CSRD Research Career Scientist Award Application

Durham Va Medical Center, Durham NC

Investigators

Abstract

Dr. Beckham is an experienced investigator in the areas of posttraumatic stress disorder (PTSD), suicide prevention and substance abuse. She utilizes multiple research approaches (epidemiological, clinical observation, experimental laboratory, ecological momentary assessment and electronic diaries, mobile health applications, genetics, electronic health records and clinical trials) to investigate the phenomenology of PTSD, common comorbidities with PTSD (e.g., substance misuse), tobacco and cannabis use, suicide prevention and the genetics of PTSD and suicide. PTSD and Cardiovascular Disease. Dr. Beckham has had ongoing funding in the area of cardiovascular function and PTSD demonstrating that individuals with PTSD: 1) demonstrate high levels of hostility; 2) have damaging physiological responses to negative affect; 3) display increased autonomic activity outside the laboratory; and 4) have deficits in autonomic regulatory activity beyond simple over-reactivity of the sympathetic nervous system. She has a current R01 investigating a treatment to mitigate this risk. PTSD and Smoking. As part of her interest in the physical health effects of PTSD, Dr. Beckham began investigating smoking among Veterans with PTSD. She demonstrated that Veterans with PTSD smoke much more than the general population and even more than other individuals with trauma exposure who do not develop PTSD. Her work has provided information on: 1) the physiological and psychological mechanisms that underlie this increased smoking behavior; 2) biobehavioral mechanisms of relapse to smoking among smokers with PTSD; 3) the attentional processes involved in tobacco addiction among smokers with PTSD: and 4) innovative methods for treating and engaging smokers with PTSD. Genetics of PTSD. Dr. Beckham became director of the genetics research laboratory for the Mid-Atlantic Mental Illness Research, Education and Clinical Center in 2005. She added genetics aims to the 3,500 Veteran research registry of Iraq/Afghanistan era veterans. She joined the Consortium for PTSD Genetics in 2012 and actively contributed to the early GWAS publications of genetics and PTSD identifying sex and ancestry-specific risk loci, new DNA methylation loci and a meta-analysis of traumatic stress and accelerated DNA methylation age in PTSD. She has ongoing studies of genetics and PTSD and suicide. Cannabis and PTSD. Given the self-report by Veterans that cannabis is therapeutically helpful, Dr. Beckham began investigating cannabis in PTSD. She reported information about the prevalence of cannabis use among Veterans with PTSD and demonstrated that cannabis use disorder is associated with increased suicidal ideation, increased suicidal attempts, increased non-suicidal self-injury and violence. This work continues with two new grants examining whether significant reductions in cannabis among Veterans with PTSD and cannabis use disorder (CUD) will result in improved psychiatric and functional outcomes and whether significant cannabis reduction will be helpful in improving function among individuals with CUD. Veteran Suicide Prevention. Dr. Beckham was awarded a merit review to examine the genetics of suicide. She was invited to co-lead a large research effort that has resulted in findings regarding: 1) the genetics of suicidal ideation, attempts and suicide; 2) natural language processing methods to detect negative life events leading up to suicide; and 3) the use of artificial intelligence and machine learning to improve suicide prediction. This work continues through 1) an MVP funded project to work with operations to use the information discovered in the initial three-year project to improve the REACH-VET model currently used to predict suicide among Veterans; 2) A gene-by-environment genome-wide interaction study of suicidal thoughts and behaviors in Veterans using the MVP cohort; and 3) a study using big data and machine learning to understand the association between altitude and suicide among Veterans.