Nancy Skopp - Academia.edu (original) (raw)

Papers by Nancy Skopp

Telemedicine Journal and E-health, Sep 1, 2019

PURPOSE Measurement of simulator-related side effects (SSEs) is an integral component of competen... more PURPOSE Measurement of simulator-related side effects (SSEs) is an integral component of competent and ethical use of virtual reality exposure (VRE), but common SSEs may overlap with symptoms of anxiety. Limited research exists about the frequency of SSEs during VRE treatment for post-traumatic stress disorder (PTSD) and no research compares self-reported SSEs for those undergoing VRE with those participating in exposure therapy without virtual reality. This study compared the SSEs of active duty soldiers with PTSD randomly assigned to exposure therapy through traditional prolonged exposure or VRE. METHODOLOGY A total of 108 soldiers participated in up to 10 sessions of exposure therapy. Of those, 93 provided data on simulator sickness both before and after initiation of imaginal exposure. Approximately half (n = 49) used the Virtual Iraq/Afghanistan system to support engagement with their trauma memory. Soldiers completed a 4-item, self-reported measure of SSE after each session. RESULTS Controlling for age, gender, baseline anxiety symptoms, and SSE symptom counts at the first two sessions of therapy (before initiating imaginal exposure), there was no statistically significant difference between the treatment groups in SSEs at the beginning of imaginal exposure or over the course of treatment. CONCLUSIONS This finding suggests that caution should be exercised in the interpretation of SSE measurements during the use of VRE for PTSD. Virtual reality did not account for any increase in self-reported SSE. It is possible that anxiety accounts for a meaningful proportion of SSE reports during VRE.

Psychological Services, Feb 1, 2023

Caring Contacts (CC), a low-cost intervention originally designed and tested by Jerome Motto in 1... more Caring Contacts (CC), a low-cost intervention originally designed and tested by Jerome Motto in 1976, remains one of the few strategies to demonstrate efficacy in the prevention of suicide deaths. Interest in CC has increased steadily over the last several years in tandem with rising U.S. suicide rates and the acceleration of suicide prevention initiatives. There have been several efforts to design interventions modeled after Motto's strategy, and the recent publication of additional large-scale randomized controlled trials (RCTs) in alignment with the intent of Motto's original model afford an opportunity to systematically review efficacy findings. The current systematic review provides an updated and focused analysis of the evidence supporting the efficacy of CC. A systematic literature search of MEDLINE, EMBASE, PsycINFO, Cochrane Library, and ClinicalTrials.gov was conducted, and PRISMA, Cochrane, and GRADE guidelines were followed. Of 2,746 abstracts reviewed, 13 publications, comprising six randomized controlled trials (RCTs) met inclusion criteria. The studies encompassed 6,218 participants across four countries and military, veteran, and civilian health care systems. The primary outcome was suicide mortality; secondary outcomes were suicide attempts and emergency department (ED) presentations/hospitalizations. The DerSimonian-Laird random-effects univariate meta-analysis was used to estimate summary effect sizes and evaluate statistical heterogeneity. Summary risk ratio estimates ranged from 0.57 to 1.29 across outcomes and time points; most estimates indicated a protective effect. For suicide deaths and ED presentations/hospitalization, interval estimates at 1-year postrandomization were consistent with either an increase or a decrease in risk. A protective effect was observed for suicide attempts at 1-year postrandomization. Implications and methodological recommendations for future work in this area reviewed and discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Military Psychology, 2021

Suicide and Life-Threatening Behavior, 2016

US Army suicide rates increased significantly in the last decade and have remained high. To infor... more US Army suicide rates increased significantly in the last decade and have remained high. To inform future research hypotheses, Army suicide surveillance data (2012–2014) were compared to similar Army data for suicides from 1975 to 1982. Preliminary data suggest that suicide rates increased across most demographic groups, but may have decreased among divorced soldiers. Mental health utilization increased over time. Legal problems and physical health problems were identified in a higher percentage of cases in the recent data relative to the 1975–1982 era. Potential implications for suicide prevention are discussed.

Suicide & life-threatening behavior, Jan 5, 2016

The association between suicide and combat injuries sustained during the wars in Iraq and Afghani... more The association between suicide and combat injuries sustained during the wars in Iraq and Afghanistan was examined. A retrospective population-based cohort design was conducted using official military records to identify combat injuries (October 7, 2001, to December 31, 2007). Those who were injured during combat had higher crude suicide rates than those who deployed and were not injured (incidence rate ratio [IRR] = 1.50; confidence interval [CI] = 1.06, 2.12), or never deployed (IRR = 1.46; CI = 1.04, 2.06). After adjusting for demographics, these findings were no longer statistically significant. Although our data did not support an elevated suicide risk among wounded service members, additional research is needed to examine the impact of injury severity.

JAMA Psychiatry, 2015

We are grateful for Dr Bryan’s careful consideration of our article. His analysis was helpful in ... more We are grateful for Dr Bryan’s careful consideration of our article. His analysis was helpful in summarizing and emphasizing some points from our article. It was unclear whether he felt deployment history should not have been used as an exposure variable in our study or whether he believes the available data now suggest that the field should move on to other questions. We believe he is arguing the latter because he described the use of deployment history in his own meta-analysis2 that was released shortly after our study. We were gratified to learn that his results were generally consistent with the results we reported on the association between deployment and suicide, and we agree that there are new opportunities for future research.... Language: en

Journal of Traumatic Stress, 2011

A retrospective cohort study was conducted to examine risk and protective factors for combat-rela... more A retrospective cohort study was conducted to examine risk and protective factors for combat-related posttraumatic stress disorder (PTSD) symptoms reported by soldiers (n = 2,583) at postdeployment. Positive appraisals of military service related negatively, OR = 0.86, 95% CI [0.83, 0.89], to screening positive for presumed PTSD at postdeployment. Decreases in perceived intimate relationship strength from predeployment to postdeployment were positively associated with presumed PTSD at higher, but not lower, levels of combat exposure; this effect, OR = 1.91, 95% CI [1.08, 3.39], was found only for female soldiers. Overall risk for postdeployment presumed PTSD was found to be nearly 2.5 times greater for women, as compared to men. In addition, positive screening rates of anxiety, depression, hazardous alcohol use, and PTSD increased from predeployment to postdeployment, with the most prominent increase found for PTSD.

Journal of Clinical Psychology, 2012

Journal of Psychiatric Research, 2021

Recent expansions in the roles of women in combat have prompted increased interest in the psychol... more Recent expansions in the roles of women in combat have prompted increased interest in the psychological toll combat exposure may have on female service members as compared to males. This study examined the interactive effects of gender and combat exposure on transitions in posttraumatic stress disorder (PTSD) diagnostic status (presence or absence of PTSD diagnosis). We used administrative data of 20,000 U.S. Army soldiers whose combat exposure was assessed after return from deployment between January 1, 2008 and June 30, 2014; soldiers' PTSD diagnostic status was determined using International Classification of Diseases-9 diagnoses at four time points separated by 12 months. We used a mixed-effects logit transition model to examine the effects of combat and gender on incidence, persistence, and prevalence of PTSD diagnosis. Incidence and prevalence of PTSD diagnosis were higher among women, but persistence of PTSD diagnosis was higher in men. Higher rates of new PTSD diagnosis among women were not dependent on combat exposure, suggesting that other types of trauma may be responsible for increased rates among women. Gender differences in prevalence and persistence of PTSD diagnosis were greater among combat-exposed soldiers than among those not exposed to combat. Men maintained a PTSD diagnosis over longer periods of time than women suggesting greater PTSD persistence, and this pattern was particularly pronounced among soldiers exposed to combat. These results have implications for the recent policy changes and gender-based prevention strategies, and suggest that women in combat roles may be no more vulnerable to PTSD than are their male counterparts. Though the gender differences were small, they are indicative of healthcare utilization patterns that may be important for prevention and that warrant further exploration.

Psychiatry Research-neuroimaging, Dec 1, 2017

Annals of Epidemiology, Mar 1, 2018

Suicide and Life Threatening Behavior, Sep 27, 2019

Psychiatry Research-neuroimaging, Nov 1, 2016

Journal of Telemedicine and Telecare, Aug 17, 2016

Psychology of popular media culture, Jul 1, 2018

This research examined Facebook (FB) use among 166 active-duty U.S. Service Members (SMs) deploye... more This research examined Facebook (FB) use among 166 active-duty U.S. Service Members (SMs) deployed to Afghanistan. SMs anonymously completed a survey about FB use during their current deployment. Data were collected on FB network size, time spent on FB, FB use integration and emotional connection (via the Social Media Use and Integration Scale), maladaptive FB use (via the Maladaptive Facebook Use Scale), and perceived social support (via the Social Provisions Scale). The majority of SMs had FB accounts (81%, n = 135), which they used during deployment. FB use integration and emotional connection was positively associated with perceived social support, whereas maladaptive FB use and time spent on FB were negatively associated with perceived social support. Non-FB users were more highly educated, higher in rank, and older compared to FB users. FB integration into users’ social routines and users’ emotional connection to FB may help increase positive perceptions of social support among deployed SMs. Education on the constructive use of FB during deployment may be useful in enhancing perceived social support and reducing maladaptive FB use.