Fernanda Rossi, Ph.D.

All Publications

• A Clinical Decision Support Tool for Intimate Partner Violence Screening Among Women Veterans: Development and Qualitative Evaluation of Provider Perspectives. JMIR formative research Rossi, F. S., Wu, J., Timko, C., Nevedal, A. L., Wiltsey Stirman, S. 2024; 8: e57633

  Abstract

  Women veterans, compared to civilian women, are especially at risk of experiencing intimate partner violence (IPV), pointing to the critical need for IPV screening and intervention in the Veterans Health Administration (VHA). However, implementing paper-based IPV screening and intervention in the VHA has revealed substantial barriers, including health care providers' inadequate IPV training, competing demands, time constraints, and discomfort addressing IPV and making decisions about the appropriate type or level of intervention.This study aimed to address IPV screening implementation barriers and hence developed and tested a novel IPV clinical decision support (CDS) tool for physicians in the Women's Health Clinic (WHC), a primary care clinic within the Veterans Affairs Palo Alto Health Care System. This tool provides intelligent, evidence-based, step-by-step guidance on how to conduct IPV screening and intervention.Informed by existing CDS development frameworks, developing the IPV CDS tool prototype involved six steps: (1) identifying the scope of the tool, (2) identifying IPV screening and intervention content, (3) incorporating IPV-related VHA and clinic resources, (4) identifying the tool's components, (5) designing the tool, and (6) conducting initial tool revisions. We obtained preliminary physician feedback on user experience and clinical utility of the CDS tool via the System Usability Scale (SUS) and semistructured interviews with 6 WHC physicians. SUS scores were examined using descriptive statistics. Interviews were analyzed using rapid qualitative analysis to extract actionable feedback to inform design updates and improvements.This study includes a detailed description of the IPV CDS tool. Findings indicated that the tool was generally well received by physicians, who indicated good tool usability (SUS score: mean 77.5, SD 12.75). They found the tool clinically useful, needed in their practice, and feasible to implement in primary care. They emphasized that it increased their confidence in managing patients reporting IPV but expressed concerns regarding its length, workflow integration, flexibility, and specificity of information. Several physicians, for example, found the tool too time consuming when encountering patients at high risk; they suggested multiple uses of the tool (eg, an educational tool for less-experienced health care providers and a checklist for more-experienced health care providers) and including more detailed information (eg, a list of local shelters).Physician feedback on the IPV CDS tool is encouraging and will be used to improve the tool. This study offers an example of an IPV CDS tool that clinics can adapt to potentially enhance the quality and efficiency of their IPV screening and intervention process. Additional research is needed to determine the tool's clinical utility in improving IPV screening and intervention rates and patient outcomes (eg, increased patient safety, reduced IPV risk, and increased referrals to mental health treatment).

  View details for DOI 10.2196/57633

  View details for PubMedID 39321455

• The association between lifetime trauma exposure typologies and mental health outcomes among veterans. Psychiatry research Rossi, F. S., Nillni, Y., Fox, A. B., Galovski, T. E. 2023; 326: 115321

  Abstract

  We know little about veterans' lifetime trauma exposure patterns and how such patterns are associated with mental health outcomes. This study sought to identify lifetime trauma exposure typologies among veterans and examine associations between these typologies and mental health outcomes. It used baseline data from a national longitudinal mail-based survey of 3,544 veterans and oversampled for women (51.6%) and veterans living in high crime areas (67.6%). Most veterans (94.2%) reported trauma exposure, and 80.1% reported exposure to two or more traumas. Prevalence of mental health outcomes was: 27.7% anxiety, 31.3% depression, 37.9% posttraumatic stress disorder, 44.4% alcohol use disorder, 10.4% suicide attempt, and 33.5% mental health comorbidity. Latent class analysis was used to identify patterns of lifetime trauma exposure and logistic regression was used to examine the odds of mental health outcomes as a function of class membership. Five lifetime trauma exposure typologies emerged: (1) low trauma; (2) high combat and community violence; (3) intimate partner violence trauma; (4) high global physical assault; and (5) high trauma. Classes showed differential associations with mental health outcomes. Findings have implications for clinical practice including informing providers' mental health treatment plans to correspond to each veteran's trauma exposure typology.

  View details for DOI 10.1016/j.psychres.2023.115321

  View details for PubMedID 37356252

• Screening for Intimate Partner Violence in Family Mediation: An Examination of Multiple Methodological Approaches Using Item Response Theory. Assessment Rossi, F. S., Applegate, A. G., Beck, C. J., Timko, C., Holtzworth-Munroe, A. 2021: 10731911211022843

  Abstract

  Many divorcing/separating parties seeking mediation to resolve family-related issues report intimate partner violence (IPV) victimization from the other party in the case. It is imperative that mediation staff screen parties for IPV so they can make informed decisions regarding how to proceed with mediation. Existing IPV screens for mediation have significant limitations. We examined three methodological approaches using item response theory that address these limitations by increasing the efficiency and clinical utility of an existing standardized IPV screen for mediation, the Mediator's Assessment of Safety Issues and Concerns (N = 904 mediating parties). We identified three subsets of items, with initial evidence for their validity, focused on helping mediation staff identify high levels of IPV or parties at risk for potentially negative mediation outcomes or needing specialized safety accommodations in mediation. Clinical recommendations are provided indicating which approach is most promising to be used in mediation settings. Overall, findings help advance understanding of how item response theory methodology can enhance the precision of IPV screening in mediation.

  View details for DOI 10.1177/10731911211022843

  View details for PubMedID 34151599

• Evaluation of intimate partner violence screening administration formats in a court-affiliated family mediation program. Psychology, Public Policy, and Law Huber Gifford, H., Jiang, L. J., Applegate, A. G., Walsh, A. M., Rossi, F. S., Lott, K., Gillenwater, L. A., Holtzworth-Munroe, A. 2024
• Intimate partner violence screening for separating or divorcing parents: An introduction to the mediator's assessment of safety issues and concerns-short (MASIC-S) FAMILY COURT REVIEW Rossi, F. S., Applegate, A. G., Tomlinson, C., Holtzworth-Munroe, A. 2023

  View details for DOI 10.1111/fcre.12762

  View details for Web of Science ID 001112420000001

• Improving depression management with support from close others: A thematic analysis of individuals with depression and their partners in care. Chronic illness Javier, S. J., Risbud, R., Rossi, F. S., Slightam, C., Aikens, J., Guetterman, T., Piette, J. D., Trivedi, R. 2023: 17423953231175690

  Abstract

  With support from others, individuals with depression can build skills and implement lifestyle changes that help them manage their illness. The objective of the current study was to understand how the CarePartners for Depression Program, a randomized clinical trial aimed at enhancing the role of caregivers in the management of depression, improved communication and shared understandings of depression among individuals with depression and their close others.We conducted in-depth, semi-structured interviews with individuals with depression and their caregivers who participated in the CarePartners program. Interviews were qualitatively coded using a thematic analytic framework.We conducted individual interviews with 39 participants in the CarePartners program, including 18 individuals with depression, 14 out-of-home care partners, and 7 informal caregivers. Three central themes were derived from analyses: (a) The quality of interpersonal relationships influenced the management of depression; (2) having clearly defined roles for CarePartners improved communication between CarePartners and individuals with depression; and (3) shared understanding of depression improved management of depression.Our findings established the conditions under which the management of depression was influenced in a dyadic intervention. Dyadic interventions may make it easier for individuals to support patients with depression by fostering communication and collaboration.

  View details for DOI 10.1177/17423953231175690

  View details for PubMedID 37904531

• Parents reporting partner violence: Reaching or not reaching agreement in mediation or litigating without mediation CONFLICT RESOLUTION QUARTERLY Jiang, L. J., Applegate, A. G., Tomlinson, C. S., Rossi, F. S., Beck, C. J., Adams, J. M., Holtzworth-Munroe, A. 2023

  View details for DOI 10.1002/crq.21387

  View details for Web of Science ID 000986834300001

• Relationship of perceived neighborhood danger with depression and PTSD among veterans: The moderating role of social support and neighborhood cohesion. American journal of community psychology Galovski, T. E., Rossi, F. S., Fox, A. B., Vogt, D., Duke, C. C., Nillni, Y. I. 2023

  Abstract

  Little is known about the impact of perceived neighborhood danger on military veterans' mental health, a population potentially at higher risk for this experience, or whether interpersonal social support and neighborhood cohesion can help buffer against poor mental health. This study examined: (1) the impact of perceived neighborhood danger on depression and posttraumatic stress disorder (PTSD) among veterans; (2) whether interpersonal social support and neighborhood cohesion can mitigate these effects; and (3) how prior trauma history may interact with these factors. Six moderation models were examined using data from 3049 veterans enrolled in the Longitudinal Investigation of Gender, Health, and Trauma study, a mail-based survey that oversampled for veterans in high crime neighborhoods. Most notably, results indicated that perceived neighborhood danger was associated with increased depression and PTSD (all p<.001). Interpersonal social support or neighborhood cohesion mitigated the effect of perceived neighborhood danger on veterans' depression, but, only for those without prior trauma (all p<.011). For trauma-exposed veterans, interpersonal social support was more effective in mitigating the effect of perceived neighborhood danger on depression than neighborhood cohesion (p=.006). Findings help inform interventions to improve the mental health of veterans living in high crime neighborhoods.

  View details for DOI 10.1002/ajcp.12655

  View details for PubMedID 36661400

• Intimate partner violence predicting outcomes in specialized mediation and traditional litigation Journal of Family Violence Huber Gifford, H., Jiang, L. J., Beck, C. J., Applegate, A. G., Adams, J. M., Rossi, F. S., Tomlinson, C. S., Holtzworth-Munroe, A. 2023
• Caregivers of people with substance use or mental health disorders in the US. Substance abuse Timko, C., Lor, M. C., Rossi, F., Peake, A., Cucciare, M. A. 2022; 43 (1): 1268-1276

  Abstract

  Background: Caregiving for persons with substance use and/or mental health disorders (SU/MHD) and other conditions places significant strains on caregivers. Methods: The present study used Behavioral Risk Factor Surveillance System (a US health survey) data to (1) compare caregivers of recipients with SU/MHD to those of recipients with other conditions on demographic and caregiving characteristics and health outcomes and (2) examine demographic and caregiving characteristics that were associated with poorer health outcomes among caregivers of persons with SU/MHD. Results: Caregivers of people with SU/MHD were more likely than other caregiver groups (of recipients with medical, cognitive, developmental disability, and old age-related conditions) to report poor general health, physical health, and mental health, as well as activities limitations, having been diagnosed with depression, and binge drinking. Among the group of caregivers of recipients with SU/MHD, those caring for a parent were more likely to report poor physical health, poor mental health, depression, and binge drinking than those caring for a friend, relative, child, or spouse. In addition, caregivers who provided SU/MHD-related caregiving for a longer duration and for whom caregiving included household help were less likely to report poor mental health, depression, or binge drinking. Conclusions: Findings underscore the importance of the substance use disorder treatment system developing improved institutional and structural support for caregivers of recipients with SU/MHD.

  View details for DOI 10.1080/08897077.2022.2074605

  View details for PubMedID 35849747

• PTSD and Depression Symptoms Increase Women's Risk for Experiencing Future Intimate Partner Violence. International journal of environmental research and public health Iverson, K. M., Rossi, F. S., Nillni, Y. I., Fox, A. B., Galovski, T. E. 2022; 19 (19)

  Abstract

  Psychological distress may impact women's risk for future intimate partner violence (IPV). Yet, limited research has utilized longitudinal research designs and there is a scarcity of research looking at the three most commonly implicated mental health factors-posttraumatic stress disorder (PTSD), depression, and alcohol use-within the same study. Research is especially scarce for women veterans, who experience substantial risk for these mental health concerns and experiencing IPV. This study examined the role of PTSD symptoms, depression symptoms, and alcohol use in increasing risk for experiencing future IPV while simultaneously accounting for the impact of recent IPV experience on subsequent mental health. This study included a sample of 1921 women veterans (Mage = 36.5), who were asked to complete three mail surveys over the course of 8 months as part of a larger longitudinal survey study of US veterans' health and well-being. The survey assessed experiences of IPV, PTSD symptoms (PCL-5), depression symptoms (PHQ-9), and alcohol use (AUDIT-C) at each of the three time points. Results from separate path analysis models provided support for the role of PTSD symptoms and depression symptoms (but not alcohol use) in increasing risk for IPV experience over time. However, the path analysis models provided little support, with the exception of PTSD, for the impact of IPV experience on subsequent mental health symptoms. Findings point to the importance of better understanding the mechanisms by which PTSD and depression symptoms can increase risk for IPV to inform theory and prevention and treatment efforts. Detection and treatment of PTSD and depression symptoms among women may help reduce risk for future violence in intimate relationships.

  View details for DOI 10.3390/ijerph191912217

  View details for PubMedID 36231518

• Association Between Mental Health Conditions and Outpatient Care Fragmentation: a National Study of Older High-Risk Veterans. Journal of general internal medicine Trivedi, R. B., Rossi, F. S., Javier, S. J., Greene, L., Singer, S. J., Vanneman, M. E., Goldstein, M., Zulman, D. M. 2022

  Abstract

  BACKGROUND: Healthcare fragmentation may lead to adverse consequences and may be amplified among older, sicker patients with mental health (MH) conditions.OBJECTIVE: To determine whether older Veterans with MH conditions have more fragmented outpatient non-MH care, compared with older Veterans with no MH conditions.DESIGN: Retrospective cohort study using FY2014 Veterans Health Administration (VHA) administrative data linked to Medicare data.PARTICIPANTS: 125,481 VHA patients ≥ 65 years old who were continuously enrolled in Medicare Fee-for-Service Parts A and B and were at high risk for hospitalization.MAIN OUTCOME AND MEASURES: The main outcome was non-MH care fragmentation as measured by (1) non-MH provider count and (2) Usual Provider of Care (UPC), the proportion of care with the most frequently seen non-MH provider. We tested the association between no vs. any MH conditions and outcomes using Poisson regression and fractional regression with logit link, respectively. We also compared Veterans with no MH condition with each MH condition and combinations of MH conditions, adjusting for sociodemographics, comorbidities, and drive-time to VHA specialty care.KEY RESULTS: In total, 47.3% had at least one MH condition. Compared to those without MH conditions, Veterans with MH conditions had less fragmented care, with fewer non-MH providers (IRR = 0.96; 95% CI: 0.96-0.96) and more concentrated care with their usual provider (OR = 1.08 for a higher UPC; 95% CI: 1.07, 1.09) in adjusted models. Secondary analyses showed that those with individual MH conditions (e.g., depression) had fewer non-MH providers (IRR range: 0.86-0.98) and more concentrated care (OR range: 1.04-1.20). A similar pattern was observed when examining combinations of MH conditions (IRR range: 0.80-0.90; OR range: 1.16-1.30).CONCLUSIONS: Contrary to expectations, having a MH condition was associated with less fragmented non-MH care among older, high-risk Veterans. Further research will determine if this is due to different needs, underuse, or appropriate use of healthcare.

  View details for DOI 10.1007/s11606-022-07705-z

  View details for PubMedID 35869316

• Systematic Review of Dyadic Interventions for Ambulatory Care Sensitive Conditions: Current Evidence and Key Gaps. Clinical gerontologist Wooldridge, J. S., Rossi, F. S., Anderson, C., Yarish, N. M., Pukhraj, A., Trivedi, R. B. 2022: 1-29

  Abstract

  OBJECTIVES: Identify non-pharmacological interventions to support patient/caregiver dyads with ACSCs; review the effects of dyadic interventions on health services outcomes; and review the effectiveness of dyadic interventions on patient and caregiver biopsychosocial outcomes.METHODS: A systematic review of randomized controlled trials (RCTs).RESULTS: Twenty-six manuscripts representing 20 unique RCTs (Mean N = 154 patients, 140 caregivers) were eligible. Eleven RCTs examined caregiving in patients with HF, seven with T2DM, one with COPD, and one with mixed ACSCs. Dyadic interventions for ACSCs were diverse in terms of length and content, with most including an educational component. Only 4/26 included studies had a low risk of bias. Interventions were most successful at improving quality of life, clinical health outcomes, health behaviors, and health services outcomes, with fewer improvements in patient mental health outcomes, psychosocial outcomes, relationship outcomes, and caregiver outcomes in general. The largest effect sizes were reported from trials focused on T2DM.CONCLUSIONS: High-quality research with consistent measuring instruments is needed to understand which interventions are associated with improved patient and caregiver outcomes.CLINICAL IMPLICATIONS: There may be clinically relevant benefits to including caregivers in interventions for patients with ACSCs, and clinicians should consider this when devising treatment plans.

  View details for DOI 10.1080/07317115.2022.2086089

  View details for PubMedID 35713392

• Patterns of Adverse Childhood Experiences and Cardiovascular Risk Factors in U.S. Adults. Stress and health : journal of the International Society for the Investigation of Stress Wooldridge, J. S., Tynan, M., Rossi, F. S., Gasperi, M., McLean, C. L., Bosch, J., Trivedi, R. B., Herbert, M. S., Afari, N. 2022

  Abstract

  Adverse Childhood Experiences (ACEs) are associated with poor health yet, we know little about how distinct patterns of ACE types are associated with cardiovascular (CVD) risk factors. The current study 1) examined associations of latent ACE classes with modifiable CVD risk factors including high cholesterol, smoking, diabetes, hypertension, high triglycerides, physical inactivity, overweight/obesity, and lifetime depression; and 2) examined the impact of socioeconomic status-related (SES) factors on these relationships. Using a cross-sectional analysis of the NESARC-III (n=36,309) data, four latent classes of ACEs were previously identified: 1) low adversity, 2) primarily household dysfunction, 3) primarily maltreatment, and 4) multiple adversity types. We examined the association of these classes with CVD risk factors in adulthood and subsequently, the same model accounting for SES-related factors. Tobacco smoking, overweight/obesity, and lifetime depression were each associated with higher odds of being in classes 2, 3, and 4 than class 1, respectively. These relationships held after adjusting for SES-related factors. Class 4 was associated with the most CVD risk factors, including high triglycerides and high cholesterol after controlling for SES-related factors. The consistent associations between tobacco smoking, overweight/obesity, and lifetime depression with each adverse ACE profile, even after controlling for SES, suggest behavioral CVD prevention programs should target these CVD risk factors simultaneously. This article is protected by copyright. All rights reserved.

  View details for DOI 10.1002/smi.3167

  View details for PubMedID 35618265

• Latent Class Patterns of Adverse Childhood Experiences and Their Relationship to Veteran Status and Sex in the National Epidemiologic Survey of Alcohol and Related Conditions Wave III. Military medicine Tynan, M., Wooldridge, J. S., Rossi, F., McLean, C. L., Gasperi, M., Bosch, J., Timko, C., Herbert, M., Afari, N. 1800

  Abstract

  INTRODUCTION: Adverse childhood experiences (ACEs) are associated with poor psychosocial and health outcomes in adulthood. Veterans and females experience ACEs disproportionately. A greater understanding of this disparity may be achieved by examining the relationship between distinct ACE patterns and these demographic characteristics. Therefore, this study examined distinct ACE patterns and their association with Veteran status, sex, and other demographics in a nationally representative sample of U.S. adults to inform interventions tailored to ACE patterns experienced by specific groups.MATERIALS AND METHODS: Latent class analysis (LCA) was conducted with data from the National Epidemiologic Survey of Alcohol and Related Conditions-III, a nationally representative structured diagnostic interview conducted from 2012-2013. The target population was the noninstitutionalized adult population living in the USA. The analytic sample was 36,190 (mean age 46.5years; 48.1% male). Of these participants, 3,111 were Veterans. Data were analyzed between September 2020 and January 2021.RESULTS: Latent class analysis revealed a four-class solution: (1) "Low adversity" (75.3%); (2) "Primarily household dysfunction" (9.0%); (3) "Primarily maltreatment" (10.7%); and (4) "Multiple adversity types" (5.1%). Compared to "Low adversity," members in the other classes were more likely to be Veterans (odds ratio (OR)C2vC1=1.33, ORC3vC1 =1.55, ORC4vC1 =1.98) and female (ORC2vC1=1.58, ORC3vC1=1.22, ORC4vC1=1.65). While lower education and income were also related to higher adversity class membership, Veteran status and sex were the strongest predictors, even when controlling for education and income.CONCLUSIONS: Distinct and meaningful patterns of ACEs identified in this study highlight the need for routine ACE screenings in Veterans and females. As in the current study, operationalizing and clustering ACEs can inform screening measures and trauma-informed interventions in line with personalized medicine. Future work can test if classes are differentially associated with health outcomes.

  View details for DOI 10.1093/milmed/usab536

  View details for PubMedID 34977940

• Predictors of attendance at court-referred shuttle or videoconferencing mediation among separating or divorcing parents reporting high levels of intimate partner violence FAMILY COURT REVIEW Jiang, L. J., Rossi, F. S., Beck, C. J., Applegate, A. G., Adams, J. M., Holtzworth-Munroe, A. 2021

  View details for DOI 10.1111/fcre.12577

  View details for Web of Science ID 000731403800001

• Substance Use, PTSD Symptoms, and Suicidal Ideation Among Veteran Psychiatry Inpatients:A Latent Class Trajectory Analysis. Journal of studies on alcohol and drugs Vest, N. A., Rossi, F. S., Ilgen, M., Humphreys, K., Timko, C. 2021; 82 (6): 792-800

  Abstract

  OBJECTIVE: In this study, we aimed to inform clinical practice by identifying distinct subgroups of U.S. veteran psychiatry inpatients on their alcohol and drug use severity, posttraumatic stress disorder (PTSD) symptoms, and suicidal ideation over time.METHOD: Participants were 406 patients with co-occurring substance use and mental health disorders. A parallel latent growth trajectory model was used to characterize participants' symptom severity across 15 months posttreatment intake.RESULTS: Four distinct classes were identified: 47% "normative improvement," 32% "high PTSD," 11% "high drug use," and 9% "high alcohol use." Eighty percent of the sample had reduced their drinking and drug intake by half from baseline to 3 months, and those levels remained stable from 3 to 15 months. The High PTSD, High Drug Use, and High Alcohol Use classes all reported levels of PTSD symptomatology at baseline consistent with a clinical diagnosis, and symptom levels remained high and stable across all 15 months. The Normative Improvement class showed declining drug and alcohol intake and was the only class exhibiting reductions in PTSD symptomatology over time. High substance use classes showed initial declines in suicidal ideation, then an increase from 9 to 15 months.CONCLUSIONS: The reduction in frequency of drinking and drug use for 80% of the sample was substantial and supports the potential efficacy of current treatment approaches. However, the high and stable levels of PTSD for more than 50% of the sample, as well as the reemergence of suicidal ideation in a sizable subgroup, underscore the difficulty in finding and linking patients to effective interventions to decrease symptomatology over time.

  View details for PubMedID 34762039

• PREPARING MEDIATORS TO MEDIATE CASES REPORTING HIGH IPV IN A RANDOMIZED CONTROLLED TRIAL: THE IMPORTANCE OF A MEDIATION MANUAL, TRAINING, AND CONSULTATION FAMILY COURT REVIEW Applegate, A. G., Beck, C. J., Adams, J. M., Rossi, F. S., Holtzworth-Munroe, A. 2021

  View details for DOI 10.1111/fcre.12605

  View details for Web of Science ID 000698610100001

• Concerned others' help utilization and patients' alcohol treatment outcomes. Drug and alcohol dependence Timko, C., Rossi, F. S., Grant, K. M., Lor, M. C., Cucciare, M. A. 2021; 228: 108983

  Abstract

  BACKGROUND: This study of dyads composed of patients in treatment for alcohol use disorders (AUDs) and their Concerned Others (COs) examined (1) COs' attendance at three types of help (educational sessions, treatment sessions with the patient, and treatment sessions without the patient) during a 3-month period after patients' admission, and (2) whether COs' use of help was associated with better treatment outcomes reported by COs about patients, and patients about themselves.METHODS: Dyads (n=277) were assessed when patients entered AUD treatment and 3 months later (80 %). COs rated their patient's AUD, and patients rated their own AUD, on the Brief Addiction Monitor. At 3-month follow-up, COs answered three items about help (education, treatment with patient, treatment without patient) from their patient's treatment program. Main analyses were analyses of covariance to examine associations between COs' help use and patients' outcomes.RESULTS: At 3-month follow-up, COs who had obtained one type of help were significantly more likely to have also obtained the other two types of help. However, relatively few COs (39 %) obtained any type of help. COs who obtained help rated their patient as having more protection against future substance use. And, when COs had obtained help, patients rated themselves as having less risk of future substance use, and had attended a greater number of AA meetings, than when COs had not obtained help.CONCLUSIONS: Findings suggest that COs' use of help can benefit patients in AUD treatment. Clinicians and researchers should increase the availability and use of help among COs.

  View details for DOI 10.1016/j.drugalcdep.2021.108983

  View details for PubMedID 34507007

• Patients With Alcohol Use Disorders and Their Concerned Others: Concordance of Lived Experience as a Moderator of Treatment Outcomes JOURNAL OF STUDIES ON ALCOHOL AND DRUGS Timko, C., Cucciare, M. A., Grant, K. M., Young, L., Rossi, F. S., Lor, M., Woodhead, E. 2021; 82 (3): 395-400

  View details for Web of Science ID 000660332900010

• ASSOCIATION BETWEEN SUBSTANCE USE DISORDER AND HEALTHCARE FRAGMENTATION PATTERNS IN VETERANS AT HIGH RISK FOR HOSPITALIZATION Rossi, F., Timko, C., Javier, S., Zulman, D. M., Greene, L., Singer, S., Vanneman, M., Trivedi, R. B. OXFORD UNIV PRESS INC. 2021: S61

  View details for Web of Science ID 000648922700123

• ASSOCIATION BETWEEN MENTAL HEALTH CONDITIONS AND CARE FRAGMENTATION AMONG A NATIONAL SAMPLE OF VETERANS 65 YEARS AND OLDER Trivedi, R. B., Rossi, F., Javier, S., Greene, L., Singer, S., Vanneman, M., Zulman, D. M. OXFORD UNIV PRESS INC. 2021: S60

  View details for Web of Science ID 000648922700120

• Intimate Partner Violence (IPV) and Family Dispute Resolution: A Randomized Controlled Trial Comparing Shuttle Mediation, Videoconferencing Mediation, and Litigation PSYCHOLOGY PUBLIC POLICY AND LAW Holtzworth-Munroe, A., Beck, C. J., Applegate, A. G., Adams, J. M., Rossi, F. S., Jiang, L. J., Tomlinson, C. S., Hale, D. F. 2021; 27 (1): 45–64

  View details for DOI 10.1037/law0000278

  View details for Web of Science ID 000619665800005

• Patients With Alcohol Use Disorders and Their Concerned Others: Concordance of Lived Experience as a Moderator of Treatment Outcomes. Journal of studies on alcohol and drugs Timko, C., Cucciare, M. A., Grant, K. M., Young, L. B., Rossi, F. S., Lor, M. C., Woodhead, E. 2021; 82 (3): 395-400

  Abstract

  Growing up with an adult with an alcohol use disorder (AUD) is common and negatively affects adult functioning. This study examined two questions concerning the lived experience of growing up in a home with AUD.The first question asked how adults entering AUD treatment (n = 402) who had this lived experience (58%) compared to those who did not (42%) on indicators of alcohol use severity. Patients with lived experience reported alcohol use at a younger age, more times having been arrested and charged, and greater risk for future substance use. The second question examined concordance between patients and their concerned others on this lived experience (n = 277 dyads) and patients' treatment outcomes 3 months later. The associations between patients' lived experience and better treatment outcomes were stronger when patients' concerned others had a concordant lived experience. When patient-concerned other dyads reported concordant lived experiences at baseline, patients had lower substance use and risk scores at the 3-month follow-up than when the dyads reported discordant lived experiences with regard to growing up in a home with AUD; effect sizes were small.Concordance and discordance on this lived experience could be considered in treatment planning for patients with AUD and their concerned others. Providers could ask about each member's childhood and aim interventions at helping dyads discuss their childhoods in ways that validate each other's needs and provide emotional support, without stigmatization. Delivery may consider relationship type (spousal or other) and be in educational or treatment sessions that include the dyad or one member.

  View details for PubMedID 34100708

• "Relationship between substance use disorder (SUD) and healthcare fragmentation patterns in veterans at high-risk for hospitalization" (SW19) Rossi, F., Timko, C., Javier, S. J., Zulman, D. M., Greene, L., Singer, S., Vanneman, M. E., Goldstein, M., Trivedi, R. BMC. 2020

  View details for Web of Science ID 000603567100107

• Psychotherapy Utilization, Preferences, and Retention among Women Veterans with Post-traumatic Stress Disorder. Women's health issues : official publication of the Jacobs Institute of Women's Health Farmer, C. C., Rossi, F. S., Michael, E. M., Kimerling, R. 2020

  Abstract

  BACKGROUND: Psychotherapy is the gold standard treatment for post-traumatic stress disorder (PTSD), yet psychotherapy use and retention among veterans is low. Little is known about the barriers to care and factors associated with women veterans' PTSD psychotherapy use and retention. Using a nationally representative sample of 986 women Veteran's Health Administration primary care users with PTSD and a perceived need for mental health care, we examined 1) the proportion of women who used psychotherapy, 2) retention in psychotherapy among women who used any psychotherapy, and 3) individual factors related to psychotherapy use and retention.METHODS: Women completed a survey on their mental health care experiences. Outpatient mental health care use in the year before the survey was obtained from Veteran's Health Administration administrative data.RESULTS: Most women (79.1%) used psychotherapy, and 41.7% of those women had a minimal therapeutic dose of psychotherapy (≥8 visits). Mental health diagnostic comorbidity and being African American/Black or identifying as neither African American/Black nor White were significantly associated with higher psychotherapy use. Mental health diagnostic comorbidity, exposure to military sexual trauma, and receiving treatment aligned with gender-related and group-related preferences were associated with higher psychotherapy retention. Being a parent was associated with lower retention.CONCLUSIONS: Although a significant proportion of women veterans with PTSD are using psychotherapy, retention is enhanced when women are able to obtain treatment aligned with their preferences. Thus, efforts to promote patient-centered, shared decisions regarding mental health treatment options could increase the efficacy and efficiency of treatment for PTSD among women.

  View details for DOI 10.1016/j.whi.2020.06.003

  View details for PubMedID 32680627

• Subtypes of Violent Separating or Divorcing Couples Seeking Family Mediation and Their Association With Personality and Criminality Characteristics PSYCHOLOGY OF VIOLENCE Rossi, F. S., Holtzworth-Munroe, A., Applegate, A. G., Beck, C. J. 2020; 10 (4): 390–99

  View details for DOI 10.1037/vio0000271

  View details for Web of Science ID 000543752300004

• Trying Times and Trying Out Solutions: Intimate Partner Violence Screening and Support for Women Veterans During COVID-19. Journal of general internal medicine Rossi, F. S., Shankar, M., Buckholdt, K., Bailey, Y., Israni, S. T., Iverson, K. M. 2020

  Abstract

  Initial reports indicate widespread increases in intimate partner violence (IPV) rates during the coronavirus disease 2019 (COVID-19) pandemic. Women veterans are at particular risk for experiencing IPV, and the COVID-19 pandemic and resulting stay-at-home orders may be exacerbating this risk. IPV screening and intervention are an integral part of the care provided to women veterans in the Veteran's Health Administration (VHA). Current changes in healthcare delivery during COVID-19 may present challenges to the VHA's standard methods of initiating IPV screening and intervention with women veterans. We discuss the potential challenges VHA healthcare providers may be encountering when conducting routine IPV screening during the COVID-19 pandemic and when providing resources and support to women veterans experiencing IPV. We describe solutions to these challenges, including existing efforts led by the VHA IPV Assistance Program (IPVAP) as well as additional potential solutions. New ideas and partnerships will be critical for helping the VHA continue to assist women veterans experiencing IPV as the COVID-19 pandemic evolves. Though our focus is on women veterans and the VHA, the challenges and solutions we discuss are likely applicable to other populations experiencing IPV and other health care systems screening for IPV.

  View details for DOI 10.1007/s11606-020-05990-0

  View details for PubMedID 32607932

• An Examination of the Association Between Patient Experience and Quality of Mental Health Care Among Women Veterans. Administration and policy in mental health Rossi, F. S., Javier, S. J., Kimerling, R. n. 2020

  Abstract

  Improving patient experience is one strategy that may increase the quality of mental health care if better experience is linked to the likelihood of a potentially therapeutic dose (PTD) of treatment. This study sought to examine: (1) the proportion of women veterans who obtained a PTD of mental health treatment; and (2) the association between women's experiences with Veterans Health Administration (VHA) mental health services and obtaining a PTD of mental health treatment. We assessed patient experience via a survey that measured experiences with gender-sensitive care, ease of getting care, perceived quality of care, and extent to which care met needs. We used VHA administrative data to determine mental health utilization across a national sample of 2109 women veterans with episodes of mental health care that included psychotherapy or pharmacotherapy. Results indicated that 71% of women received a PTD. Positive ratings regarding perceived quality of care and whether care met needs were associated with higher odds of receiving a PTD of treatment. Findings provide supporting evidence for the continued necessity  of offering patient-centered mental health care to women veterans. Careful consideration of women veterans' mental health care experiences may be crucial in promoting high value mental health care for this population in VHA.

  View details for DOI 10.1007/s10488-020-01046-x

  View details for PubMedID 32415345

• SHUTTLE AND ONLINE MEDIATION: A REVIEW OF AVAILABLE RESEARCH AND IMPLICATIONS FOR SEPARATING COUPLES REPORTING INTIMATE PARTNER VIOLENCE OR ABUSE FAMILY COURT REVIEW Rossi, F. S., Holtzworth-Munroe, A., Applegate, A. G., Beck, C. J., Adams, J. M., Hale, D. F. 2017; 55 (3): 390-403

  View details for DOI 10.1111/fcre.12293

  View details for Web of Science ID 000417420100006

• Family mediation for divorce and parental separation Foundations for couples' therapy: Research for the real world Poladian, A. R., Rossi, F. S., Rudd, B. N., Holtzworth-Munroe, A. edited by Fitzgerald, J. Routledge/Taylor & Francis Group. 2017: 256-267
• Intimate partner violence and child custody Parenting Plan Evaluations: Applied Research for the Family Court Rossi, F. S., Holtzworth-Munroe, A., Rudd, B. N., Olesen, N. edited by Drozd, L. M., Saini, M. Oxford University Press. 2016; 2: 346-373
• Divorce and Parental Separation Encyclopedia of Mental Health Rudd, B. N., Holtzworth-Munroe, A., Rossi, F. S. edited by Friedman, H. S. Academic Press. 2016; 2: 79-87
• Detection of Intimate Partner Violence and Recommendation for Joint Family Mediation: A Randomized Controlled Trial of Two Screening Measures PSYCHOLOGY PUBLIC POLICY AND LAW Rossi, F. S., Holtzworth-Munroe, A., Applegate, A. G., Beck, C. A., Adams, J. M., Hale, D. F. 2015; 21 (3): 239-251

  View details for DOI 10.1037/law0000043

  View details for Web of Science ID 000369824200002

• DOES LEVEL OF INTIMATE PARTNER VIOLENCE AND ABUSE PREDICT THE CONTENT OF FAMILY MEDIATION AGREEMENTS? FAMILY COURT REVIEW Rossi, F. S., Holtzworth-Munroe, A., Applegate, A. G. 2015; 53 (1): 134-161

  View details for DOI 10.1111/fcre.12135

  View details for Web of Science ID 000212241400009

• Mediator's Assessment of Safety Issues and Concerns (MASIC): Reliability and Validity of a New Intimate Partner Violence Screen ASSESSMENT Pokman, V., Rossi, F. S., Holtzworth-Munroe, A., Applegate, A. G., Beck, C. A., D'Onofrio, B. M. 2014; 21 (5): 529-542

  Abstract

  We investigated reliability and validity of the Mediator's Assessment of Safety Issues and Concerns (MASIC), a screening interview for intimate partner violence and abuse (IPV/A) in family mediation settings. Clients at three family mediation clinics in the United States and Australia (N = 391) provided reports of the other parent's IPV/A. Internal consistency of the total screen was excellent. A confirmatory factor analysis provided evidence that the MASIC assesses seven types of IPV/A: psychological abuse, coercive controlling behaviors, threats of severe violence, physical violence, severe physical violence, sexual violence, and stalking. Sex differences on differing types of violence victimization were generally consistent with previous research. Higher levels of victimization predicted self-reported consequences of abuse (e.g., fear, injuries). More abusive parties, as identified by their partners on the MASIC, had more Protective Orders and No Contact Orders and criminal convictions and crimes potentially related to IPV/A. Results provide initial evidence of the reliability and validity of the MASIC but more research is needed.

  View details for DOI 10.1177/1073191114528372

  View details for Web of Science ID 000342751400002

  View details for PubMedID 24671737

• Intimate Partner Violence and Parenting Arrangements In Parenting Plan Evaluations: Applied Research for the Family Court Tomlinson, C. S., Huber, H., Jiang, L. J., Rossi, F. S., Rudd, B. N., Holtzworth-Munroe, A. 0000; 3