No abstract

Although many people use videoconferencing technology to eliminate distance concerns as they conduct personal and professional activities, a large majority of psychologists have never used telepsychology. This is a barrier to mental health services for millions of people needing help but are limited by time or distance from traditional in-person therapy. The purpose of this study was to identify demographic, organizational, and clinical statistical predictors of psychologists' use of telepsychology in their clinical practice. The sample consisted of 1,791 psychologists currently practicing psychotherapy, representing all 50 U.S. states, and averaging more than 26 years in practice. Results suggested that psychologists were much more likely to use telepsychology if they practiced in organizations where policies supporting telepsychology exist, more likely if they had received telepsychology training, and less likely if they were practicing in rural areas. Psychologists were more likely to use telepsychology if they practiced in Veterans Affairs Medical Centers or within an individual or group practice. Use of telepsychology was higher for psychologists focusing on sports performance and life coaching, as well as lower for psychologists providing testing and evaluation and when treating grief. The implications for psychologists and the settings they practice within are considered. Organizations interested in encouraging telepsychology use should adopt policies supporting the use of telepsychology and provide adequate training to do so. Public Significance StatementTelepsychology can help psychologists reach underserved communities, but only 21% of psychologists in the current study reported using telepsychology within their practice. Results of the study suggest that organizations promoting telepsychology use should craft specific policies supporting its use and provide psychologists adequate training.

The present study examined the psychometric properties and diagnostic efficiency of the Davidson Trauma Scale (DTS), a self-report measure of posttraumatic stress disorder (PTSD) symptoms. Participants included 158 U.S. military veterans who have served since September 11, 2001 (post-9/11). Results support the DTS as a valid self-report measure of PTSD symptoms. The DTS demonstrated good internal consistency, concurrent validity, and convergent and divergent validity. Diagnostic efficiency was excellent when discriminating between veterans with PTSD and veterans with no Axis I diagnosis. However, although satisfactory by conventional standards, efficiency was substantially attenuated when discriminating between PTSD and other Axis I diagnoses. Thus, results illustrate that potency of the DTS as a diagnostic aid was highly dependent on the comparison group used for analyses. Results are discussed in terms of applications to clinical practice and research.

The present study examined the structural validity of the 25-item Connor-Davidson Resilience Scale (CD-RISC) in a large sample of U.S. veterans with military service since 9/11/2001. Participants (n=1981) completed the 25-item CD-RISC, a structured clinical interview and a self-report questionnaire assessing psychiatric symptoms. The study sample was randomly divided into two sub-samples, an initial sample [Sample 1: n = 990] and a replication sample [Sample 2: n = 991]. Findings derived from exploratory factor analysis (EFA) did not support the five-factor analytic structure as initially suggested in Connor and Davidson’s (2003) instrument validation study. Although Parallel Analyses (PA) indicated a two-factor structural model, we tested one to six factor solutions for best model fit using confirmatory factor analysis (CFA). Results supported a two-factor model of resilience, comprised of adaptability (8-item) and self-efficacy (6-item) themed items however, only the adaptability themed factor was found to be consistent with our view of resilience —a factor of protection against the development of psychopathology following trauma exposure. The adaptability themed factor may be a useful measure of resilience for post 9/11 U.S. military veterans.

Research generally supports a 4-factor structure of posttraumatic stress disorder (PTSD) symptoms. However, few studies have established factor invariance by comparing multiple groups. This study examined PTSD symptom structure using the Davidson Trauma Scale (DTS) across three veteran samples: treatment-seeking Vietnam-era veterans, treatment-seeking post-Vietnam-era veterans, and Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veteran research participants. Confirmatory factor analyses of DTS items demonstrated that a 4-factor structural model of the DTS (reexperiencing, avoidance, numbing, and hyperarousal) was superior to five alternate models, including the conventional 3-factor model proposed by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric Association, 1994). Results supported factor invariance across the three veteran cohorts, suggesting that cross-group comparisons

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/Iraq-era veterans. The study includes the comprehensive behavioral health characterization of over 3600 study participants and the genetic, metabolomic, neurocognitive, and neuroimaging data for many of the participants. The study design also incorporates an infrastructure for a data repository to re-contact participants for follow-up studies. The overwhelming majority (94%) of participants consented to be re-contacted for future studies, and our recently completed feasibility study indicates that 73-83% of these participants could be reached successfully for enrollment into longitudinal follow-up investigations. Longitudinal concurrent cohort follow-up studies will be conducted (5-10+ years post-baseline) to examine predictors of illness chronicity, resilience, recovery, functional outcome, and other variables, and will include neuroimaging, genetic/epigenetic, serum biomarker, and neurocognitive studies, among others. To date, the PDMH study has generated more than 35 publications from the baseline data and the repository has been leveraged in over 20 publications from follow-up studies drawing from this cohort. Limitations that may affect data collection for a longitudinal follow-up study are also presented.

No abstract

Objective: To examine whether the Theory of Reasoned Action (TRA) and Technology Acceptance Model (TAM) apply to psychologists' openness to using telepsychology. Method: Participants were 1,791 psychologists currently practicing psychotherapy. Participants represented all 50 US states and averaged 26.33 (SD = 11.18) years in clinical practice. The study used a cross-sectional, national online design. Results: Path analyses derived from the TRA and TAM evidenced poor fit. A newly-developed, third model achieved adequate to fit in which perceived attitudes of others concerning telepsychology were associated with perceived ease of use (β = 0.25, p < .001) and usefulness (β = 0.30, p < .001) of telepsychology. Perceived ease of use (β = 0.30, p < .001) and usefulness (β = 0.32, p < .001) of telepsychology both uniquely predicted current use of telepsychology. Conclusions: Organizations should adopt methods for delivering telepsychology that are easy to use and possess demonstrable utility. K E Y W O R D S technology acceptance model, telehealth, telepsychology, theory of reasoned action