Doron Amsalem

Columbia University | CU · Department of Psychiatry

BACKGROUND Stigma towards transgender children and adolescents contributes to significantly reduced health and educational outcomes compared to non-transgender individuals. Contact with a member of a stigmatized community can dismantle stereotypes and reduce stigma. Recent evidence suggests that video-based contact interventions can be as effective...

Aim: Stigma is a major mental healthcare barrier. This study compares the efficacy of two types of brief video interventions, targeting public and self-stigma, in reducing public stigma towards people living with psychosis. We hypothesized both interventions would similarly reduce public stigma and outperform the control group. As a secondary anal...

Objective: Self-stigma, a phenomenon wherein individuals internalize self-directed negative stereotypes about mental illness, is associated with negative outcomes related to recovery. This randomized controlled study assessed the efficacy of a brief social contact-based video intervention in reducing self-stigma in a large sample of individuals age...

Background and Hypothesis Racial discrimination and public stigma toward Black individuals living with schizophrenia create disparities in treatment-seeking and engagement. Brief, social-contact-based video interventions efficaciously reduce stigma. It remains unclear whether including racial identity experiences in video narrative yields greater s...

BACKGROUND Global education in psychiatry is heavily influenced by knowledge from Western, high-income countries, which obscures local voices and expertise. AIM To adapt a human simulation model to psychiatric education in a context that is specific to local languages and cultures. METHODS We conducted an observational study consisting of six human...

Objective: This study aimed to compare the efficacy of two brief video interventions in reducing mental health-related stigma: one featuring a person with lived experience of mental illness, the other featuring an actor guided by focus groups of individuals with lived experience. Methods: Participants (N=1,216) ages 18-30 were randomly assigned...

Objective Black individuals living with psychosis are at risk for stigma and marginalization due to systematic discrimination and barriers to receiving treatment. Social contact-based interventions have the potential to reduce stigma; however, interventions with elements specific to the experiences of Black youth are limited. Therefore, we aimed to...

Objective: People with mental illnesses may avoid or delay treatment due to a fear of labeling and discrimination, a phenomenon known as self-stigma. Self-stigma is a major barrier to care and creates obstacles to pursuing employment, independent living, and a fulfilling social life. We aimed to gather input from people with lived experience of men...

Hospitalization of children in an inpatient psychiatric ward is stressful for both the children and their parents, and separation from the parents during hospitalization is probably one major cause of this stress. We designated one room in a closed inpatient unit to enable a parent to stay with his/her child, including overnight, during the 1st wee...

Objective: Emerging cross-sectional data indicate that essential workers in the COVID-19 era face increased mental health risks. This study longitudinally examined clinical symptoms of generalized anxiety disorder, depression, and posttraumatic stress disorder (PTSD) among U.S. essential workers, including health care workers and workers in indisp...

Background In collaboration with members of the transgender and gender diverse (TGD) community, we created a didactic resource about the unique needs of TGD youth. Methods We developed teaching materials enhanced by video clips of two TGD adolescents openly sharing aspects of their lived experience. We compared the video and no video conditions in...

Objective: Women with schizophrenia encounter specific gender-related stressors that may affect their recovery process. They are more susceptible to victimization and tend to experience more shame and stigma about their illness. Confronting stigma early in the illness could enhance treatment seeking. No studies have examined the efficacy of stigma-...

Objective: Confronting stigma early in life could enhance treatment seeking. In two randomized controlled trials (RCTs), one focused on psychosis and the other on adolescent depression, the efficacy and equivalence of brief social contact-based videos were evaluated and compared with a control condition. The outcomes of interest were changes in il...

Moral injury (MI) describes the intense feelings of shame, guilt, anger, and betrayal that individuals may experience after violating their own moral codes or witnessing the moral transgressions of others. While MI is not a diagnosable mental health disorder, it has been associated with elevated symptoms of depression and anxiety, suicidal ideation...

Background and Hypothesis Public stigma reduces treatment-seeking and increases the duration of untreated psychosis among young people with psychosis. Social contact-based video interventions have been shown to be effective at reducing stigma; however, more research is needed regarding very brief interventions less than 2 minutes long, which are su...

Background Despite an elevated risk of psychopathology stemming from COVID-19-related stress, many essential workers stigmatise and avoid psychiatric care. This randomised controlled trial was designed to compare five versions of a social-contact-based brief video intervention for essential workers, differing by protagonist gender and race/ethnicit...

Objective: Many health care workers avoid seeking mental health care, despite COVID-19-related increases in risk of psychopathology. This study assessed the effects of two versions (distinguished by the race of the protagonist) of a brief social contact-based video on treatment-seeking intention and stigma toward mental health services among U.S....

Introduction Social contact-based video interventions effectively reduce stigma toward individuals with psychosis. Objectives We recently demonstrated the efficacy of a 90-second social contact–based video intervention in reducing stigma. The current randomized controlled study presents four briefer videos differing in presenter’s gender and race,...

Background Social contact-based interventions effectively reduce stigma toward psychosis. We recently demonstrated the efficacy of a 90-second video intervention in reducing stigma. The current randomized controlled study presents four briefer videos differing in presenter's gender/race, with baseline, postintervention, and 30-day follow-up assessm...

Background In collaboration with members of the transgender and gender diverse (TGD) community, we created a didactic resource about the unique needs of TGD youth. Methods We developed teaching materials enhanced by video clips of two TGD adolescents openly sharing aspects of their lived experience. We compared the video and no video conditions in...

Importance: Transphobia and stigma remain barriers to seeking mental health care for gender-diverse adolescents. Objective: To examine the utility of brief social contact-based video interventions of transgender protagonists with depression to reduce transphobia and depression-related stigma and increase treatment-seeking intentions among adoles...

Objective To test the utility of brief social contact–based video interventions of a Black adolescent girl to reduce stigmatized attitudes and increase help‐seeking intentions around adolescent depression. Methods We conducted a randomized controlled trial (RCT) with 14‐ to18‐year‐old healthy volunteers drawn from the general US population. We enr...

Objective The authors developed and tested video clips depicting three paradigmatic substance use disorder (SUD) clinical scenarios, each portrayed by a different simulated patient interacting with the same clinician.Methods The authors embedded 21 short video clips (with a cumulative duration of 27 min) into a 2-h session on SUDs. The didactic was...

Background Emerging cross-sectional data indicate that healthcare workers (HCWs) in the COVID-19 era face particular mental health risks. Moral injury – a betrayal of one’s values and beliefs, is a potential concern for HCWs who witness the devastating impact of acute COVID-19 illness while too often feeling helpless to respond. This study longitud...

Objective Psychiatric comorbidities are common in physical illness and significantly affect health outcomes. Attitudes of general hospital doctors toward psychiatry are important as they influence referral patterns and quality of care. Little is known about these attitudes and their cultural correlates. The aim of this study was to identify attitud...

Background: Psychotherapy noncompletion rates for veterans and their families are high. This study sought to (a) measure noncompletion rates of such patients at a university-based treatment center, (b) compare veteran and family member attrition rates, (c) identify dropout predictors, and (d) explore clinicians' perspectives on treatment noncomple...

Objectives: During the first peak of the COVID-19 outbreak in the United States, we investigated the impact of digital interventions to reduce COVID-19 related fear, loneliness, and public stigma. Methods: We recruited and randomly assigned 988 United States residents to: 1) no intervention 2) informational sheet to learn about COVID-19, 3) (2) AND...

Background: Many healthcare workers do not seek help, despite their enormous stress and greater risk for anxiety, depression and post-traumatic stress disorder (PTSD). Aims: This study screened for psychopathology and evaluated the efficacy of a brief, social contact-based video intervention in increasing treatment-seeking intentions among healt...

Objective: Public stigma is a barrier to care and increases the duration of untreated psychosis among individuals with first-episode psychosis. The authors recently demonstrated the efficacy of a 90-second social contact-based video intervention in reducing such stigma. That proof-of-concept study was the first to employ so brief an antistigma int...

Background Confronting stigma early in life could enhance receptivity to seeking treatment. We evaluated the efficacy of social contact interventions to reduce stigma toward depression and to enhance treatment‐seeking intentions among adolescents. We hypothesized that the brief video‐based interventions would be more effective than their matched co...

Background Veterans have higher rates of anxiety, depression, and posttraumatic stress disorder (PTSD), and may be vulnerable to mental health consequences of the Covid‐19 pandemic. More than half of veterans who meet mental illness criteria do not seek help. This study screened for clinical symptoms and evaluated the efficacy of a brief, online so...

Background: Delivering difficult news to individuals diagnosed with mental health disorders and their family members can be challenging. The use of simulated patients (SP) is an effective teaching method to enhance clinical skills, particularly those around communication. We developed, implemented, and evaluated the effectiveness of an SP-based tra...

Objective: Military service members and veterans have high rates of posttraumatic stress disorder (PTSD), as do military family members. Exposure-based, cognitive-behavioral approaches have received ample research, but other PTSD therapies require further empirical attention. Interpersonal psychotherapy (IPT) targets affective awareness, life circ...

Objective: Military service members and veterans have high rates of posttraumatic stress disorder (PTSD), as do military family members. Exposure-based, cognitive-behavioral approaches have received ample research, but other PTSD therapies require further empirical attention. Interpersonal psychotherapy (IPT) targets affective awareness, life circu...

Objectives: Co-constructive patient simulation (CCPS) is a novel medical education approach that provides a participatory and emotionally supportive alternative to traditional supervision and training. CCPS can adapt iteratively and in real time to emergent vicissitudes and challenges faced by clinicians. We describe the first implementation of CCP...

Introduction: In simulation sessions using standardized patients (SPs), it is the instructors, rather than the learners, who traditionally identify learning goals. We describe co-constructive patient simulation (CCPS), an experiential method in which learners address self-identified goals. Methods: In CCPS, a designated learner creates a case sc...

Introduction Medical culture can make trainees feel like there is neither room for mistakes, nor space for personal shortcomings in the makeup of physicians. A dearth of role models who can exemplify that it is acceptable to need support compounds barriers to help-seeking once students struggle. We conducted a mixed-methods study to assess the impa...

The 2020 COVID-19 pandemic has abruptly overwhelmed normal life. Beyond the fear and fatality of the virus itself comes a likely wave of psychiatric disorders. Simultaneously, social distancing has changed overnight how psychiatrists and other mental health professionals must treat patients. Telepsychotherapy, until now a promising but niche treatm...

Introduction: The mental status exam (MSE) is a structured approach to gathering a patient's behavioral and cognitive information. Analogous to the physical exam, it provides a template to collect clinical data in a systematic fashion. The MSE is a core competency of undergraduate medical education (UME) and an entrustable professional activity in...

Objective Stigma decreases healthcare seeking and treatment adherence and increases the duration of untreated psychosis among people with first-episode psychosis (FEP). This study evaluated the efficacy of a brief video-based intervention in reducing stigma among youth toward individuals with FEP and schizophrenia. We hypothesized that the social-c...

Objective Video-based depictions of electroconvulsive therapy (ECT) can be useful for educational purposes, but many of the readily available resources may worsen already stigmatized views of the procedure. Educators’ common reliance on such material highlights the paucity of equipoised depictions of modern ECT well suited for the training of healt...

The coronavirus disease 2019 (COVID-19) outbreak has rapidly spread, originating in Wuhan province, China, in late 2019 and making its way around the world in a matter of months. The outbreak is overwhelming intensive care units and health care capacity. According to the World Health Organization, as of May 20, 2020, there are 4 761 559 confirmed c...

Background Use of standardized (or simulated) patients (SP) is considered an effective teaching method for improving clinical and communication skills. This study assesses the effect of a single-day simulated patients (SP)-based training course on medical students’ communication and basic skills in clinical psychiatry during their psychiatry rotati...

Objective: To examine the effect of a novel antistigma intervention curriculum (ASIC) in reducing stigma toward psychiatry among medical students. Methods: Medical students from 8 hospitals in central Israel were divided into intervention (n = 57) and control (n = 163) arms. The students completed the 30-item Attitudes Toward Psychiatry (ATP-30)...

Introduction Depression and suicidal ideation are common among medical students, a group at higher risk for suicide completion than their age-normed peers. Medical students have health-seeking behaviors that are not commensurate with their mental health needs, a discrepancy likely related to stigma and to limited role-modeling provided by physician...

Objective The Mental status exam (MSE) is a core component of psychiatric education. Innovative ways of teaching the MSE by making it “come alive” may prove useful in a wide range of curricular initiatives. Methods The authors developed a publicly available online repository of sixteen video-based depictions by simulated psychiatric patients (SPPs...

Introduction: Stigma towards psychiatry and to people with serious mental illness (SMI) are prevalent among healthcare providers and can adversely affect patient care. Such stigmatized views can adversely affect recruitment into the already underserved field of mental health nursing. Aim/question: We adapted two stigma-related instruments in a s...

Aims We describe two experiential programmes toward school shaming and bullying (S/B), aiming at prevention, identification and early intervention. Methods Teachers attended a 2-day train-the-trainer workshop. 1stday: 8 simulation-based S/B scenarios, where communication with pupils and with parents role-played by actors was exercised. Teacher-act...

The present study examined whether the effectiveness of the Children’s Friendship Training (CFT) in children with ADHD is maintained following treatment endpoint and whether it is effective in a different culture outside the USA. Parent reports of social skills, behavioral problems, conflict, and children’s social knowledge were collected at baseli...

Objective: The purpose of the present study was to investigate how patients with schizophrenia and their relatives learn about the diagnosis and to study their feelings and degree of satisfaction with the process of delivering that information. Method: A total of 16 individuals who had been recently diagnosed with schizophrenia spectrum disorder...

Objective: Subtle expressions of stigmata or microaggressions consist of insensitive and demeaning remarks or statements which negate an individual's perception of their reality. They are differentiated from more traditional and overt forms of discrimination in that they are often voiced by well-intentioned individuals who are unaware of the negat...

Background The objective of this study was to compare the outcomes of 2 consecutive pregnancies of the same women who conceived after restrictive bariatric surgeries. Methods A retrospective study comparing consecutive pregnancy outcomes of the same women, who conceived before and twice after a restrictive bariatric surgery, was conducted. Result...

Abstract Objective: To evaluate pregnancy outcome and rates of anemia in patients following bariatric operation in comparison with obese pregnant women. Methods: A retrospective population-based study comparing pregnancy outcome of patients following bariatric with the obese population, was conducted. Multivariate logistic regression models were co...