Treating Anxiety in Public Sector Medical Settings

Summary

Principal Investigator: Peter P Roy-Byrne
Affiliation: University of Washington
Country: USA
Abstract: [unreadable] DESCRIPTION (provided by candidate): This is a mid-career investigator award in patient-oriented research that is designed to strengthen my research and further the development and growth of young investigators in the application of evidence based treatments, especially for anxiety disorders, in public sector medical settings. Poor and medically disadvantaged populations are clearly underrepresented in research studies, especially in treatment studies. We clearly need more clinical investigators to work in these settings and with these populations. There also is a need for public sector research infrastructures that will support state-of-the-art research. Finally, given the deficiencies in quality of care for anxiety disorders in most medical settings, but especially the public sector, we need to know how to best tailor and deliver evidence-based treatments. My three goals for this Mid-Career Investigator Award in Patient-Oriented Research (K24) are therefore (1) to crystallize a new career research focus in translational research that would increase the relevance, speed the development, and facilitate the utilization of research-focused treatments and services interventions for anxiety disorders in the public sector medical setting; (2) to create a practice infrastructure that supports state-of-the-art research on the application of evidence based treatments in public sector medical settings; (3) to mentor junior investigators interested in research on the application of evidence-based treatments in the public sector. My broad background in clinical research will allow me to relate to the developing clinician-scientist across multiple levels of research interest and to steer them toward the field of services research. As my skills in this latter area evolve over the course of this award, I hope to be able to mentor them even more effectively in this specific area as well.
Funding Period: 2002-12-01 - 2008-08-30
more information: NIH RePORT

Top Publications

  1. pmc Perceived social support mediates anxiety and depressive symptom changes following primary care intervention
    Halina J Dour
    Department of Psychology, University of California, Los Angeles, California
    Depress Anxiety 31:436-42. 2014
  2. pmc Incremental benefits and cost of coordinated anxiety learning and management for anxiety treatment in primary care
    J M Joesch
    Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine and Harborview Center for Healthcare Improvement for Addictions, Mental Illness, and Medically Vulnerable Populations CHAMMP, Seattle, WA 98104 2499, USA
    Psychol Med 42:1937-48. 2012
  3. pmc Diagnostic overlap of generalized anxiety disorder and major depressive disorder in a primary care sample
    Tomislav D Zbozinek
    Department of Psychology, University of California, Los Angeles, CA 90095, USA
    Depress Anxiety 29:1065-71. 2012
  4. pmc Anxiety treatment improves physical functioning with oblique scoring of the SF-12 short form health survey
    Andrea N Niles
    Department of Psychology, University of California, Los Angeles, CA, USA
    Gen Hosp Psychiatry 35:291-6. 2013
  5. pmc Effects of pain and prescription opioid use on outcomes in a collaborative care intervention for anxiety
    Peter Roy-Byrne
    Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98104, USA
    Clin J Pain 29:800-6. 2013
  6. pmc Does a quality improvement intervention for anxiety result in differential outcomes for lower-income patients?
    Greer Sullivan
    Department of Veterans Affairs South Central Mental Illness Research, Education, and Clinical Center, North Little Rock, AR, USA
    Am J Psychiatry 170:218-25. 2013
  7. pmc Race and beliefs about mental health treatment among anxious primary care patients
    Justin Hunt
    University of Arkansas for Medical Sciences, Psychiatric Research Institute, Little Rock, AR 72205, USA
    J Nerv Ment Dis 201:188-95. 2013
  8. pmc Age differences in treatment response to a collaborative care intervention for anxiety disorders
    Julie Loebach Wetherell
    Department of Psychiatry, 9500 Gilman Drive, Dept 9111N 1, La Jolla, CA 92093 9111, USA
    Br J Psychiatry 203:65-72. 2013
  9. pmc Suicidal ideation and risk factors in primary care patients with anxiety disorders
    Jessica Bomyea
    SDSU UCSD Joint Doctoral Program in Clinical Psychology, San Diego, CA 92037, USA
    Psychiatry Res 209:60-5. 2013
  10. pmc Who gets the most out of cognitive behavioral therapy for anxiety disorders? The role of treatment dose and patient engagement
    Daniel Glenn
    Department of Psychology, University of California, Los Angeles, CA 90095 1563, USA
    J Consult Clin Psychol 81:639-49. 2013

Scientific Experts

  • Peter P Roy-Byrne
  • Michelle Craske
  • Paul Holtzheimer
  • Raphael D Rose
  • C D Sherbourne
  • M B Stein
  • A J Lang
  • D A Chavira
  • Laura Campbell-Sills
  • Joanna J Arch
  • W Katon
  • Greer Sullivan
  • Alexander Bystritsky
  • Daniela Golinelli
  • Adrienne J Means-Christensen
  • Trevor J Schraufnagel
  • Halina J Dour
  • Justin Hunt
  • Jutta M Joesch
  • Daniel Glenn
  • Jessica Bomyea
  • Andrea N Niles
  • Julie Loebach Wetherell
  • J M Joesch
  • Tomislav D Zbozinek
  • Meg Cristofalo
  • Snigdha Mukherjee
  • Joshua F Wiley
  • Daniela Gollineli
  • Andrew J Petkus
  • Steven R Thorp
  • Stacy S Welch
  • Alexander Bystritksy
  • Xiaotong Han
  • G Sullivan
  • Kate B Wolitzky-Taylor
  • Doug Zatzick
  • Doris Boutain
  • Kristin Bumgardner
  • Mark J Edlund
  • Dana Perry
  • Jeanne Miranda
  • Trevor Schraufnagel
  • Bobby Verdugo
  • Amy W Wagner
  • David C Dugdale
  • Adrienne Means-Christensen
  • Jennifer Wu
  • Daniel Lessler
  • Martin C Schulman

Detail Information

Publications41

  1. pmc Perceived social support mediates anxiety and depressive symptom changes following primary care intervention
    Halina J Dour
    Department of Psychology, University of California, Los Angeles, California
    Depress Anxiety 31:436-42. 2014
    ..The current study tested whether perceived social support serves as a mediator of anxiety and depressive symptom change following evidence-based anxiety treatment in the primary care setting. Gender, age, and race were tested as moderators...
  2. pmc Incremental benefits and cost of coordinated anxiety learning and management for anxiety treatment in primary care
    J M Joesch
    Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine and Harborview Center for Healthcare Improvement for Addictions, Mental Illness, and Medically Vulnerable Populations CHAMMP, Seattle, WA 98104 2499, USA
    Psychol Med 42:1937-48. 2012
    ..This study describes incremental benefits, costs and net benefits of CALM versus usual care (UC)...
  3. pmc Diagnostic overlap of generalized anxiety disorder and major depressive disorder in a primary care sample
    Tomislav D Zbozinek
    Department of Psychology, University of California, Los Angeles, CA 90095, USA
    Depress Anxiety 29:1065-71. 2012
    ..The present study addressed the symptom overlap of people meeting DSM-IV-TR diagnostic criteria for GAD, MDD, or both to investigate whether comorbidity might be explained by overlapping diagnostic criteria...
  4. pmc Anxiety treatment improves physical functioning with oblique scoring of the SF-12 short form health survey
    Andrea N Niles
    Department of Psychology, University of California, Los Angeles, CA, USA
    Gen Hosp Psychiatry 35:291-6. 2013
    ..Replication was tested in reanalysis of data from the earlier Collaborative Care for Anxiety and Panic (CCAP) randomized clinical trial for the treatment of panic disorder...
  5. pmc Effects of pain and prescription opioid use on outcomes in a collaborative care intervention for anxiety
    Peter Roy-Byrne
    Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98104, USA
    Clin J Pain 29:800-6. 2013
    ....
  6. pmc Does a quality improvement intervention for anxiety result in differential outcomes for lower-income patients?
    Greer Sullivan
    Department of Veterans Affairs South Central Mental Illness Research, Education, and Clinical Center, North Little Rock, AR, USA
    Am J Psychiatry 170:218-25. 2013
    ..An alternative hypothesis was that lower-income participants would improve at a higher rate because the intervention facilitates access to evidence-based treatment, which typically is less available to persons with lower incomes...
  7. pmc Race and beliefs about mental health treatment among anxious primary care patients
    Justin Hunt
    University of Arkansas for Medical Sciences, Psychiatric Research Institute, Little Rock, AR 72205, USA
    J Nerv Ment Dis 201:188-95. 2013
    ..Other crucial barriers to quality care exist in our health care system and our society as a whole...
  8. pmc Age differences in treatment response to a collaborative care intervention for anxiety disorders
    Julie Loebach Wetherell
    Department of Psychiatry, 9500 Gilman Drive, Dept 9111N 1, La Jolla, CA 92093 9111, USA
    Br J Psychiatry 203:65-72. 2013
    ..Some data suggest that older adults with anxiety disorders do not respond as well to treatment as do younger adults...
  9. pmc Suicidal ideation and risk factors in primary care patients with anxiety disorders
    Jessica Bomyea
    SDSU UCSD Joint Doctoral Program in Clinical Psychology, San Diego, CA 92037, USA
    Psychiatry Res 209:60-5. 2013
    ..Results highlight the complex determinants of suicidal behavior and the need for more nuanced suicide assessment in this population, including evaluation of comorbidity and general functioning. ..
  10. pmc Who gets the most out of cognitive behavioral therapy for anxiety disorders? The role of treatment dose and patient engagement
    Daniel Glenn
    Department of Psychology, University of California, Los Angeles, CA 90095 1563, USA
    J Consult Clin Psychol 81:639-49. 2013
    ..The present study explored treatment dose and patient engagement as predictors of treatment outcome in cognitive behavioral therapy (CBT) for anxiety disorders...
  11. pmc Trajectories of change in anxiety severity and impairment during and after treatment with evidence-based treatment for multiple anxiety disorders in primary care
    Jutta M Joesch
    Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine and Harborview Center for Healthcare Improvement for Addictions, Mental Illness, and Medically Vulnerable Populations CHAMMP, Seattle, Washington
    Depress Anxiety 30:1099-106. 2013
    ..This study aimed to identify (1) clusters of participants with similar patterns of change in anxiety severity and impairment (trajectory groups); and (2) characteristics that predict trajectory group membership...
  12. pmc Design of the Coordinated Anxiety Learning and Management (CALM) study: innovations in collaborative care for anxiety disorders
    Greer Sullivan
    South Central VA Mental Illness Research Education and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, AR 72214 1706, USA
    Gen Hosp Psychiatry 29:379-87. 2007
    ..Since anxiety disorders are most often treated in primary care, quality improvement interventions, such as the Coordinated Anxiety Learning and Management (CALM) intervention, are needed in primary care...
  13. pmc Functioning and disability levels in primary care out-patients with one or more anxiety disorders
    C D Sherbourne
    Health Program, RAND Corporation, Santa Monica, CA 90407 2138, USA
    Psychol Med 40:2059-68. 2010
    ..This study compared the functional impact of combinations of anxiety disorders in primary care out-patients...
  14. pmc Delivery of evidence-based treatment for multiple anxiety disorders in primary care: a randomized controlled trial
    Peter Roy-Byrne
    Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine and Harborview Center for Healthcare Improvement for Addictions, Mental Illness, and Medically Vulnerable Populations, Seattle, Washington 98104, USA
    JAMA 303:1921-8. 2010
    ..Although such advances have been made for depression, little work has been performed for anxiety disorders...
  15. pmc Quality of and patient satisfaction with primary health care for anxiety disorders
    Murray B Stein
    Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093 0855, USA
    J Clin Psychiatry 72:970-6. 2011
    ..Most patients with anxiety disorders receive their care from primary care practitioners (PCPs). The purpose of this study was to evaluate quality of and patient satisfaction with primary health care for anxiety disorders...
  16. pmc Utility of the Beck Depression Inventory to screen for and track depression in injection drug users seeking hepatitis C treatment
    Paul E Holtzheimer
    Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA
    Gen Hosp Psychiatry 32:426-32. 2010
    ..Effective screening strategies are needed to help non-psychiatric clinicians identify depressive disorders...
  17. pmc Disorder-specific impact of coordinated anxiety learning and management treatment for anxiety disorders in primary care
    Michelle G Craske
    Department of Psychology, University of California at Los Angeles, Los Angeles, CA 90095 1563, USA
    Arch Gen Psychiatry 68:378-88. 2011
    ..Anxiety disorders commonly present in primary care, where evidence-based mental health treatments often are unavailable or suboptimally delivered...
  18. pmc Training primary care staff to deliver a computer-assisted cognitive-behavioral therapy program for anxiety disorders
    Raphael D Rose
    Department of Psychology, University of California, Los Angeles, CA 90095 1563, USA
    Gen Hosp Psychiatry 33:336-42. 2011
    ..This paper describes the training approach used with primary care staff to deliver an evidence-based computer-assisted cognitive-behavioral therapy (CBT) program for anxiety disorders within a collaborative care treatment delivery model...
  19. pmc Abbreviated PTSD Checklist (PCL) as a guide to clinical response
    Ariel J Lang
    Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
    Gen Hosp Psychiatry 34:332-8. 2012
    ..The objective of this study was to evaluate two abbreviated versions of the PTSD Checklist (PCL), a self-report measure of posttraumatic stress disorder (PTSD) symptoms, as an index of change related to treatment...
  20. pmc Treatment for anxiety disorders: Efficacy to effectiveness to implementation
    Michelle G Craske
    University of California, Los Angeles, Department of Psychology, Franz Hall, 405 Hilgard Avenue, Los Angeles, CA 90095, USA
    Behav Res Ther 47:931-7. 2009
    ..Future directions for our research include dissemination and implementation of the CALM program, testing potential alternations to the CALM program, and distance delivery of CALM...
  21. ncbi Adherence to treatment among economically disadvantaged patients with panic disorder
    Snigdha Mukherjee
    South Central Mental Illness Research, Education and Clinical Center, North Little Rock, Arkansas, USA
    Psychiatr Serv 57:1745-50. 2006
    ..The purpose of this study was to examine the feelings of disadvantaged patients about and experiences of treatment for anxiety disorders in primary care settings...
  22. ncbi Paroxetine response and tolerability among ethnic minority patients with mood or anxiety disorders: a pooled analysis
    Peter P Roy-Byrne
    Department of Psychiatry and Behavioral Sciences, University of Washington at Harborview Medical Center, Seattle 98104, USA
    J Clin Psychiatry 66:1228-33. 2005
    ....
  23. pmc Predictors of clinical improvement in a randomized effectiveness trial for primary care patients with panic disorder
    Denise A Chavira
    Department of Psychiatry, University of California, San Diego, CA 92037, USA
    J Nerv Ment Dis 197:715-21. 2009
    ..A greater understanding of these predictors may help clinicians identify who is at greatest risk for persistent panic-related symptoms and to plan the intensity of interventions accordingly...
  24. doi Unmet need for mental health and addictions care in urban community health clinics: frontline provider accounts
    Meg Cristofalo
    Center for Healthcare Improvement for Addictions, Mental Illness and Medically Vulnerable Populations CHAMMP, Department of Psychiatry, University of Washington School of Medicine at Harborview Medical Center, Seattle, WA 98104 2499, USA
    Psychiatr Serv 60:505-11. 2009
    ....
  25. ncbi Use of herbal medicine in primary care patients with mood and anxiety disorders
    Peter P Roy-Byrne
    Department of Psychiatry and Behavioral Sciences, Harborview Medical Center, University of Washington School of Medicine, Box 359911, 325 9th Ave, Seattle, WA 98104, USA
    Psychosomatics 46:117-22. 2005
    ..Use was not associated with receipt of pharmacotherapy or psychotherapy for anxiety or depression...
  26. ncbi Medical illness and response to treatment in primary care panic disorder
    Peter Roy-Byrne
    Department of Psychiatry and Behavioral Science, University of Washington School of Medicine at Harborview Medical Center, WA 98104, USA
    Gen Hosp Psychiatry 27:237-43. 2005
    ..Although studies have suggested that comorbid medical illness can affect the outcome of patients with depression, little is known about whether medical illness comorbidity affects treatment outcome in patients with anxiety...
  27. ncbi Perceived unmet need for mental health treatment and barriers to care among patients with panic disorder
    Michelle G Craske
    University of California, Los Angeles, CA 90024 1563, USA
    Psychiatr Serv 56:988-94. 2005
    ..This study estimated the extent of perceived unmet need for mental health treatment among individuals with panic disorder in primary care settings, investigated the determinants of unmet need, and assessed barriers to care...
  28. ncbi Does the addition of cognitive behavioral therapy improve panic disorder treatment outcome relative to medication alone in the primary-care setting?
    Michelle G Craske
    Department of Psychology, University of California Los Angeles, 405 Holgard Avenue, Los Angeles, CA 90095, USA
    Psychol Med 35:1645-54. 2005
    ..Using an as-treated analysis, we evaluated whether the addition of CBT enhanced outcomes for panic disorder relative to medications alone in the primary-care setting...
  29. ncbi Functional impact and health utility of anxiety disorders in primary care outpatients
    Murray B Stein
    Department of Psychiatry, University of California San Diego, La Jolla, CA 92093 0985, USA
    Med Care 43:1164-70. 2005
    ..The objective of this study was to examine the relative impact of anxiety disorders and major depression on functional status and health-related quality of life of primary care outpatients...
  30. ncbi Treating minority patients with depression and anxiety: what does the evidence tell us?
    Trevor J Schraufnagel
    Department of Psychiatry and Behavioral Sciences, University of Washington, Harborview Medical Center, Seattle, 98104, USA
    Gen Hosp Psychiatry 28:27-36. 2006
    ..The purpose of this study is to examine the current state of knowledge regarding treating ethnic/racial minority patients with mood and anxiety disorders, emphasizing data-based studies whenever possible...
  31. ncbi Correlates of alcohol use among anxious and depressed primary care patients
    Joanna J Arch
    Department of Psychology, University of California, Los Angeles, 90095 1563, USA
    Gen Hosp Psychiatry 28:37-42. 2006
    ..The purpose of this study is to determine the patterns of alcohol use for primary care patients with anxiety disorders and/or major depression in three urban university-affiliated outpatient clinics...
  32. ncbi Incremental cost-effectiveness of a collaborative care intervention for panic disorder
    Wayne Katon
    Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, 98195 6560, USA
    Psychol Med 36:353-63. 2006
    ..This study describes the incremental cost-effectiveness of a combined cognitive behavioral therapy (CBT) and pharmacotherapy intervention for patients with panic disorder versus usual primary-care treatment...
  33. ncbi In search of mixed anxiety-depressive disorder: a primary care study
    Adrienne J Means-Christensen
    Department of Psychiatry, University of California, San Diego, California, USA
    Depress Anxiety 23:183-9. 2006
    ..These data dispute the need for a mixed anxiety-depression category (beyond mood and anxiety syndromes currently in DSM-IV) in future editions of the DSM...
  34. ncbi Using five questions to screen for five common mental disorders in primary care: diagnostic accuracy of the Anxiety and Depression Detector
    Adrienne J Means-Christensen
    Department of Psychiatry, University of California, San Diego, CA 92093 0985, USA
    Gen Hosp Psychiatry 28:108-18. 2006
    ..However, before patients in primary care can be treated, they must be identified. This study set out to validate a very brief screening instrument for identifying primary care patients with anxiety and depression...
  35. ncbi Poverty and response to treatment among panic disorder patients in primary care
    Peter Roy-Byrne
    Department of Psychiatry and Behavioral Science, University of Washington School of Medicine at Harborview Medical Center, 326 9th Ave, Seattle, WA 98104, USA
    Am J Psychiatry 163:1419-25. 2006
    ....
  36. ncbi CBT intensity and outcome for panic disorder in a primary care setting
    Michelle G Craske
    University of California, Los Angeles, Los Angeles, CA 90095 1563, USA
    Behav Ther 37:112-9. 2006
    ..The significance of follow-up booster phone contact is discussed as an index of continued self-management of panic and anxiety following acute treatment...
  37. ncbi Panic disorder
    Peter P Roy-Byrne
    Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine at Harborview Medical Center, Seattle, WA 98104 2499, USA
    Lancet 368:1023-32. 2006
    ..The adaptation and dissemination of these treatments to the frontlines of medical-care delivery should be urgent goals for the public-health community...
  38. ncbi Relationships among pain, anxiety, and depression in primary care
    Adrienne J Means-Christensen
    Department of Psychology, Radford University, Radford, Virginia, USA
    Depress Anxiety 25:593-600. 2008
    ..An awareness of these relationships may be particularly important in primary care settings where a patient who presents with reports of pain may have an undiagnosed anxiety or depressive disorder...
  39. pmc Validation of a brief measure of anxiety-related severity and impairment: the Overall Anxiety Severity and Impairment Scale (OASIS)
    Laura Campbell-Sills
    Department of Psychiatry, University of California, San Diego, La Jolla, CA 92093 0603, USA
    J Affect Disord 112:92-101. 2009
    ..A prior investigation with a nonclinical sample supported the reliability and validity of the OASIS; however, to date it has not been validated for use in clinical samples...
  40. pmc Computer-assisted delivery of cognitive behavioral therapy for anxiety disorders in primary-care settings
    Michelle G Craske
    Department of Psychology, University of California, Los Angeles, California, USA
    Depress Anxiety 26:235-42. 2009
    ..The purpose of the current report is to (1) present the structure and format of the computer-assisted CBT program, and (2) to present evidence for acceptance of the program by clinicians and the effectiveness of the program for patients...
  41. pmc A randomized effectiveness trial of cognitive-behavioral therapy and medication for primary care panic disorder
    Peter P Roy-Byrne
    Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine at Harborview Medical Center, Seattle, USA
    Arch Gen Psychiatry 62:290-8. 2005
    ..Although numerous studies have assessed the effectiveness of treatments for depression in primary care, few such studies have been conducted for panic disorder...