Dr. Bahraini is a Clinical Research Psychologist and Director of Education at the Rocky Mountain MIRECC for suicide prevention. In addition, she is an Associate Professor of Psychiatry and Physical Medicine and Rehabilitation at the University of Colorado School of Medicine. She obtained a PhD in Counseling Psychology from the University of Denver in 2008 and completed a post-doctoral fellowship at the Rocky Mountain Mental Illness, Research, Education and Clinical Center (MIRECC) in 2010. She is a licensed clinical psychologist in the state of Colorado.
Dr. Bahraini's research primarily focuses on designing and testing implementation interventions to improve the uptake of evidence-based practices in suicide prevention in the Veterans Health Administration (VHA). Along these lines, she is interested in stepped implementation strategies and adaptive designs to examinine which types of interventions may be more effective in different healthcare settings. She has worked closely with the Office of Mental Health and Suicide Prevention (OMHSP) to develop and implement national suicide prevention programs and initiatives, including REACH VET and the VA Suicide Risk Identification Strategy (VA Risk ID). She recently received a QUERI Partnered Evaluation Initiative to develop an adaptive implementation strategy, which provides different degrees of implementation support in a step-wise fashion, to improve the uptake of suicide risk screening and evaluation in VHA ambulatory care settings.
Other areas of research interests include:
· Development and validation of quality metrics and clinical performance measures for suicide prevention
· Effective strategies for implementation of clinical practice guidelines for suicide prevention
· Optimization of audit and feedback interventions to increase the quality of suicide risk screening, assessment and management
· Use of social media to improve dissemination of suicide prevention research
Fellowship Applications: Dr. Bahraini is accepting fellowship applications for 2020. Applicants with an interest in dissemination and implementation of evidence-based practices in suicide prevention and working with operation partners on system level interventions are encouraged to apply. Fellows could be involved in current partnered-research initiatives or propose secondary projects that may help expand or augment existing projects. Please email Dr. Bahraini for more details or to set up a time to discuss potential projects and research alignment prior to applying.
Areas of Expertise
Clinical and Research Interests: Rehabilitation and recovery of Veterans with mild traumatic brain injury and psychiatric comorbidity; clinical outcomes research in traumatic brain injury; dissemination and implementation of suicide prevention interventions and clinical practice guidelines.
Education, Licensure & Certifications
Year of Licensure: 2010
Examining the Effectiveness of an Adaptive Implementation Intervention to Improve Uptake of the VA Suicide Risk Identification Strategy (PI: Bahraini)
VA Quality Enhancement Research Initiative
This national quality improvement project will utilize an adaptive strategy to improve implementation of VA Risk ID to fidelity. Using a sequential multiple assignment randomized trial (SMART) design, two evidence-based implementation strategies will be evaluated: 1) Audit and Feedback (A/F); 2) A/F plus External Facilitation (A/F+EF). We will evaluate these strategies across several domains based on the RE-AIM QuEST mixed methods framework. In addition to focusing on implementation outcomes, such as the impact of these strategies on implementation of VA Risk ID to fidelity, and potential barriers to adopting these strategies, we will examine the impact of the clinical innovation (i.e., VA Risk ID) on patient-level outcomes. https://www.queri.research.va.gov/national_partnered_evaluations/suicide_identification.cfm
Understanding Impact of VHA's New Suicidal Ideation Screening Initiative: Veterans' Perspectives (PI: Dobscha)
VA Health Services Research & Development
The primary goal of this study is to characterize Veteran experiences with VHA's new SI screening process and the clinical evaluation that takes place in response to screening results. We will also examine the extent to which screening process variables are associated with mental health treatment utilization over six months.
Pathways to Partnership - Suicide Prevention for Rural Veterans (PI: Mohatt)
VA Office of Rural Health
This Enterprise Wide Collaborative Rural Access Intervention for Rural Veteran Suicide Prevention integrates multiple evidence-based practices and existing VA programs (e.g., suicide risk management in primary care, crisis support, firearm safety, and the Home-Based Mental Health Evaluation [HOME] program) into a comprehensive portfolio of best practices that work synergistically to strengthen VA and community partnerships to empower and mobilize communities around suicide prevention, improve access for rural Veterans, and effectively target known risk and protective factors for suicide.
Towards Optimizing Behavioral Markers of Suicide Risk (PI: Barnes)
VA Clinical Services Research & Development
This study will utilize computerized reaction-time tasks that serve as behavioral markers of suicide risk to evaluate the theory that suicide-related cognitive processes are likely to emerge when people who are at risk of suicide experience distress. If this is the case, inducing a dysphoric mood prior to administering the tasks should optimize their accuracy for identifying Veterans at high risk of attempting suicide in the near future.
Statement about Research Program: My primary area of research is broadly focused on rehabilitation and recovery of Veterans with mild traumatic brain injury and co-occurring posttraumatic stress disorder. Both of these conditions, which are associated with increased risk of suicide, are highly prevalent in returning Veterans who have served in Iraq and Afghanistan; yet research focused on understanding the interplay of these two conditions, their impact on functioning and diagnostic and treatment considerations when both conditions are present is limited. My specific program of research is focused on: 1) assessment of mental and neuropsychological alterations associated with PTSD and mTBI and their impact on coping and recovery; 2) psychometric analysis and validation of patient reported outcomes for mTBI rehabilitation and 3) implementation and dissemination of best practices – clinical and community based - to promote recovery and prevent adverse outcomes following TBI
Bahraini, N.H., Monteith, L.L., Gerber, H.R., Forster, J.E., Hostetter, T.A., & Brenner, L.A. (2017). The Association Between Posttraumatic Stress Disorder and Perceptions of Deployment-Related Injury in Veterans With and Without Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation. doi: 10.1097/HTR.0000000000000307.
Monteith, L.L., Bahraini, N.H., & Menefee, D.S. (2017). Perceived burdensomeness, thwarted belongingness, and fearlessness about death: Associations with suicidal ideation among female veterans exposed to military sexual trauma. Journal of Clinical Psychology. Advance online publication. doi:10.1002/jclp.22462
Brenner, L.A., Betthauser, L.M., Bahraini, N., Lusk, J.L., Terrio, H., Scher, A., Schwab, K. (2015). Soldiers Returning From Deployment: A Qualitative Study Regarding Exposure, Coping, and Reintegration. Rehabilitation Psychology. [Epub ahead of print]
Brenner, L.A., Bahraini, N., Homaifar, B.Y., Monteith, L.L., Nagamoto, H., Dorsey-Holliman, B., Forster, J.E. (2015). Executive Functioning and Suicidal Behavior among Veterans with and without a History of Traumatic Brain Injury. Archives of Physical Medicine Rehabilitation. [Epub ahead of print]
Miller RS, Weaver LK, Bahraini N, Churchill S, Price RC, Skiba V, Caviness J, Mooney S, Hetzell B, Liu J, Deru K, Ricciardi R, Fracisco S, Close NC, Surrett GW, Bartos C, Ryan M, Brenner LA. Effects of Hyperbaric Oxygen on Symptoms and Quality of Life Among Service Members With Persistent Postconcussion Symptoms: A Randomized Clinical Trial. JAMA Intern Med, 2015; 175; 43-52.
Bahraini NH, Breshears RE, Hernández TD, Schneider AL, Forster JE, Brenner LA. Traumatic Brain Injury and Posttraumatic Stress Disorder. Psychiatr Clin North Am. 2014 Mar;37(1):55-75. http://www.ncbi.nlm.nih.gov/pubmed/24529423
Brenner, L. A., Hoffberg, A. S., Shura, R. D., Bahraini, N., & Wortzel, H. S. (2013). Interventions for mood-related issues post traumatic brain injury: Novel treatments and ongoing limitations of current research. Current Physical Medicine and Rehabilitation Reports, September 2013, Volume 1, Issue 3, pp 143-150 http://link.springer.com/article/10.1007/s40141-013-0022-1