Laurel A Copeland
Biographic Data
| ID | 2147935 |
|---|---|
| NAME | Laurel A Copeland |
| GIVEN NAMES | Laurel A |
| FAMILY NAME | Copeland |
| SIGNATURE | COPELAND L A |
| AFFILIATIONS | VA Central Western Massachusetts Healthcare System |
| ORCID | 0000-0002-9478-0209 |
| VERIFIED | Yes |
| TOTAL WORKS | 27 |
| TOTAL CITATIONS | 43 |
| AUTHOR COUNT | 27 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1997 |
| LATEST PUBLICATION YEAR | 2022 |
| H-INDEX | 4 |
Emergence of probable PTSD among U.S. veterans over the military-to-civilian transition
This study illustrates the need for ongoing social support for veterans coping with symptoms of PTSD, life stressors, and postmilitary trauma, suggesting a countervailing influence of psychological resilience and contemporaneous (but not historical) social support on symptom exacerbation. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
The transition to civilian life: Impact of comorbid PTSD, chronic pain, and sleep disturbance on veterans’ social functioning and suicidal ideation
Although these findings underscore the impact of PTSD on functioning and SI, they also highlight the complexity of multimorbidity and the importance of bolstering social functioning for veterans. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
Adopting a Companion Dog Helps Veterans with Posttraumatic Stress Disorder in a Pilot Randomized Trial
Despite significant treatment advances, many military veterans continue to suffer from posttraumatic stress disorder ( PTSD ) and associated symptoms, suggesting a need for new interventions. This pilot trial examined the change in psychological symptoms of 19 veterans in treatment for PTSD who were randomized either to adopt a dog immediately from a Humane Society shelter ( n = 9) or to a three-month waitlist followed by dog adoption ( n = 10). …
Changes in the health and broader well-being of U.S. veterans in the first three years after leaving military service: Overall trends and group differences
The interaction of exposure to adverse childhood and combat experiences on the current mental health of new post‐9/11 veterans
Military veterans have greater exposure to adverse childhood experiences (ACEs) than civilians and many also encounter warfare exposures, which can increase the likelihood of mental health problems. The purpose of this study was to test an interaction between childhood traumas and warfare exposures on the mental health of a sample of nearly 10,000 new post‐9/11 veterans. Results revealed that male veterans exposed to one or two ACEs, but no warfa…
Prenatal Stress Exposure and Post-traumatic Stress Disorder Associated With Risk of Postpartum Alcohol Misuse Among Women Veterans
Psychosocial Determinants of Readmission After Surgery
BACKGROUND: Quality of life and psychosocial determinants of health, such as health literacy and social support, are associated with increased health care utilization and adverse outcomes in medical populations. However, the effect on surgical health care utilization is less understood. OBJECTIVE: We sought to examine the effect of patient-reported quality of life and psychosocial determinants of health on unplanned hospital readmissions in a sur…
Racial Differences in the Cesarean Section Rates Among Women Veterans Using Department of Veterans Affairs Community Care
BACKGROUND: Racial disparities in maternal morbidity and mortality remain a pressing public health problem. Variations in cesarean section (C-section) rates among racial and ethnic groups have been well documented, though reasons for these variations remain unknown. In the Department of Veterans Affairs (VA), nearly half of all women Veterans are of reproductive age and >40% of these women are racial and ethnic minorities. Because the VA does not…
The impact of adverse childhood experiences (ACEs) and combat exposure on mental health conditions among new post-9/11 veterans
This study confirms prior studies demonstrating a relationship between ACEs and combat on subsequent mental health problems. Importantly, 2 different types of combat exposure had differential effects on mental health problems. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Veterans’ Use of Programs and Services as They Transition to Civilian Life: Baseline Assessment for the Veteran Metrics Initiative
A substantial minority of veterans struggle as they reintegrate into civilian life, reporting problems with vocational attainment, legal/financial/housing challenges, physical and mental health conditions, and social/interpersonal issues. While there are thousands of programs and services offered to veterans, little is known about which ones they use. In the current exploratory study, veterans separated from active duty in the prior three-months …
Going It Alone: Post-9/11 Veteran Nonuse of Healthcare and Social Service Programs During Their Early Transition to Civilian Life
Transitioning from military to civilian life is challenging for a substantial number of veterans. Successful transitions require veterans to function well in various well-being domains including employment, education, financial, health, and social relationships. There are many programs and services designed to assist veterans transition to civilian life. However, veterans rarely avail themselves of supportive resources. This study examined vetera…
Homeless Status, Postdischarge Health Care Utilization, and Readmission After Surgery
INTRODUCTION: Homeless Veterans are vulnerable to poor care transitions, yet little research has examined their risk of readmission following inpatient surgery. This study investigates the predictors of surgical readmission among homeless relative to housed Veteran patients. METHODS: Inpatient general, vascular, and orthopedic surgeries occurring in the Veterans Health Administration from 2008 to 2014 were identified. Administrative International…
Near Real-time Surveillance for Consequences of Health Policies Using Sequential Analysis
BACKGROUND: New health policies may have intended and unintended consequences. Active surveillance of population-level data may provide initial signals of policy effects for further rigorous evaluation soon after policy implementation. OBJECTIVE: This study evaluated the utility of sequential analysis for prospectively assessing signals of health policy impacts. As a policy example, we studied the consequences of the widely publicized Food and Dr…
Comorbidity Correlates of Death Among New Veterans of Iraq and Afghanistan Deployment
BACKGROUND: Veterans of the wars in Iraq and Afghanistan who receive care in the Veterans Health Administration (VA) have high disease burden. Distinct comorbidity patterns have been shown to be differentially associated with adverse outcomes, including death. This study determined correlates of 5-year mortality. MATERIALS AND METHODS: VA demographic, military, homelessness, and clinical measures informed this retrospective analysis. Previously c…
Mental health treatment after major surgery among Vietnam-era Veterans with posttraumatic stress disorder
The purpose of this study was to examine mental health treatment use among Vietnam Veterans with posttraumatic stress disorder and determine whether undergoing major surgery interrupted mental health treatment or increased the risk of psychiatric hospitalization. Using retrospective data from Veterans Health Administration's electronic medical record system, a total of 3320 Vietnam-era surgery patients with preoperative posttraumatic stress disor…
Association of parental status and diagnosis of posttraumatic stress disorder among veterans of Operations Iraqi and Enduring Freedom
Research indicates that concerns about disruption of family relationships during military service may be associated with greater posttraumatic stress symptomatology. The current study sought to extend previous findings by examining the relative odds of a posttraumatic stress disorder (PTSD) diagnosis among Operations Enduring and Iraqi Freedom (OEF/OIF) veterans with dependent children versus veterans without dependent children. Administrative da…
Racial/Ethnic Differences in Health Care Visits Made Before Suicide Attempt Across the United States
BACKGROUND: Suicide is a public health concern, but little is known about the patterns of health care visits made before a suicide attempt, and whether those patterns differ by race/ethnicity. OBJECTIVES: To examine racial/ethnic variation in the types of health care visits made before a suicide attempt, when those visits occur, and whether mental health or substance use diagnoses were documented. RESEARCH DESIGN: Retrospective, longitudinal stud…
Prevalence of Suicidality Among Hispanic and African American Veterans Following Surgery
Objectives. We evaluated factors associated with suicidal behavior and ideation (SBI) during 3 years of follow-up among 89 995 Veterans Health Administration (VHA) patients who underwent major surgery from October 2005 to September 2006. Methods. We analyzed administrative data using Cox proportional hazards models. SBI was ascertained by International Classification of Disease, 9th Revision codes. Results. African Americans (18% of sample; 16 25…
Complex Comorbidity Clusters in OEF/OIF Veterans: The Polytrauma Clinical Triad and Beyond
BACKGROUND: A growing body of research on US Veterans from Afghanistan and Iraq [Operations Enduring and Iraqi Freedom, and Operation New Dawn (OEF/OIF)] has described the polytrauma clinical triad (PCT): traumatic brain injury (TBI), posttraumatic stress disorder (PTSD), and pain. Extant research has not explored comorbidity clusters in this population more broadly, particularly co-occurring chronic diseases. OBJECTIVES: The aim of the study was…
Perceived Access to General Medical and Psychiatric Care Among Veterans With Bipolar Disorder
Objectives. We examined associations between patient characteristics and self-reported difficulties in accessing mental health and general medical care services. Methods. Patients were recruited from the Continuous Improvement for Veterans in Care–Mood Disorders study. We used multivariable logistic regression analyses to assess whether predisposing (demographic characteristics), enabling (e.g., homelessness), or need (bipolar symptoms, substance…
Clinical and Demographic Factors Associated With Homelessness and Incarceration Among VA Patients With Bipolar Disorder
Objectives. We assessed the association between homelessness and incarceration in Veterans Affairs patients with bipolar disorder. Methods. We used logistic regression to model each participant's risk of incarceration or homelessness after we controlled for known risk factors. Results. Of 435 participants, 12% reported recent homelessness (within the past month), and 55% reported lifetime homelessness. Recent and lifetime incarceration rates were…
Likelihood of Home Death Associated With Local Rates of Home Birth: Influence of Local Area Healthcare Preferences on Site of Death
Objectives. We tested whether local cultural and social values regarding the use of health care are associated with the likelihood of home death, using variation in local rates of home births as a proxy for geographic variation in these values. Methods. For each of 351110 adult decedents in Washington state who died from 1989 through 1998, we calculated the home birth rate in each zip code during the year of death and then used multivariate regre…
Unforeseen Inpatient Mortality Among Veterans With Schizophrenia
BACKGROUND: Patients with schizophrenia have co-occurring medical conditions, like other patients, but may lack the capacity to provide good self-care or to work with their providers to ensure appropriate medical treatment. We hypothesized that death among patients with schizophrenia occurs more frequently after minimal care of comorbid conditions. METHODS: All patients who died in veterans affairs (VA) hospitals during FY02 were categorized as t…
Pharmacy Data Identify Poorly Adherent Patients With Schizophrenia at Increased Risk for Admission
BACKGROUND: Health care organizations may be able to use pharmacy data to identify patients with schizophrenia and poor antipsychotic adherence. OBJECTIVE: To determine whether a pharmacy-based measure of outpatient adherence, the medication possession ratio (MPR), is associated with adverse outcomes among patients with schizophrenia, as evidenced by increased psychiatric admission. RESEARCH DESIGN: Cohort study linking pharmacy and utilization d…
Health care costs of seriously mentally ill patients enrolled in enhanced treatment
Patients with psychosis (N = 866) were recruited into enhanced or standard Veterans Administration (VA) treatment. Enhanced programs, previously shown to be more effective, were less costly than VA standard care. Adjusted costs fell from $32,000-$55,000 (for the 1st year) to $20,000-$36,000 (for the 4th year). Costs were associated positively with schizophrenia, living in the Northeast region of the United States, and poorer baseline functioning
A Longitudinal Study of Self-Esteem: Implications for Adolescent Development
Clinical and Demographic Factors Associated With Homelessness and Incarceration Among VA Patients With Bipolar Disorder
Objectives. We assessed the association between homelessness and incarceration in Veterans Affairs patients with bipolar disorder. Methods. We used logistic regression to model each participant's risk of incarceration or homelessness after we controlled for known risk factors. Results. Of 435 participants, 12% reported recent homelessness (within the past month), and 55% reported lifetime homelessness. Recent and lifetime incarceration rates were…
Veterans’ Use of Programs and Services as They Transition to Civilian Life: Baseline Assessment for the Veteran Metrics Initiative
A substantial minority of veterans struggle as they reintegrate into civilian life, reporting problems with vocational attainment, legal/financial/housing challenges, physical and mental health conditions, and social/interpersonal issues. While there are thousands of programs and services offered to veterans, little is known about which ones they use. In the current exploratory study, veterans separated from active duty in the prior three-months …
Changes in the health and broader well-being of U.S. veterans in the first three years after leaving military service: Overall trends and group differences
Perceived Access to General Medical and Psychiatric Care Among Veterans With Bipolar Disorder
Objectives. We examined associations between patient characteristics and self-reported difficulties in accessing mental health and general medical care services. Methods. Patients were recruited from the Continuous Improvement for Veterans in Care–Mood Disorders study. We used multivariable logistic regression analyses to assess whether predisposing (demographic characteristics), enabling (e.g., homelessness), or need (bipolar symptoms, substance…
Going It Alone: Post-9/11 Veteran Nonuse of Healthcare and Social Service Programs During Their Early Transition to Civilian Life
Transitioning from military to civilian life is challenging for a substantial number of veterans. Successful transitions require veterans to function well in various well-being domains including employment, education, financial, health, and social relationships. There are many programs and services designed to assist veterans transition to civilian life. However, veterans rarely avail themselves of supportive resources. This study examined vetera…
The interaction of exposure to adverse childhood and combat experiences on the current mental health of new post‐9/11 veterans
Military veterans have greater exposure to adverse childhood experiences (ACEs) than civilians and many also encounter warfare exposures, which can increase the likelihood of mental health problems. The purpose of this study was to test an interaction between childhood traumas and warfare exposures on the mental health of a sample of nearly 10,000 new post‐9/11 veterans. Results revealed that male veterans exposed to one or two ACEs, but no warfa…
Prevalence of Suicidality Among Hispanic and African American Veterans Following Surgery
Objectives. We evaluated factors associated with suicidal behavior and ideation (SBI) during 3 years of follow-up among 89 995 Veterans Health Administration (VHA) patients who underwent major surgery from October 2005 to September 2006. Methods. We analyzed administrative data using Cox proportional hazards models. SBI was ascertained by International Classification of Disease, 9th Revision codes. Results. African Americans (18% of sample; 16 25…
A Longitudinal Study of Self-Esteem: Implications for Adolescent Development
Effectiveness of specialized treatment programs for veterans with serious and persistent mental illness: A three-year follow-up
This is the first study to test concurrently the effectiveness of four treatment programs for patients with serious mental illness. Three-year outcome data on utilization and functioning demonstrated important positive changes for seriously mentally ill veterans enrolled in specialized, enhanced inpatient and community case management treatment programs, when compared to patients in an enhanced day treatment program or traditional standard care
Pharmacy Data Identify Poorly Adherent Patients With Schizophrenia at Increased Risk for Admission
BACKGROUND: Health care organizations may be able to use pharmacy data to identify patients with schizophrenia and poor antipsychotic adherence. OBJECTIVE: To determine whether a pharmacy-based measure of outpatient adherence, the medication possession ratio (MPR), is associated with adverse outcomes among patients with schizophrenia, as evidenced by increased psychiatric admission. RESEARCH DESIGN: Cohort study linking pharmacy and utilization d…
Health care costs of seriously mentally ill patients enrolled in enhanced treatment
Patients with psychosis (N = 866) were recruited into enhanced or standard Veterans Administration (VA) treatment. Enhanced programs, previously shown to be more effective, were less costly than VA standard care. Adjusted costs fell from $32,000-$55,000 (for the 1st year) to $20,000-$36,000 (for the 4th year). Costs were associated positively with schizophrenia, living in the Northeast region of the United States, and poorer baseline functioning
Likelihood of Home Death Associated With Local Rates of Home Birth: Influence of Local Area Healthcare Preferences on Site of Death
Objectives. We tested whether local cultural and social values regarding the use of health care are associated with the likelihood of home death, using variation in local rates of home births as a proxy for geographic variation in these values. Methods. For each of 351110 adult decedents in Washington state who died from 1989 through 1998, we calculated the home birth rate in each zip code during the year of death and then used multivariate regre…
Unforeseen Inpatient Mortality Among Veterans With Schizophrenia
BACKGROUND: Patients with schizophrenia have co-occurring medical conditions, like other patients, but may lack the capacity to provide good self-care or to work with their providers to ensure appropriate medical treatment. We hypothesized that death among patients with schizophrenia occurs more frequently after minimal care of comorbid conditions. METHODS: All patients who died in veterans affairs (VA) hospitals during FY02 were categorized as t…
Perceived Access to General Medical and Psychiatric Care Among Veterans With Bipolar Disorder
Objectives. We examined associations between patient characteristics and self-reported difficulties in accessing mental health and general medical care services. Methods. Patients were recruited from the Continuous Improvement for Veterans in Care–Mood Disorders study. We used multivariable logistic regression analyses to assess whether predisposing (demographic characteristics), enabling (e.g., homelessness), or need (bipolar symptoms, substance…
Clinical and Demographic Factors Associated With Homelessness and Incarceration Among VA Patients With Bipolar Disorder
Objectives. We assessed the association between homelessness and incarceration in Veterans Affairs patients with bipolar disorder. Methods. We used logistic regression to model each participant's risk of incarceration or homelessness after we controlled for known risk factors. Results. Of 435 participants, 12% reported recent homelessness (within the past month), and 55% reported lifetime homelessness. Recent and lifetime incarceration rates were…
Prevalence of Suicidality Among Hispanic and African American Veterans Following Surgery
Objectives. We evaluated factors associated with suicidal behavior and ideation (SBI) during 3 years of follow-up among 89 995 Veterans Health Administration (VHA) patients who underwent major surgery from October 2005 to September 2006. Methods. We analyzed administrative data using Cox proportional hazards models. SBI was ascertained by International Classification of Disease, 9th Revision codes. Results. African Americans (18% of sample; 16 25…
Complex Comorbidity Clusters in OEF/OIF Veterans: The Polytrauma Clinical Triad and Beyond
BACKGROUND: A growing body of research on US Veterans from Afghanistan and Iraq [Operations Enduring and Iraqi Freedom, and Operation New Dawn (OEF/OIF)] has described the polytrauma clinical triad (PCT): traumatic brain injury (TBI), posttraumatic stress disorder (PTSD), and pain. Extant research has not explored comorbidity clusters in this population more broadly, particularly co-occurring chronic diseases. OBJECTIVES: The aim of the study was…
Association of parental status and diagnosis of posttraumatic stress disorder among veterans of Operations Iraqi and Enduring Freedom
Research indicates that concerns about disruption of family relationships during military service may be associated with greater posttraumatic stress symptomatology. The current study sought to extend previous findings by examining the relative odds of a posttraumatic stress disorder (PTSD) diagnosis among Operations Enduring and Iraqi Freedom (OEF/OIF) veterans with dependent children versus veterans without dependent children. Administrative da…
Racial/Ethnic Differences in Health Care Visits Made Before Suicide Attempt Across the United States
BACKGROUND: Suicide is a public health concern, but little is known about the patterns of health care visits made before a suicide attempt, and whether those patterns differ by race/ethnicity. OBJECTIVES: To examine racial/ethnic variation in the types of health care visits made before a suicide attempt, when those visits occur, and whether mental health or substance use diagnoses were documented. RESEARCH DESIGN: Retrospective, longitudinal stud…
Comorbidity Correlates of Death Among New Veterans of Iraq and Afghanistan Deployment
BACKGROUND: Veterans of the wars in Iraq and Afghanistan who receive care in the Veterans Health Administration (VA) have high disease burden. Distinct comorbidity patterns have been shown to be differentially associated with adverse outcomes, including death. This study determined correlates of 5-year mortality. MATERIALS AND METHODS: VA demographic, military, homelessness, and clinical measures informed this retrospective analysis. Previously c…
Mental health treatment after major surgery among Vietnam-era Veterans with posttraumatic stress disorder
The purpose of this study was to examine mental health treatment use among Vietnam Veterans with posttraumatic stress disorder and determine whether undergoing major surgery interrupted mental health treatment or increased the risk of psychiatric hospitalization. Using retrospective data from Veterans Health Administration's electronic medical record system, a total of 3320 Vietnam-era surgery patients with preoperative posttraumatic stress disor…
Homeless Status, Postdischarge Health Care Utilization, and Readmission After Surgery
INTRODUCTION: Homeless Veterans are vulnerable to poor care transitions, yet little research has examined their risk of readmission following inpatient surgery. This study investigates the predictors of surgical readmission among homeless relative to housed Veteran patients. METHODS: Inpatient general, vascular, and orthopedic surgeries occurring in the Veterans Health Administration from 2008 to 2014 were identified. Administrative International…
Near Real-time Surveillance for Consequences of Health Policies Using Sequential Analysis
BACKGROUND: New health policies may have intended and unintended consequences. Active surveillance of population-level data may provide initial signals of policy effects for further rigorous evaluation soon after policy implementation. OBJECTIVE: This study evaluated the utility of sequential analysis for prospectively assessing signals of health policy impacts. As a policy example, we studied the consequences of the widely publicized Food and Dr…
Going It Alone: Post-9/11 Veteran Nonuse of Healthcare and Social Service Programs During Their Early Transition to Civilian Life
Transitioning from military to civilian life is challenging for a substantial number of veterans. Successful transitions require veterans to function well in various well-being domains including employment, education, financial, health, and social relationships. There are many programs and services designed to assist veterans transition to civilian life. However, veterans rarely avail themselves of supportive resources. This study examined vetera…
The impact of adverse childhood experiences (ACEs) and combat exposure on mental health conditions among new post-9/11 veterans
This study confirms prior studies demonstrating a relationship between ACEs and combat on subsequent mental health problems. Importantly, 2 different types of combat exposure had differential effects on mental health problems. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Veterans’ Use of Programs and Services as They Transition to Civilian Life: Baseline Assessment for the Veteran Metrics Initiative
A substantial minority of veterans struggle as they reintegrate into civilian life, reporting problems with vocational attainment, legal/financial/housing challenges, physical and mental health conditions, and social/interpersonal issues. While there are thousands of programs and services offered to veterans, little is known about which ones they use. In the current exploratory study, veterans separated from active duty in the prior three-months …
Prenatal Stress Exposure and Post-traumatic Stress Disorder Associated With Risk of Postpartum Alcohol Misuse Among Women Veterans
Psychosocial Determinants of Readmission After Surgery
BACKGROUND: Quality of life and psychosocial determinants of health, such as health literacy and social support, are associated with increased health care utilization and adverse outcomes in medical populations. However, the effect on surgical health care utilization is less understood. OBJECTIVE: We sought to examine the effect of patient-reported quality of life and psychosocial determinants of health on unplanned hospital readmissions in a sur…
Racial Differences in the Cesarean Section Rates Among Women Veterans Using Department of Veterans Affairs Community Care
BACKGROUND: Racial disparities in maternal morbidity and mortality remain a pressing public health problem. Variations in cesarean section (C-section) rates among racial and ethnic groups have been well documented, though reasons for these variations remain unknown. In the Department of Veterans Affairs (VA), nearly half of all women Veterans are of reproductive age and >40% of these women are racial and ethnic minorities. Because the VA does not…
Emergence of probable PTSD among U.S. veterans over the military-to-civilian transition
This study illustrates the need for ongoing social support for veterans coping with symptoms of PTSD, life stressors, and postmilitary trauma, suggesting a countervailing influence of psychological resilience and contemporaneous (but not historical) social support on symptom exacerbation. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
The transition to civilian life: Impact of comorbid PTSD, chronic pain, and sleep disturbance on veterans’ social functioning and suicidal ideation
Although these findings underscore the impact of PTSD on functioning and SI, they also highlight the complexity of multimorbidity and the importance of bolstering social functioning for veterans. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
Adopting a Companion Dog Helps Veterans with Posttraumatic Stress Disorder in a Pilot Randomized Trial
Despite significant treatment advances, many military veterans continue to suffer from posttraumatic stress disorder ( PTSD ) and associated symptoms, suggesting a need for new interventions. This pilot trial examined the change in psychological symptoms of 19 veterans in treatment for PTSD who were randomized either to adopt a dog immediately from a Humane Society shelter ( n = 9) or to a three-month waitlist followed by dog adoption ( n = 10). …
Medicine (26 works) · Psychiatry (21 works) · Psychology (13 works) · Mental health (10 works) · Posttraumatic Stress Disorder Research (10 works) · Veterans Affairs (9 works) · Gerontology (8 works) · Health care (8 works) · Environmental health (7 works) · Clinical Psychology (6 works)