Jean Beckham

Overview:

Interest in assessment and treatment of trauma, particularly as occurs for both women and men during military service; focus in treatment outcome of differential and collective contribution for psychopharmacological and behavioral interventions in PTSD populations; long term physical health effects of chronic posttraumatic stress disorder.

Positions:

Professor in Psychiatry and Behavioral Sciences

Psychiatry & Behavioral Sciences, Behavioral Medicine
School of Medicine

Division Director of Behavioral Medicine

Psychiatry & Behavioral Sciences, Behavioral Medicine
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.S. 1984

Florida State University

Ph.D. 1988

Florida State University

Grants:

IPA - Adam Mann

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
Role
Principal Investigator
Start Date
End Date

IPA - Tiffany Mosher

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
Role
Principal Investigator
Start Date
End Date

Association of Posttraumatic Stress Disorder and Heart Disease in Women Veterans: Examining Risk Factors and Effects of Pharmacotherapy on Clinical Outcomes

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
Role
Principal Investigator
Start Date
End Date

IPA - Eric Elbogen

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
Role
Principal Investigator
Start Date
End Date

Pain Management using Mobile Technology in Veterans with PTSD and TBI

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
Awarded By
National Institutes of Health
Role
Co Investigator
Start Date
End Date

Publications:

Race-related differences in acute pain complaints among inner-city women: the role of socioeconomic status.

Previous research has shown that African Americans (AA) report higher pain intensity and pain interference than other racial/ethnic groups as well as greater levels of other risk factors related to worse pain outcomes, including PTSD symptoms, pain catastrophizing, and sleep disturbance. Within a Conservation of Resources theory framework, we tested the hypothesis that socioeconomic status (SES) factors (i.e., income, education, employment, perception of income meeting basic needs) largely account for these racial/ethnic differences. Participants were 435 women [AA, 59.1%; Hispanic/Latina (HL), 25.3%; Non-Hispanic/White (NHW), 15.6%] who presented to an Emergency Department (ED) with an acute pain-related complaint. Data were extracted from psychosocial questionnaires completed at the participants' baseline interview. Structural equation modeling was used to examine whether racial/ethnic differences in pain intensity and pain interference were mediated by PTSD symptoms, pain catastrophizing, sleep quality, and sleep duration, and whether these mediation pathways were, in turn, accounted for by SES factors. Results indicated that SES factors accounted for the mediation relationships linking AA race to pain intensity via PTSD symptoms and the mediation relationships linking AA race to pain interference via PTSD symptoms, pain catastrophizing, and sleep quality. Results suggested that observed racial/ethnic differences in AA women's pain intensity, pain interference, and common risk factors for elevated pain may be largely due to racial/ethnic differences in SES. These findings highlight the role of social inequality in persistent health disparities facing inner-city, AA women.
Authors
Lillis, TA; Burns, J; Aranda, F; Burgess, HJ; Purim-Shem-Tov, YA; Bruehl, S; Beckham, JC; Pinkerton, LM; Hobfoll, SE
MLA Citation
Lillis, Teresa A., et al. “Race-related differences in acute pain complaints among inner-city women: the role of socioeconomic status..” J Behav Med, Dec. 2019. Pubmed, doi:10.1007/s10865-019-00123-3.
URI
https://scholars.duke.edu/individual/pub1423150
PMID
31832845
Source
pubmed
Published In
J Behav Med
Published Date
DOI
10.1007/s10865-019-00123-3

Exploring resilience models in a sample of combat-exposed military service members and veterans: a comparison and commentary

© 2018, © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Background: The term resilience is applied in numerous ways in the mental health field, leading to different perspectives of what constitutes a resilient response and disparate findings regarding its prevalence following trauma. Objective: illustrate the impact of various definitions on our understanding and prevalence of resilience, we compared various resilience definitions (absence of PTSD, absence of current mental health diagnosis, absence of generalized psychological distress, and an alternative trauma load–resilience discrepancy model of the difference between actual and predicted distress given lifetime trauma exposure) within a combat-exposed military personnel and veteran sample. Method: In this combat-trauma exposed sample (N = 849), of which approximately half were treatment seeking, rates of resilience were determined across all models, the kappa statistic was used to determine the concordance and strength of association across models, and t-tests examined the models in relation to a self-reported resilience measure. Results: Prevalence rates were 43.7%, 30.7%, 87.4%, and 50.1% in each of the four models. Concordance analyses identified 25.7% (n = 218) considered resilient by all four models (kappa = .40, p < .001). Correlations between models and self-reported resilience were strong, but did not fully overlap. Conclusions:The discussion highlights theoretical considerations regarding the impact of various definitions and methodologies on resilience classifications, links current findings to a systems-based perspective, and ends with suggestions for future research approaches on resilience.
Authors
Sheerin, CM; Stratton, KJ; Amstadter, AB; McDonald, SD; Beckham, JC; Brancu, M; Calhoun, PS; Dedert, E; Elbogen, EB; Fairbank, JA; Green, KT; Kilts, JD; Kimbrel, NA; Kirby, A; Marx, CE; Moore, SD; Morey, RA; Naylor, JC; Runnals, JJ; Swinkels, C; Szabo, ST; Tupler, LA; Van Voorhees, EE; Weiner, RD; Pickett, TC; Hurley, RA; Rowland, J; Taber, KH; Yoash-Gantz, RE; McCarthy, G
MLA Citation
Sheerin, C. M., et al. “Exploring resilience models in a sample of combat-exposed military service members and veterans: a comparison and commentary.” European Journal of Psychotraumatology, vol. 9, no. 1, Jan. 2018. Scopus, doi:10.1080/20008198.2018.1486121.
URI
https://scholars.duke.edu/individual/pub1423189
Source
scopus
Published In
European Journal of Psychotraumatology
Volume
9
Published Date
DOI
10.1080/20008198.2018.1486121

From obligation to opportunity: future of patient-reported outcome measures at the Veterans Health Administration.

Patient-reported outcome (PRO) measures are particularly important in mental health services because patients are the central and essential source of information about their mental health status. PRO measures have the potential to engage patients in meaningful and focused conversations during clinical encounters, but unfortunately they often do not serve this purpose in mental health care. Administration of routine outcome measures has often been viewed by clinicians as an obligatory quality improvement process that takes time away from the clinical encounter. This commentary describes current practical barriers to using PRO measures in practice. Then, focusing specifically on the Veterans Health Administration, a unit of the U.S. Department of Veterans Affairs (VA), we propose processes within which PRO measures in mental health services could support the clinical encounter and enhance patient-centered mental health care. With the increasing number of Accountable Care Organizations and other integrated health-care systems that focus on mental health-care delivery, VA has an opportunity to leverage its long-standing electronic medical record technologies and integrated health system to serve as a model for incorporating PRO measures into mental health-care practices. This commentary provides a vision for the future of mental health delivery by incorporating PRO measures at the VA and in other health-care systems.
Authors
Coles, TM; Wilson, SM; Kim, B; Beckham, JC; Kinghorn, WA
MLA Citation
Coles, Theresa M., et al. “From obligation to opportunity: future of patient-reported outcome measures at the Veterans Health Administration..” Transl Behav Med, vol. 9, no. 6, Nov. 2019, pp. 1157–62. Pubmed, doi:10.1093/tbm/ibz121.
URI
https://scholars.duke.edu/individual/pub1402158
PMID
31348511
Source
pubmed
Published In
Transl Behav Med
Volume
9
Published Date
Start Page
1157
End Page
1162
DOI
10.1093/tbm/ibz121

The association of resilience on psychiatric, substance use, and physical health outcomes in combat trauma-exposed military service members and veterans.

Objective: Although Combat exposure is associated with a range of psychiatric outcomes, many veterans do not develop psychopathology. Resilience is a multifaceted construct associated with reduced risk of distress and psychopathology; however, few studies have examined the relationship of resilience with a broader spectrum of health outcomes following combat exposure. It also remains important to determine the association of resilience above and beyond other documented risk and protective factors. Method: In a sample of combat-exposed veterans (N = 1,046) deployed to Iraq and Afghanistan, we examined a quantitative method for exploring relative psychological resilience (discrepancy-based psychiatric resilience; DBPR) and tested the hypothesis that resilience would be associated with reduced risk for psychiatric diagnosis count, substance use, and physical health outcomes, above and beyond other known correlates (e.g. combat exposure, social support). Results: In the final model, results suggested an inverse association of discrepancy-based psychiatric resilience with current psychiatric diagnosis count (β = -0.57, p < .001), alcohol use (β = -0.16, p < .001), drug use (β = -0.13, p < .001), and physical health concerns (β = -0.42, p < .001) after accounting for other relevant risk and protective factors. Conclusions: Results extend the nomological net of this quantitative resilience construct to include other relevant health outcomes, and demonstrate that resilience may have more of a buffering relationship with psychiatric and physical health concerns compared to substance use outcomes.
Authors
Sheerin, CM; Amstadter, AB; Kurtz, ED; Bountress, KE; Stratton, KJ; McDonald, SD; Mid-Atlantic Va Mirecc Workgroup,
MLA Citation
Sheerin, Christina M., et al. “The association of resilience on psychiatric, substance use, and physical health outcomes in combat trauma-exposed military service members and veterans..” Eur J Psychotraumatol, vol. 10, no. 1, 2019. Pubmed, doi:10.1080/20008198.2019.1625700.
URI
https://scholars.duke.edu/individual/pub1397064
PMID
31263518
Source
pubmed
Published In
European Journal of Psychotraumatology
Volume
10
Published Date
Start Page
1625700
DOI
10.1080/20008198.2019.1625700

Smoking abstinence effects on emotion dysregulation in adult cigarette smokers with and without attention-deficit/hyperactivity disorder.

BACKGROUND: Cigarette smoking is robustly associated with attention-deficit/hyperactivity disorder (ADHD), but little is known about psychological mechanisms accounting for this comorbid relationship. This study examined difficulties in emotion regulation, or emotion dysregulation, among adult cigarette smokers with and without ADHD. Emotion dysregulation was predicted to be higher in an ADHD group at screening and after 24 -h smoking abstinence compared to a non-ADHD group. METHODS: Cigarette smokers with (n = 19) and without (n = 20) ADHD completed a screening visit, baseline visit, and two experimental visits: smoking as usual (i.e., smoking satiated) and after biochemically-verified 24 -h smoking abstinence (i.e., smoking abstinent). Three emotion dysregulation rating scales (two self-report and one clinician rated) were administered at the screening visit and experimental sessions. Experimental sessions also included two emotion dysregulation behavioral tasks. RESULTS: The ADHD group scored higher on all three rating scales at screening (p's < .001). For experimental sessions, group (ADHD, non-ADHD) x condition (smoking satiated, smoking abstinence) interactions were not significant across measures. However, group main effects emerged indicating higher emotion dysregulation in the ADHD group across all measures (p's < .001). Main effects also emerged for experimental condition, but were more mixed across emotion dysregulation measures. CONCLUSIONS: Emotion dysregulation was higher among adult smokers with ADHD and during smoking abstinence across diagnostic groups, suggesting that this malleable psychological mechanism plays a role in smoking both for those with and without ADHD-such findings can inform treatment and prevention efforts.
Authors
MLA Citation
Mitchell, John T., et al. “Smoking abstinence effects on emotion dysregulation in adult cigarette smokers with and without attention-deficit/hyperactivity disorder..” Drug Alcohol Depend, vol. 205, Dec. 2019. Pubmed, doi:10.1016/j.drugalcdep.2019.107594.
URI
https://scholars.duke.edu/individual/pub1416588
PMID
31639512
Source
pubmed
Published In
Drug Alcohol Depend
Volume
205
Published Date
Start Page
107594
DOI
10.1016/j.drugalcdep.2019.107594