I am a clinical psychologist in the VA Ann Arbor Healthcare System and clinical assistant professor at the University of Michigan Department of Psychiatry. My clinical specialization is in the treatment of psychotic-based disorders and recovery-oriented approaches to care. Research interests include peripheral psychophysiological measures of attention and emotions, computer-based treatments, healthcare delivery, and peer-based interventions.
Using data from a sample of 398 veterans diagnosed with depression, the present study used princi... more Using data from a sample of 398 veterans diagnosed with depression, the present study used principal components analysis to shorten the Mental Health Recovery Measure (MHRM) to a 10-item instrument. Results indicated the 10-item MHRM had excellent internal reliability. Construct validity for the 10-item MHRM was evidenced by correlations with measures of depression coping self-efficacy, social adjustment, hopelessness, and depression. The 10-item MHRM derived in the present study was compared with a 10-item version of the MHRM that was previously empirically derived in a sample of veterans with schizophrenia (Armstrong, Cohen, Hellemann, Reist, & Young, 2014). Results suggest that similar items represent the underlying construct of recovery for veterans with depression and veterans with schizophrenia. Veterans with depression reported lower average levels of recovery than veterans with schizophrenia. Study limitations, directions for future investigations, and the implications of ro...
ABSTRACT Depressive disorders are a serious public health concern and treatment priority for the ... more ABSTRACT Depressive disorders are a serious public health concern and treatment priority for the Veterans Health Administration. Computer-based Cognitive Behavioral Therapy (cCBT) is an effective intervention for patients with major depressive disorders; however, rates of program completion are an area of concern, which may be improved through the assistance of peers. This pilot study investigated the feasibility of a Veteran-peer assisted cCBT intervention. Participants were patients diagnosed with depression at an Outpatient Mental Health (OMH) or Primary Care Mental Health (PCMH) clinic at a single VHA facility. Participants were paired with a Veteran-peer and given access to a widely used cCBT program via the Internet. Measures of depressive symptoms were obtained at baseline, 4-, and 8-weeks follow-up. Completion rates and program satisfaction were also assessed. At 8 weeks, symptom reductions and completion rates were comparable to study results of brief individual, group CBT, and staff assisted computerized CBT interventions. Significant reductions in depressive symptoms were observed in patients from both clinics, although ratings of program usefulness, relevance, and ease of use were higher for individuals recruited from the PCMH clinic. Peer-assisted cCBT for depression is feasible but further research is needed to determine the clinical efficacy of this approach.
Prior research found lower employment rates among working-aged patients who use the VA than among... more Prior research found lower employment rates among working-aged patients who use the VA than among non-Veterans or Veterans who do not use the VA, with the lowest reported employment rates among VA patients with mental disorders. This study assessed employment status, employment functioning, and barriers to employment among VA patients treated in primary care settings, and examined how depression and anxiety were associated with these outcomes. The sample included 287 VA patients treated in primary care in a large Midwestern VA Medical Center. Bivariate and multivariable analyses were conducted examining associations between socio-demographic and clinical predictors of six employment domains, including: employment status, job search self-efficacy, work performance, concerns about job loss among employed Veterans, and employment barriers and likelihood of job seeking among not employed Veterans. 54% of respondents were employed, 36% were not employed, and 10% were economically inactiv...
Using data from a sample of 398 veterans diagnosed with depression, the present study used princi... more Using data from a sample of 398 veterans diagnosed with depression, the present study used principal components analysis to shorten the Mental Health Recovery Measure (MHRM) to a 10-item instrument. Results indicated the 10-item MHRM had excellent internal reliability. Construct validity for the 10-item MHRM was evidenced by correlations with measures of depression coping self-efficacy, social adjustment, hopelessness, and depression. The 10-item MHRM derived in the present study was compared with a 10-item version of the MHRM that was previously empirically derived in a sample of veterans with schizophrenia (Armstrong, Cohen, Hellemann, Reist, & Young, 2014). Results suggest that similar items represent the underlying construct of recovery for veterans with depression and veterans with schizophrenia. Veterans with depression reported lower average levels of recovery than veterans with schizophrenia. Study limitations, directions for future investigations, and the implications of ro...
Abstract: The current dissertation examined induced mood's effect on sensorimotor gating, as... more Abstract: The current dissertation examined induced mood's effect on sensorimotor gating, as indexed by prepulse inhibition of startle, and investigated whether dispositional personality factors associated with dopamine sensitivity would moderate that relationship. ...
Prior research found lower employment rates among working-aged patients who use the VA than among... more Prior research found lower employment rates among working-aged patients who use the VA than among non-Veterans or Veterans who do not use the VA, with the lowest reported employment rates among VA patients with mental disorders. This study assessed employment status, employment functioning, and barriers to employment among VA patients treated in primary care settings, and examined how depression and anxiety were associated with these outcomes. The sample included 287 VA patients treated in primary care in a large Midwestern VA Medical Center. Bivariate and multivariable analyses were conducted examining associations between socio-demographic and clinical predictors of six employment domains, including: employment status, job search self-efficacy, work performance, concerns about job loss among employed Veterans, and employment barriers and likelihood of job seeking among not employed Veterans. 54% of respondents were employed, 36% were not employed, and 10% were economically inactiv...
Employment is a vital part of the postdeployment return to civilian life. This study investigated... more Employment is a vital part of the postdeployment return to civilian life. This study investigated factors associated with employment-related outcomes (employment status, self-reported work performance, and self-reported work satisfaction) among National Guard members returning from Operation Enduring Freedom, Operation Iraqi Freedom, or Operation New Dawn deployments. The sample consisted of 1,151 National Guard service members who had returned from overseas deployments approximately six months earlier. Bivariate and multivariable analyses were performed to examine associations between predictors and employment-related outcome variables. Higher-risk alcohol use was associated with reduced odds of being employed as well as with lower ratings of work satisfaction, whereas psychiatric symptom load was associated with lower self-reported work performance and work satisfaction ratings. Perceived social resources were associated with higher self-reported work performance and work satisfaction, whereas better physical functioning was associated with better self-reported work performance. Policy makers and clinicians may need to consider and assess alcohol use among unemployed National Guard members. They may also need to consider psychiatric symptom load and physical functioning among employed service members who perceive poor work performance and have low work satisfaction. Further research is needed on causal links between these predictors and employment outcomes.
ABSTRACT Depressive disorders are a serious public health concern and treatment priority for the ... more ABSTRACT Depressive disorders are a serious public health concern and treatment priority for the Veterans Health Administration. Computer-based Cognitive Behavioral Therapy (cCBT) is an effective intervention for patients with major depressive disorders; however, rates of program completion are an area of concern, which may be improved through the assistance of peers. This pilot study investigated the feasibility of a Veteran-peer assisted cCBT intervention. Participants were patients diagnosed with depression at an Outpatient Mental Health (OMH) or Primary Care Mental Health (PCMH) clinic at a single VHA facility. Participants were paired with a Veteran-peer and given access to a widely used cCBT program via the Internet. Measures of depressive symptoms were obtained at baseline, 4-, and 8-weeks follow-up. Completion rates and program satisfaction were also assessed. At 8 weeks, symptom reductions and completion rates were comparable to study results of brief individual, group CBT, and staff assisted computerized CBT interventions. Significant reductions in depressive symptoms were observed in patients from both clinics, although ratings of program usefulness, relevance, and ease of use were higher for individuals recruited from the PCMH clinic. Peer-assisted cCBT for depression is feasible but further research is needed to determine the clinical efficacy of this approach.
Using data from a sample of 398 veterans diagnosed with depression, the present study used princi... more Using data from a sample of 398 veterans diagnosed with depression, the present study used principal components analysis to shorten the Mental Health Recovery Measure (MHRM) to a 10-item instrument. Results indicated the 10-item MHRM had excellent internal reliability. Construct validity for the 10-item MHRM was evidenced by correlations with measures of depression coping self-efficacy, social adjustment, hopelessness, and depression. The 10-item MHRM derived in the present study was compared with a 10-item version of the MHRM that was previously empirically derived in a sample of veterans with schizophrenia (Armstrong, Cohen, Hellemann, Reist, & Young, 2014). Results suggest that similar items represent the underlying construct of recovery for veterans with depression and veterans with schizophrenia. Veterans with depression reported lower average levels of recovery than veterans with schizophrenia. Study limitations, directions for future investigations, and the implications of ro...
ABSTRACT Depressive disorders are a serious public health concern and treatment priority for the ... more ABSTRACT Depressive disorders are a serious public health concern and treatment priority for the Veterans Health Administration. Computer-based Cognitive Behavioral Therapy (cCBT) is an effective intervention for patients with major depressive disorders; however, rates of program completion are an area of concern, which may be improved through the assistance of peers. This pilot study investigated the feasibility of a Veteran-peer assisted cCBT intervention. Participants were patients diagnosed with depression at an Outpatient Mental Health (OMH) or Primary Care Mental Health (PCMH) clinic at a single VHA facility. Participants were paired with a Veteran-peer and given access to a widely used cCBT program via the Internet. Measures of depressive symptoms were obtained at baseline, 4-, and 8-weeks follow-up. Completion rates and program satisfaction were also assessed. At 8 weeks, symptom reductions and completion rates were comparable to study results of brief individual, group CBT, and staff assisted computerized CBT interventions. Significant reductions in depressive symptoms were observed in patients from both clinics, although ratings of program usefulness, relevance, and ease of use were higher for individuals recruited from the PCMH clinic. Peer-assisted cCBT for depression is feasible but further research is needed to determine the clinical efficacy of this approach.
Prior research found lower employment rates among working-aged patients who use the VA than among... more Prior research found lower employment rates among working-aged patients who use the VA than among non-Veterans or Veterans who do not use the VA, with the lowest reported employment rates among VA patients with mental disorders. This study assessed employment status, employment functioning, and barriers to employment among VA patients treated in primary care settings, and examined how depression and anxiety were associated with these outcomes. The sample included 287 VA patients treated in primary care in a large Midwestern VA Medical Center. Bivariate and multivariable analyses were conducted examining associations between socio-demographic and clinical predictors of six employment domains, including: employment status, job search self-efficacy, work performance, concerns about job loss among employed Veterans, and employment barriers and likelihood of job seeking among not employed Veterans. 54% of respondents were employed, 36% were not employed, and 10% were economically inactiv...
Using data from a sample of 398 veterans diagnosed with depression, the present study used princi... more Using data from a sample of 398 veterans diagnosed with depression, the present study used principal components analysis to shorten the Mental Health Recovery Measure (MHRM) to a 10-item instrument. Results indicated the 10-item MHRM had excellent internal reliability. Construct validity for the 10-item MHRM was evidenced by correlations with measures of depression coping self-efficacy, social adjustment, hopelessness, and depression. The 10-item MHRM derived in the present study was compared with a 10-item version of the MHRM that was previously empirically derived in a sample of veterans with schizophrenia (Armstrong, Cohen, Hellemann, Reist, & Young, 2014). Results suggest that similar items represent the underlying construct of recovery for veterans with depression and veterans with schizophrenia. Veterans with depression reported lower average levels of recovery than veterans with schizophrenia. Study limitations, directions for future investigations, and the implications of ro...
Abstract: The current dissertation examined induced mood's effect on sensorimotor gating, as... more Abstract: The current dissertation examined induced mood's effect on sensorimotor gating, as indexed by prepulse inhibition of startle, and investigated whether dispositional personality factors associated with dopamine sensitivity would moderate that relationship. ...
Prior research found lower employment rates among working-aged patients who use the VA than among... more Prior research found lower employment rates among working-aged patients who use the VA than among non-Veterans or Veterans who do not use the VA, with the lowest reported employment rates among VA patients with mental disorders. This study assessed employment status, employment functioning, and barriers to employment among VA patients treated in primary care settings, and examined how depression and anxiety were associated with these outcomes. The sample included 287 VA patients treated in primary care in a large Midwestern VA Medical Center. Bivariate and multivariable analyses were conducted examining associations between socio-demographic and clinical predictors of six employment domains, including: employment status, job search self-efficacy, work performance, concerns about job loss among employed Veterans, and employment barriers and likelihood of job seeking among not employed Veterans. 54% of respondents were employed, 36% were not employed, and 10% were economically inactiv...
Employment is a vital part of the postdeployment return to civilian life. This study investigated... more Employment is a vital part of the postdeployment return to civilian life. This study investigated factors associated with employment-related outcomes (employment status, self-reported work performance, and self-reported work satisfaction) among National Guard members returning from Operation Enduring Freedom, Operation Iraqi Freedom, or Operation New Dawn deployments. The sample consisted of 1,151 National Guard service members who had returned from overseas deployments approximately six months earlier. Bivariate and multivariable analyses were performed to examine associations between predictors and employment-related outcome variables. Higher-risk alcohol use was associated with reduced odds of being employed as well as with lower ratings of work satisfaction, whereas psychiatric symptom load was associated with lower self-reported work performance and work satisfaction ratings. Perceived social resources were associated with higher self-reported work performance and work satisfaction, whereas better physical functioning was associated with better self-reported work performance. Policy makers and clinicians may need to consider and assess alcohol use among unemployed National Guard members. They may also need to consider psychiatric symptom load and physical functioning among employed service members who perceive poor work performance and have low work satisfaction. Further research is needed on causal links between these predictors and employment outcomes.
ABSTRACT Depressive disorders are a serious public health concern and treatment priority for the ... more ABSTRACT Depressive disorders are a serious public health concern and treatment priority for the Veterans Health Administration. Computer-based Cognitive Behavioral Therapy (cCBT) is an effective intervention for patients with major depressive disorders; however, rates of program completion are an area of concern, which may be improved through the assistance of peers. This pilot study investigated the feasibility of a Veteran-peer assisted cCBT intervention. Participants were patients diagnosed with depression at an Outpatient Mental Health (OMH) or Primary Care Mental Health (PCMH) clinic at a single VHA facility. Participants were paired with a Veteran-peer and given access to a widely used cCBT program via the Internet. Measures of depressive symptoms were obtained at baseline, 4-, and 8-weeks follow-up. Completion rates and program satisfaction were also assessed. At 8 weeks, symptom reductions and completion rates were comparable to study results of brief individual, group CBT, and staff assisted computerized CBT interventions. Significant reductions in depressive symptoms were observed in patients from both clinics, although ratings of program usefulness, relevance, and ease of use were higher for individuals recruited from the PCMH clinic. Peer-assisted cCBT for depression is feasible but further research is needed to determine the clinical efficacy of this approach.
Uploads
Papers by C. B Nelson