers (12–62 years) were recruited on TestMyBrain.org to establish lifespan trajectories of visuospatial processing speed and associations with functional disability. VIPS task performance peaked in the early 20’s, and steadily decreased such that thresholds doubled in 60-year-olds relative to 20-year-olds (817 ms vs. 412 ms). VIPS task performance significantly correlated with self-reported cognitive functioning deficits broadly across the lifespan but was specifically related to mobility issues in middle-age. These findings have important implications for early detection of cognitive decline and provide insights into potential early intervention targets for younger and middle-aged adults.
Lendvai, D., Whittemore, R., Womack, J. A., Fortier, C. B., Milberg, W. P., & Fonda, J. R. (2023). The Impact of Blast Exposure – with or without Traumatic Brain Injury – on Metabolic Abnormalities in Post-9/11 Veterans. Journal of Traumatic Stress.Abstract
Objective: The primary aim included explorations of: (1) the associations between the history of blast exposure (BE), close blast exposure (CBE), and blast-related traumatic brain injury (bTBI) and metabolic abnormality; and (2) the potential mediating effect of comorbid psychological and somatic conditions on these associations. The secondary aim explored the association of dose-response impact of BE, CBE, and bTBI and metabolic abnormality.Setting: Data were collected by the Translational Research Center for TBI and Stress Disorders (TRACTS).Participants: Post-9/11 veterans from the TRACTS baseline sample who had conflict-zone deployment experience (N = 734).Design: Cross-sectional secondary data analysis. We computed relative risks (RRs) and 95% CI using modified Poisson regression. We quantified the impact of co-occurring psychological and somatic conditions on this association using mediation analyses.Main Measures: Exposures included BE (<100 m), CBE (<10 m), and bTBI. Metabolic abnormality outcomes included (1) overweight/obesity (defined by abnormal waist-hip ratio [WHR] and abnormal waist circumference [WC]); (2) glucose dysregulation; and (3) meeting criteria for cardiometabolic syndrome (defined by guidelines).Results: The sample was majority male (91%) and White (68%), with a mean age of 34.6 years (SD = 8.99). Most participants had 1 or more BE (83%); 48% experienced 1 or more CBE. Overweight/obesity was highly prevalent in the sample (51% had abnormal WHR and 60% abnormal WC). There was no significant direct or indirect association between BE, CBE, and bTBI and metabolic abnormalities (RRs: 0.70-1.51; P's > .05).Conclusion: Future research is needed to investigate the association of BE with metabolic abnormalities with larger, more targeted sample selection, and longer follow-up. Effective and sustainable weight management and metabolic health prevention interventions for this veteran cohort are needed.
DeGutis, J., Bahierathan, K., Barahona, K., Lee, E., Evans, T. C., Shin, H. M., Mishra, M., et al. (2023). What is the prevalence of developmental prosopagnosia? An empirical assessment of different diagnostic cutoffs. Cortex , 161, 51-64.Abstract
The prevalence of developmental prosopagnosia (DP), lifelong face recognition deficits, is widely reported to be 2-2.5%. However, DP has been diagnosed in different ways across studies, resulting in differing prevalence rates. In the current investigation, we estimated the range of DP prevalence by administering well-validated objective and subjective face recognition measures to an unselected web-based sample of 3116 18-55 year-olds and applying DP diagnostic cutoffs from the last 14 years. We found estimated prevalence rates ranged from .64-5.42% when using a z-score approach and .13-2.95% when using a percentile approach, with the most commonly used cutoffs by researchers having a prevalence rate of .93% (z-score, .45% when using percentiles). We next used multiple cluster analyses to examine whether there was a natural grouping of poorer face recognizers but failed to find consistent grouping beyond those with generally above versus below average face recognition. Lastly, we investigated whether DP studies with more relaxed diagnostic cutoffs were associated with better performance on the Cambridge Face Perception Test. In a sample of 43 studies, there was a weak nonsignificant association between greater diagnostic strictness and better DP face perception accuracy (Kendall's tau-b correlation, τb =.18 z-score; τb = .11 percentiles). Together, these results suggest that researchers have used more conservative DP diagnostic cutoffs than the widely reported 2-2.5% prevalence. We discuss the strengths and weaknesses of using more inclusive cutoffs, such as identifying mild and major forms of DP based on DSM-5.
Katrinli, S., Wani, A. H., Zhao, X., Maihofer, A. X., Zhao, Y., Nunez, D., Montalvo-Ortiz, J., et al. (2023). 25. EPIGENOME-WIDE META-ANALYSIS OF> 3200 MILITARY AND CIVILIAN PARTICIPANTS IDENTIFIES CELL-TYPE SPECIFIC DNA METHYLATION SIGNALS ASSOCIATED WITH PTSD. European Neuropsychopharmacology , 75, S70-S71.
Knight, A., Kim, S., Currao, A., Sablone, C., Milberg, W., & Fortier, C. (2023). A-124 The Impact of Attention-Deficit/Hyperactivity Disorder (ADHD) on Cognition and Function in Post-9/11 Veterans with Post-Traumatic Stress Disorder (PTSD). Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists , acad067. 141-acad067. 141.
Sablone, C. A., Knight, A., Currao, A., Lebas, A., Katz, D., Kenna, A., & Fortier, C. B. (2023). A-172 STEP-Home Intervention Improves Inhibitory and Anger Control, Reintegration, and Neurobehavioral Symptoms in Post-9/11 Veterans with TBI and Other Common Comorbidities. Archives of Clinical Neuropsychology , acad067. 189.
Merritt, V. C., Maihofer, A. X., Gasperi, M., Ketema, E., Chanfreau-Coffinier, C., Stein, M. B., Panizzon, M. S., et al. (2023). A-7 Genome-Wide Association Study of Traumatic Brain Injury in US Military Veterans. Archives of Clinical Neuropsychology , acad067. 013.
Jagger-Rickels, A., Stumps, A., Rothlein, D., Evans, T., Lee, D., McGlinchey, R., DeGutis, J., et al. (2023). Aberrant connectivity in the right amygdala and right middle temporal gyrus before and after a suicide attempt: Examining markers of suicide risk. Journal of affective disorders , 335, 24-35.
Pebole, M. M., Singleton, C. R., Hall, K. S., Petruzzello, S. J., Alston, R. J., Whitworth, J. W., & Gobin, R. L. (2023). Impact of Military Affiliation on Exercise Perceptions Among Survivors of Sexual Violence. Military Medicine , 188, e2257-e2265.Abstract
Military service members disproportionately experience sexual violence (SV) and its related health concerns. Although recent work has shown physical activity to be an effective strategy for improving physical and mental health among trauma-exposed military populations, little of this work has focused specifically on military service members with a history of SV. To address these gaps in knowledge and practice, this study identified the most salient perceived benefits/barriers of exercise among men and women survivors of SV with military affiliations. Additionally, these analyses explore willingness to engage in exercise programs, and preferences for the structure/content of these programs, among men and women survivors of SV with military affiliations.An online, cross-sectional survey of women (n = 355) and men (n = 198) survivors of SV was completed using Amazon Mechanical Turk. Inclusion criteria were men and women, age between 18 and 65 years, self-reported history of SV, and located in the United States. Information on sociodemographics and post-traumatic stress disorder symptoms was collected alongside perceived barriers and benefits to exercise, willingness to engage in exercise programs, and preferences for the structure/content of these programs. Analyses were stratified by sex. Comparisons by history of military involvement (active duty military or veteran; no military involvement/civilian) were reported.Both military-involved men (n = 68) and women (n = 139) were more likely to prefer at-home and online exercise options when compared to civilians (Ps < .05; Cramer’s Vs 0.19–0.36). Additionally, both men and women with military involvement reported strongly favoring exercising with an instructor over no instructor and preferred that this instructor identifies with their same gender (Ps < .01; Cramer’s Vs 0.28–0.36). Women with military involvement also preferred shorter program durations and exercising alone or in a group online or in person, whereas men with military involvement were open to longer program durations, when compared to their civilian counterparts (Ps < .05; Cramer’s Vs 0.19–0.37). Women and men with military involvement were more likely than their civilian counterparts to perceive that exercise benefits their psychological outlook and social interactions. They were also more likely than civilians to indicate poor exercise environment, high time expenditure, and family discouragement as perceived barriers to exercise (Ps < .05; Cohen’s ds 0.21–0.97). Military-involved women were also more likely than civilian women to endorse the perceived barrier of hard physical exercise (P < .05; Cohen’s d = 0.25).This study identified perceived benefits and barriers to exercise, along with willingness to engage in exercise programs, and exercise preferences among men and women survivors of SV with military involvement. Targeting these factors in intervention planning will be important for physical activity promotion and program engagement among veterans to reduce the disproportionate impact of SV and disease burden among U.S. service members and veterans.
DeGutis, J., Agnoli, S., Gaudet, C. E., Stumps, A., Kim, S., Evans, T. C., Jagger-Rickels, A., et al. (2023). Inhibitory control and alcohol use history predict changes in posttraumatic stress disorder symptoms. Neuropsychology.
Smith, A., Katrinli, S., Wani, A. H., Maihofer, A. X., Zannas, A. S., Nugent, N., Xhao, X., et al. (2023). LEVERAGING MULTI-OMIC DATA TO INTERPRET AN EPIGENOME-WIDE META-ANALYSIS OF PTSD IN 23 MILITARY AND CIVILIAN COHORTS. European Neuropsychopharmacology , 75, S40-S41.
DeGutis, J., Agnoli, S., Bernstein, J. P. K., Jagger-Rickels, A., Evans, T. C., Fortier, C. B., McGlinchey, R. E., et al. (2023). Poorer Inhibitory Control Uniquely Contributes to Greater Functional Disability in Post-9/11 Veterans. Archives of Clinical Neuropsychology , 38, 944-961.Abstract
Post-9/11 Veterans endorse greater self-reported functional disability than 80% of the adult population. Previous studies of trauma-exposed populations have shown that increased post-traumatic stress disorder (PTSD) and depressive symptoms are consistently associated with greater disability. Additionally, poorer cognitive performance in the domain of executive functions, particularly inhibitory control, has been associated with disability, though it is unclear if this effect is independent of and/or interacts with PTSD and depression.Three overlapping samples of n = 582, 297, and 183 combat-deployed post-9/11 Veterans completed comprehensive assessments of executive functions, PTSD and depressive symptoms, and self-reported World Health Organization Disability Assessment Schedule-II (WHODAS II).Poorer performance on measures of inhibitory control (Delis-Kaplan Executive Functioning System Color-Word Interference-CWI Test and gradual-onset Continuous Performance Test-gradCPT), but not other executive functions, were significantly associated with greater disability on the WHODAS II (ρ’s = −.13 and −.13, p = .002 and .026, respectively). CWI inhibitory control measures accounted for unique variance in disability after controlling for PTSD and depressive symptoms (R2 change = 0.02, p < .001). Further, CWI significantly moderated the effect of depressive symptoms on disability, such that better inhibitory control weakened the relationship between depression and disability.Inhibitory control deficits are uniquely associated with increased disability in combat-deployed post-9/11 Veterans, and better inhibitory control abilities may serve as a protective factor for depressive symptoms leading to increased disability.In a trauma-exposed Veteran population, does inhibitory control predict functional disability above and beyond PTSD and depressive symptoms?After controlling for PTSD and depressive symptoms, inhibitory control explained unique variance in self-reported disability. Inhibitory control also showed a moderation effect on depression where greater inhibitory control on the color-word interference test reduced the association between depression and disability symptoms.Inhibitory control represents an important mechanism in understanding and improving daily life functioning in trauma-exposed Veteran populations.Future research should further characterize the different aspects of inhibitory control deficits in trauma-exposed populations and focus on enhancing inhibitory control paired with more standard psychological distress treatments.
Mallett, R., Sowin, L., & Carr, M. (2023). 0662 Digital sleep-health surveillance: Population nightmare frequency is observable in social media. Sleep , 46, A291-A291.Abstract
Nightmares are a critical component of multidimensional sleep health. Frequent nightmare recallers suffer reduced sleep length, depressed mood, and are more likely to be diagnosed with a psychiatric disorder in the future. Reliable population estimates of nightmare frequency are difficult to obtain and often restricted to rigid timepoints (e.g., once per year). Thus, there is a need for low-cost methods to track population levels of nightmare frequency and their dynamic changes over time. In the current study, we tracked dream content and nightmare frequency using a popular new approach – digital health surveillance – that analyzes language of public and freely-accessible social media posts to track population characteristics.To evaluate whether social media could detect known changes in population sleep health, we extracted posts from r/Dreaming, a popular subreddit dedicated to dream sharing. Prior survey studies have shown a reliable increase in nightmare frequency during the first wave of the COVID-19 pandemic. Thus, we quantified the amount of nightmares posted on Reddit surrounding the World Health Organization’s (WHO) declaration of a COVID-19 as a global pandemic. Nightmares were identified using a word-search algorithm that identified nightmare-related words in a post title. Nightmare frequency was compared before and after the WHO declaration using a chi-squared analysis.The percentage of dreams posted on Reddit that were identified as nightmares was higher after the WHO declaration than before (p < .05). Additionally, the amount of anxiety in all dreams posted on Reddit was higher after the WHO declaration than before (p < .05). Weekly change in dream anxiety was positively correlated with the percentage of COVID-19 news headlines (p < .05).We observed an increase in nightmares shared on Reddit immediately following the WHO’s declaration of COVID-19 as a global pandemic. This novel approach to tracking nightmares might offer the field of sleep medicine a low-cost and real-time system for monitoring population sleep health. Other recent work suggests this method might be viable for tracking other components of sleep health.
Whitworth, J. W., SantaBarbara, N. J., Nosrat, S., Pebole, M. M., Cripe, B. G., & McKeon, G. (2023). Acute changes in affective valence and perceived distress predict reductions in PTSD symptom severity. Mental Health and Physical Activity , 25, 100523.Abstract
There is a growing amount of experimental evidence demonstrating therapeutic chronic effects of exercise (e.g., resistance exercise, running, and walking) on PTSD symptoms. However, it is currently unclear how individuals with PTSD experience exercise within individual exercise sessions (e.g., pleasurable or distressing), and if these acute experiences influence PTSD symptoms over time. Purpose: The objective of this study was to examine the acute effects of high intensity resistance exercise on affect, perceived arousal, and distress among individuals who screened positive for PTSD, using a randomized controlled design. Additionally, this study sought to explore longitudinal relations among affect, arousal, distress, and PTSD symptom severity. Methods: This study analyzed pooled data from two methodologically similar randomized controlled trials (i.e., a pilot and replication study). Participants (n = 52) were randomly assigned to exercise or non-exercise time-matched control. Data were analyzed with a series of longitudinal mixed-effects regression models. Results: The analyses suggest that positive affect increased, and distress decreased significantly during exercise sessions, relative to control. Independent of group, increases in positive affect and decreases in distress also significantly predicted decreases in PTSD symptom severity over the course of the study. Conclusions: Taken together, these findings suggest that high intensity resistance exercise is safe for individuals who screen positive for PTSD, pleasurable, and may have a therapeutic impact on trauma survivors. No evidence for symptom exacerbation was found. Future experimental studies are needed to verify these findings and determine if the observed relationships are similar for other exercise modes, durations, and intensities.
Benitez, T. J., Artigas, E., Larsen, B., Joseph, R. P., Pekmezi, D., Marquez, B., Whitworth, J. W., et al. (2023). Barriers and Facilitators to Muscle-Strengthening Activity Among Latinas in the U.S.: Results From Formative Research Assessments. Int J Behav Med.Abstract
BACKGROUND: Latinas are disproportionately affected by low physical activity (PA) levels and related health conditions (e.g., diabetes, obesity). Few Latinas in the U.S. (17%) meet the National PA Guidelines for both aerobic PA and muscle-strengthening activity (MSA), yet, research to date in this population has focused almost exclusively on aerobic PA. Performing regular MSA is linked with numerous health improvements and reduced mortality; thus, may be key to addressing health disparities in this community. This study examined perspectives on engaging in MSA among Latinas enrolled in two aerobic PA RCTs. METHODS: Brief quantitative surveys were conducted to assess interest in MSA among Latinas (N = 81), along with 19 follow-up in-depth semi-structured interviews on knowledge, barriers, and facilitators for engaging in regular MSA. Interview transcripts were analyzed by two independent bilingual researchers using a directed content analysis approach. RESULTS: Eighty-one Latinas (18-65 years) completed the survey. Most (91%) expressed interest in learning more about MSA and 60% reported not knowing how to do MSA as a substantial MSA barrier. Interview results indicated Latinas were aware of health benefits of MSA and motivated to engage in MSA but reported barriers (e.g., perception that MSA is for men, a taboo topic, and lack of knowledge on how to do MSA). CONCLUSION: This study contributes to a critical gap in PA research among Latinas. Findings will inform future culturally appropriate MSA interventions in this at-risk population. Addressing MSA and aerobic PA together in future interventions will provide a more comprehensive approach to reducing PA-related health disparities in Latinas than aerobic PA alone.
Kaplan, D. M., Palitsky, R., Dunsiger, S. I., Wu, W. C., Parker, A. G., Troubh, J. K., Whitworth, J. W., et al. (2023). Biological and psychological predictors of heart rate patterns during physical activity. Psychol Sport Exerc , 65.Abstract
OBJECTIVE: Latent class modeling (LCM) offers a promising approach for examining correlates of heart rate (HR) patterns over multiple exercise sessions. This research examined biological and psychological variables associated with different patterns of HR response to physical activity (PA). METHODS: In a three-arm randomized controlled trial (exercise video games vs. standard exercise vs. non-exercise control), HR was recorded during PA sessions over a 12-week period. LCM identified three patterns of HR during PA across 189 participants in active arms: 1) high HR across sessions with low variability within sessions, 2) linear increase in HR across sessions with low variability within sessions, and 3) high variability in HR across all sessions. Associations with biological (resting heart rate, blood pressure, BMI, age, cholesterol, triglycerides, HbA1c) and psychological (depression, motivations for PA, PA-induced feelings) predictors of latent class membership were iteratively tested. RESULTS: Psychological variables played as important a role in the final model as biological variables for predicting latent class membership. Few differences were found between LC1 and LC2, but LC3 differed from the other two groups in that participants were likelier to report that feel revitalized after PA (vs. LC1 and LC2), to be less motivated for PA (vs. LC1), reported greater depression (vs. LC1 and LC2), and were younger (vs. LC1). CONCLUSIONS: These findings demonstrate the potential of LCM to identify biological and psychological factors associated with chronotropic responses to PA, and advance understanding of the role of psychological factors in chronotropic PA outcomes.
Agnoli, S., Zuberer, A., Nanni-Zepeda, M., McGlinchey, R. E., Milberg, W. P., Esterman, M., & DeGutis, J. (2023). Depressive Symptoms are Associated with More Negative Global Metacognitive Biases in Combat Veterans, and Biases Covary with Symptom Changes over Time. C. Carona (Ed.), Depression and Anxiety , 2023, 2925551 . Hindawi.Abstract
Metacognitive awareness, insight into one’s abilities, is thought to be disrupted in depression and posttraumatic stress disorder (PTSD), with more negative metacognitive biases and reduced awareness, respectively. However, studies have rarely examined global aspects of metacognitive awareness in depression and PTSD, instead using task-specific measures. In 467 trauma-exposed post-9/11 veterans, we administered assessments of PTSD and depression, self-report and objective measures of cognitive functioning (neuropsychological battery of memory, attention, and executive function measures), and self-report and objective measures of general health (index of five cardiometabolic factors). We used self-report/objective correlations to measure metacognitive sensitivity and 'self-report minus objective' scores to measure bias. We also examined associations between changes in metacognitive awareness and changes in PTSD and depression over time. Metacognitive sensitivity was comparable between individuals with and without PTSD and depression. However, metacognitive bias was significantly more negative in those with greater depressive symptoms (i.e., underconfidence) across cognition and health, independent of PTSD symptoms. Notably, metacognitive bias changes covaried with depressive and PTSD symptom changes two years later. This shows that, in trauma-exposed veterans, negative metacognitive biases are specifically related to depressive symptoms and these biases may be relatively domain general. Further, our longitudinal results suggest that, rather than being a stable trait, metacognitive biases change with PTSD/depressive symptoms over time.
Hayes, J. P., Pierce, M. E., Brown, E., Salat, D., Logue, M. W., Constantinescu, J., Valerio, K., et al. (2023). Genetic Risk for Alzheimer Disease and Plasma Tau Are Associated With Accelerated Parietal Cortex Thickness Change in Middle-Aged Adults. Neurology Genetics , 9.

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