Paranoid personality disorder in the United States: the role of race, illicit drug use, and income.

Differential rates of schizophrenia and paranoia symptoms have been found for Black and White individuals. Paranoid personality disorder shares symptoms with schizophrenia, yet has received minimal attention with regard to potential racial differences. In a sample consisting of 180 substance use disorder treatment-seeking individuals, the association between the diagnosis of paranoid personality disorder and the variables of race, cannabis use disorder, and income were examined. Results extended previous findings to paranoid personality disorder, supporting the hypothesis that Black individuals would be diagnosed with higher rates of paranoid personality disorder. Cannabis use disorder status and income did not predict paranoid personality disorder diagnoses.

Implementation of a Telemental Health Training Program Across a Mental Health Department.

Introduction: Telemental health (TMH) has increased substantially. However, health care systems have found it challenging to implement TMH ubiquitously. A quality improvement project guided by implementation science methodology was used to design and implement a TMH training program. Materials and Methods: Implementation science methodology (Promoting Access to Research Implementation in Health Services, Reach-Effectiveness-Adoption-Implementation-Maintenance, Implementation/Facilitation) provided the framework to design and implement the training program. A total of 100 interdisciplinary mental health providers from outpatient mental health clinics participated. Results: Providers reported satisfaction with the training program. Results indicated that the training increased providers' TMH knowledge and competence. The number of providers using TMH and patients who received TMH nearly doubled. Conclusions: Implementation science methodology was important in creating an organizational framework at this facility to design, evaluate, and implement an innovative TMH training program.

Clinical treatment selection for posttraumatic stress disorder: Suggestions for researchers and clinical trainers.

Posttraumatic stress disorder (PTSD) disrupts the lives of many Veterans and their families, and multiple treatment options exist. Two evidence-based psychotherapies (EBPs)-cognitive processing therapy (CPT) and prolonged exposure (PE)-are specifically identified by Veterans Affairs (VA) and Department of Defense clinical practice guidelines as first-line treatments. Despite the strong emphasis on training clinicians to provide these EBPs, several questions remain unaddressed. We sought to answer 3 main questions: What associated clinical features are clinicians considering as they select PE or CPT to treat a given patient? What exclusionary criteria are clinicians using? How helpful do clinicians find the extant literature on comorbid conditions and associated clinical features when making treatment decisions? We contacted mental health clinicians who were VA-trained in CPT and PE and requested participation in this online survey. We (a) identified several associated factors that clinicians use to help select between these treatments, (b) determined which associated factors or comorbidities clinicians identified as exclusionary criteria for CPT or PE, and (c) evaluated the perceived utility of research to practicing clinicians. We discuss factors for which clinicians reached a consensus, areas of discrepancy (e.g., substance use), and factors for which further research guidance would be beneficial (e.g., dissociation). Findings imply that VA efforts at disseminating best treatment practices and current PTSD research have been effective. Additionally, findings can help inform treatment guidelines and clinical trainings, as well as highlight gaps in research identified by clinicians.