MiNDS Manuscripts: Herry Patel
Authors: Herry Patel & Leanne Monteiro
In this month’s MiNDS Manuscript series, Herry Patel discusses his paper recently published in the journal The Canadian Journal of Psychiatry.
Posttraumatic Stress Disorder Symptomatology and Substance Use in an Outpatient Concurrent Disorders Sample
1. What was the primary focus of your paper?
The focus of our paper was to analyze the associations between global and individual facets (i.e., avoidance behaviours, intrusive thoughts and memories, negative alterations in cognition and mood, and hypervigilance) of posttraumatic stress disorder (PTSD) symptomatology with cannabis/illicit substance use frequency and their related problems among a sample of outpatient clients with concurrent disorders.
2. Can you briefly explain the findings of your paper for someone outside the field?
Our findings suggested that greater severity of PTSD symptoms was associated with more use of cannabis and other recreational substances along with more problems related to their substance use. In addition, looking at the specific symptom clusters (i.e., individual facets) of PTSD, we found that more hypervigilance was associated with more significant cannabis-related problems, drug-related problems, and cannabis and other substance use frequency. Behaviours such as avoiding triggers of traumatic events (i.e., places, things, smells, etc.) were also associated with cannabis frequency and cannabis-related problems.
3. How did you develop this research question?
Co-occurrence between PTSD and substance use disorders (SUD) is very common and presents with an often-severe clinical presentation that is harder to treat. As such, there is a critical need to understand the associations between PTSD and substance use to inform targeted treatment interventions. Understanding how both disorders relate to one another, especially at the level of symptoms, can help to reveal the relationship between the disorders, and enable clinicians to create a targeted treatment plan for individuals with comorbid PTSD and SUD. Within a sample of outpatients from St Joseph’s Healthcare, Hamilton, there are patients with concurrent disorders that present with more severe clinical problems and are harder to treat successfully. This illustrates the need to analyze the relationship between PTSD and substance use.
4. What were some issues (writer’s block, lack of motivation, pressing deadlines, etc.) you faced when writing this paper? How did you overcome them?
One major issue was conducting the structural equation modelling (SEM) analyses when writing this paper. As a part of this paper, I taught myself SEM when I initially knew nothing about it. This created an interesting dynamic when writing this paper because I would conduct analyses and share them with the team; there was more of a focus on the statistical aspect than the interpretation of the results. This forced me to know my statistics and data in order to support my findings. Furthermore, this made me stronger as a researcher because I presented and defended my results to my colleagues effectively, which made me more confident about the results I was writing. After all, I had spent so much time justifying them.
Another major issue I faced when writing this paper was the completely different way experimental scientists and clinicians write. This paper had a team of experimental scientists and clinicians working together to show the clinical utility of our findings. I have had experiences writing papers but writing this one was a big challenge because I had to re-orient my mind to think and write like a clinician. However, this provided me with an appreciation for how these results can be interpreted and translated into ways clinicians can effectively use to help their patients.
5. Was this a collaborative effort between different labs/departments/faculties/schools?
One of the most extraordinary things about this paper was the collaborative nature of the team that wrote it. Our team consisted of experimental scientists, clinical psychologists, and statisticians. All of whom worked in different labs, clinics, and universities in different countries. I would compare how this collaboration was built and maintained to a living organism interacting with its environment and others within it. For example, my supervisor at that time, Dr. Michael Amlung, introduced me to Dr. Oshri, who helped with SEM and Dr. Holshausen, who was a critical part of interpreting the results from a clinician’s perspective. I also reached out to a postdoctoral fellow, Dr. Andrews, for her help in designing the model and statistical interpretation. While these are just a few of the connections that existed, all individuals on this paper had a common goal. Despite not all being experts in this specific field, we were interested in ensuring that the findings in this paper could be disseminated to help patients. While building these connections happened naturally, a common goal bound us and helped us maintain the collaboration. My main advice to graduate students looking to collaborate with others is to find that common goal. Finding this goal will help you and your collaborators work together and maintain a relationship to achieve that goal.
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