Karen Seal, MD

Professor

Dr. Karen Seal is a Professor of Medicine and Psychiatry in Residence at the University of California, San Francisco (UCSF). Based at the San Francisco VA Health Care System (SFVAHCS), she serves as Chief of the Integrative Health Service. In this capacity and as a general internist and integrative medicine physician, she oversees several interdisciplinary clinics including a post-9/11 Integrated Care Clinic for Iraq and Afghanistan veterans, the Integrated Pain Team Clinic, and the Integrative Health and Wellness Clinic which serve high-risk, high-needs veterans. As a health services researcher she conducts randomized controlled trials and observational studies targeting problems common in veterans such as chronic pain, opioid dependence and posttraumatic stress disorder and recently completed a trial testing a virtual worlds educational program to train primary care providers in PTSD assessment and management. She also actively mentors trainees, provides support for their research interests and seeks to involve them in one or more of the funded research studies listed below:

1. wHOPE Study (Funded by NIH, PI). This is a multi-site pragmatic trial at 5 VA sites across the U.S. to compare a Whole Health Team approach to Primary Care Group Education and both are compared to Usual Care for veterans with chronic pain enrolled in VA healthcare.
2. VOICE Study: (Funded by PCORI, Co-PI): A pragmatic effectiveness trial across 9 VA sites comparing an integrated pain team approach (modeled after the SFVAHCS Integrated Pain Team Clinic) vs. telephone collaborative management to improve pain and decrease opioid use among veterans.
3. Virtual Worlds Training in PTSD for Primary Care Providers: A pilot RCT (Funded by DoD, PI): This pilot trial compared a novel Virtual Worlds training for primary care providers in PTSD assessment and management vs. a Web-Based Training
4. Development of a Dietary Supplement Survey for Veterans (Funded by NIH, PI).We are engaged in participatory research to develop the first ever comprehensive survey of dietary supplement use among U.S. veterans.
5. Non-funded research involves use of the VA Electronic Health Record to answer relevant and timely questions such as vitamin D deficiency predicting COVID-19-related hospitalization and mortality etc.

Education
Post-Doctoral Fellowship, 05/2003 - , University of California, San Francisco, Center for AIDS Prevention Studies
MPH, 05/1998 - Epidemiology, University of California, Berkeley
MD, 05/1994 - Medicine, Stanford University School of Medicine
BS, 05/1985 - Neuroscience, Brown University
Residency, - Internal Medicine, University of California, San Francisco
Honors and Awards
  • Federal Employee of the Year for Research, VA, 2016
  • UCSF Excellence in Teaching Award in Medical Education, UCSF, 2010
  • Peninsula Community Scholar's Award for Community Service, Stanford University School of Medicine, 1991
  • Sigma Xi, Brown University, 1981-1985
Websites
Publications
  1. Pham C, Hildebrand C, Tarasovsky G, Purcell N, Seal K, Nicosia F. Implementation of Virtual, Livestream Yoga Classes for Veterans at Home During the COVID-19 Pandemic: A Mixed-Methods Pilot Program Evaluation. Global advances in integrative medicine and health 2024. PMID: 39429898


  2. Edmond SN, Kerns RD, Geda M, Luther SL, Edwards RR, Taylor SL, Rosen MI, Fritz JM, Goertz CM, Zeliadt SB, Seal KH. Initial Development of a Self-Report Survey on Use of Nonpharmacological and Self-Care Approaches for Pain Management (NSCAP). Pain medicine (Malden, Mass.) 2024. PMID: 39163504


  3. Wong RJ, Loeb R, Seal KH, Barry F, Stark Kent D, Seetharaman S, Sharma A, Lai JC, Rubin JB. The Complex Relationship Between Pain, Mental Health, and Quality-of-Life in Patients With Cirrhosis Undergoing Liver Transplant Evaluation. Journal of clinical gastroenterology 2024. PMID: 39008614


  4. Nicosia FM, Purcell N, Bertenthal D, Usman H, Seidel I, McGrath S, Hildebrand C, McCarthy B, Seal KH. Evaluation of a New Integrative Health and Wellness Clinic for Veterans at the San Francisco VA Health Care System: A Mixed-Methods Pilot Study. Global advances in integrative medicine and health 2024. PMID: 38867941


  5. Rubin JB, Loeb R, Fenton C, Huang CY, Keyhani S, Seal KH, Lai JC. The burden of significant pain in the cirrhosis population: Risk factors, analgesic use, and impact on health care utilization and clinical outcomes. Hepatology communications 2024. PMID: 38780295


  6. Moore LC, Woodruff NA, Seal KH, Feinberg T, Purcell N. Natural Product Use Among Veterans with Chronic Pain: A Qualitative Study of Attitudes and Communication with Healthcare Providers. Journal of general internal medicine 2024. PMID: 38689119


  7. Nishimi K, Neylan TC, Bertenthal D, Seal KH, O'Donovan A. Association of psychiatric disorders with clinical diagnosis of long COVID in US veterans. Psychological medicine 2024. PMID: 38311905


  8. Pyne JM, Kelly PA, Fischer EP, Owen RR, Cucciare MA, Miller CJ, Connolly SL, Zamora KA, Koenig CJ, Seal KH, Fortney JC. Trust and perceived mental health access: Exploring the relationship between perceived access barriers and veteran-reported trust. Psychological services 2023. PMID: 38127502


  9. Travis KJ, Huang AJ, Maguen S, Inslicht S, Byers AL, Seal KH, Gibson CJ. Military Sexual Trauma and Menopause Symptoms Among Midlife Women Veterans. Journal of general internal medicine 2023. PMID: 37957529


  10. Pyne JM, Seal KH, Manuel JK, DeRonne B, Oliver KA, Bertenthal D, Esserman D, Purcell N, Petrakis BA, Elwy AR. Developing and testing a COVID-19 vaccination acceptance intervention: A pragmatic trial comparing vaccine acceptance intervention vs usual care - Rationale, methods, and implementation. Contemporary clinical trials 2023. PMID: 37652356


  11. Manuel JK, Purcell N, Abadjian L, Cardoos S, Yalch M, Hill C, McCarthy B, Bertenthal D, McGrath S, Seal K. Virtual Worlds Technology to Enhance Training for Primary Care Providers in Assessment and Management of Posttraumatic Stress Disorder Using Motivational Interviewing: Pilot Randomized Controlled Trial. JMIR medical education 2023. PMID: 37639299


  12. Denneson LM, Purcell N, McGrath SL, Abadjian LR, Becker WC, Seal KH. Integration of Health Coaches in a Whole Health Team Model of Chronic Pain Care: a Qualitative Study. Journal of general internal medicine 2023. PMID: 37464147


  13. Possemato K, Johnson E, Barrie K, Ghaus S, Noronha D, Wade M, Greenbaum MA, Rosen C, Cloitre M, Owen J, Jain S, Beehler G, Prins A, Seal K, Kuhn E. A Randomized Clinical Trial of Clinician-Supported PTSD Coach in VA Primary Care Patients. Journal of general internal medicine 2023. PMID: 36932268


  14. Goldstein LA, Jakubowski KP, Huang AJ, Seal KH, Maguen S, Inslicht SS, Byers AL, Gibson CJ. Lifetime history of interpersonal partner violence is associated with insomnia among midlife women veterans. Menopause (New York, N.Y.) 2023. PMID: 36753121


  15. Baxley C, Borsari B, Reavis JV, Manuel JK, Herbst E, Becker W, Pennington D, Batki SL, Seal K. Effects of buprenorphine on opioid craving in comparison to other medications for opioid use disorder: A systematic review of randomized controlled trials. Addictive behaviors 2022. PMID: 36565531


  16. Nishimi K, Neylan TC, Bertenthal D, Dolsen EA, Seal KH, O'Donovan A. Post-traumatic stress disorder and risk for hospitalization and death following COVID-19 infection. Translational psychiatry 2022. PMID: 36411283


  17. Krebs EE, Becker WC, Nelson D, DeRonne BM, Nugent S, Jensen AC, Amundson EC, Manuel JK, Borsari B, Kats AM, Seal KH. Design, methods, and recruitment outcomes of the Veterans' Pain Care Organizational Improvement Comparative Effectiveness (VOICE) study. Contemporary clinical trials 2022. PMID: 36384218


  18. Hargrave AS, Maguen S, Inslicht SS, Byers AL, Seal KH, Huang AJ, Gibson CJ. Veterans Health Administration Screening for Military Sexual Trauma May Miss Over Half of Cases Among Midlife Women Veterans. Women's health issues : official publication of the Jacobs Institute of Women's Health 2022. PMID: 35821182


  19. Ali J, Antonelli M, Bastian L, Becker W, Brandt CA, Burgess DJ, Burns A, Cohen SP, Davis AF, Dearth CL, Dziura J, Edwards R, Erdos J, Farrokhi S, Fritz J, Geda M, George SZ, Goertz C, Goodie J, Hastings SN, Heapy A, Ilfeld BM, Katsovich L, Kerns RD, Kyriakides TC, Lee A, Long CR, Luther SL, Martino S, Matheny ME, McGeary D, Midboe A, Pasquina P, Peduzzi P, Raffanello M, Rhon D, Rosen M, Esposito ER, Scarton D, Hastings SN, Seal K, Silliker N, Taylor S, Taylor SL, Tsui M, Wright FS, Zeliadt S. Optimizing the Impact of Pragmatic Clinical Trials for Veteran and Military Populations: Lessons From the Pain Management Collaboratory. 2021. PMID: 34791412


  20. Blanken A, Gibson CJ, Li Y, Huang AJ, Byers AL, Maguen S, Inslicht S, Seal K. Racial/ethnic disparities in the diagnosis and management of menopause symptoms among midlife women veterans. Menopause (New York, N.Y.) 2022. PMID: 35796560


  21. Ranney R, Maguen S, Woods A, Seal KH, Neylan TC, Bernardy N, Wiechers I, Ryder A, Cohen BE. Comparison of mental health outcomes of augmenting medications for patients with posttraumatic stress disorder: A national veterans affairs study. Journal of evaluation in clinical practice 2022. PMID: 35709244


  22. Seal KH, Bertenthal D, Bikle DD. Response to Letters to the Editor RE: Association of Vitamin D Status and COVID-19-Related Hospitalization and Mortality. Journal of general internal medicine 2022. PMID: 35727478


  23. Holder N, Batten AJ, Shiner B, Li Y, Madden E, Neylan TC, Seal KH, Patterson OV, DuVall SL, Maguen S. Veterans receiving a second course of cognitive processing therapy or prolonged exposure therapy: is it better to switch or stay the same? 2022. PMID: 35475499


  24. Nishimi K, Neylan TC, Bertenthal D, Seal KH, O'Donovan A. Association of Psychiatric Disorders With Incidence of SARS-CoV-2 Breakthrough Infection Among Vaccinated Adults. 2022. PMID: 35420660


  25. Rubin JB, Lai JC, Leonard S, Seal K, Hoggatt KJ, Keyhani S. Long-Term Opioid Use Among Veterans with Cirrhosis: High-Dose Prescriptions in an Exceedingly High-Risk Population. 2022. PMID: 35037175


  26. Seal KH, Bertenthal D, Carey E, Grunfeld C, Bikle DD, Lu CM. Association of Vitamin D Status and COVID-19-Related Hospitalization and Mortality. 2022. PMID: 34981368


  27. Coleman BC, Purcell N, Geda M, Luther SL, Peduzzi P, Kerns RD, Seal KH, Burgess DJ, Rosen MI, Sellinger J, Salsbury SA, Gelman H, Brandt CA, Edwards RR. Assessing the impact of the COVID-19 pandemic on pragmatic clinical trial participants. 2021. PMID: 34775101


  28. Purcell N, Sells J, McGrath S, Mehlman H, Bertenthal D, Seal KH. "Then COVID happened…": Veterans' Health, Wellbeing, and Engagement in Whole Health Care During the COVID-19 Pandemic. 2021. PMID: 35174002


  29. Nicosia FM, Gibson CJ, Purcell N, Zamora K, Tighe J, Seal KH. Women Veterans' Experiences with Integrated, Biopsychosocial Pain Care: A Qualitative Study. Pain medicine (Malden, Mass.) 2021. PMID: 33547797


  30. Maguen S, Madden E, Holder N, Li Y, Seal KH, Neylan TC, Lujan C, Patterson OV, DuVall SL, Shiner B. Effectiveness and comparative effectiveness of evidence-based psychotherapies for posttraumatic stress disorder in clinical practice. Psychological medicine 2021. PMID: 34001290


  31. Seal KH, Pyne JM, Manuel JK, Li Y, Koenig CJ, Zamora KA, Abraham TH, Mesidor MM, Hill C, Uddo M, Hamilton M, Borsari B, Bertenthal D, Casey JJ, Kelly PA. Telephone veteran peer coaching for mental health treatment engagement among rural veterans: The importance of secondary outcomes and qualitative data in a randomized controlled trial. The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association 2021. PMID: 33978989


  32. Holder N, Woods A, Neylan TC, Maguen S, Seal KH, Bernardy N, Wiechers I, Ryder A, Urbieta AM, Cohen BE. Trends in Medication Prescribing in Patients With PTSD From 2009 to 2018: A National Veterans Administration Study. The Journal of clinical psychiatry 2021. PMID: 34004087


  33. Purcell N, Zamora K, Bertenthal D, Abadjian L, Tighe J, Seal KH. How VA Whole Health Coaching Can Impact Veterans' Health and Quality of Life: A Mixed-Methods Pilot Program Evaluation. Global advances in health and medicine 2021. PMID: 33747639


  34. Gibson CJ, Li Y, Jasuja GK, Self KJ, Seal KH, Byers AL. Menopausal Hormone Therapy and Suicide in a National Sample of Midlife and Older Women Veterans. Medical care 2021. PMID: 33438886


  35. Borsari B, Li Y, Tighe J, Manuel JK, Gökbayrak NS, Delucchi K, Morasco BJ, Abadjian L, Cohen BE, Baxley C, Seal KH. A pilot trial of collaborative care with motivational interviewing to reduce opioid risk and improve chronic pain management. Addiction (Abingdon, England) 2021. PMID: 33405304


  36. Bastian LA, Cohen SP, Katsovich L, Becker WC, Brummett BR, Burgess DJ, Crunkhorn AE, Denneson LM, Frank JW, Goertz C, Ilfeld B, Kanzler KE, Krishnaswamy A, LaChappelle K, Martino S, Mattocks K, McGeary CA, Reznik TE, Rhon DI, Salsbury SA, Seal KH, Semiatin AM, Shin MH, Simon CB, Teyhen DS, Zamora K, Kerns RD, NIH-DOD-VA Pain Management Collaboratory. Stakeholder Engagement in Pragmatic Clinical Trials: Emphasizing Relationships to Improve Pain Management Delivery and Outcomes. Pain medicine (Malden, Mass.) 2020. PMID: 33313726


  37. Seal KH, Becker WC, Murphy JL, Purcell N, Denneson LM, Morasco BJ, Martin AM, Reddy K, Iseghem TV, Krebs EE, Painter JM, Hagedorn H, Pyne JM, Hixon J, Maguen S, Neylan TC, Borsari B, DeRonne B, Gibson C, Matthias MS, Frank JW, Krishnaswamy A, Li Y, Bertenthal D, Chan A, Nunez A, McCamish N. Whole Health Options and Pain Education (wHOPE): A Pragmatic Trial Comparing Whole Health Team vs Primary Care Group Education to Promote Nonpharmacological Strategies to Improve Pain, Functioning, and Quality of Life in Veterans-Rationale, Methods, and I Pain medicine (Malden, Mass.) 2020. PMID: 33313734


  38. Holder N, Shiner B, Li Y, Madden E, Neylan TC, Seal KH, Lujan C, Patterson OV, DuVall SL, Maguen S. Determining the median effective dose of prolonged exposure therapy for veterans with posttraumatic stress disorder. Behaviour research and therapy 2020. PMID: 33157475


  39. Pyne JM, Kelly PA, Fischer EP, Miller CJ, Connolly SL, Wright P, Zamora K, Koenig CJ, Seal KH, Fortney JC. Initial concurrent and convergent validity of the Perceived Access Inventory (PAI) for mental health services. Psychological services 2020. PMID: 33030947


  40. Gibson CJ, Grasso J, Li Y, Purcell N, Tighe J, Zamora K, Nicosia F, Seal KH. An Integrated Pain Team Model: Impact on Pain-Related Outcomes and Opioid Misuse in Patients with Chronic Pain. Pain medicine (Malden, Mass.) 2020. PMID: 32100002


  41. Purcell N, Becker WC, Zamora KA, McGrath SL, Hagedorn HJ, Fabian ER, McCamish N, Seal KH. Tailored to Fit: How an Implementation Framework Can Support Pragmatic Pain Care Trial Adaptation for Diverse Veterans Affairs Clinical Settings. Medical care 2020. PMID: 32826776


  42. Khan AJ, Holder N, Li Y, Shiner B, Madden E, Seal K, Neylan TC, Maguen S. How do gender and military sexual trauma impact PTSD symptoms in cognitive processing therapy and prolonged exposure? Journal of psychiatric research 2020. PMID: 32798774


  43. Holder N, Shiner B, Li Y, Madden E, Neylan TC, Seal KH, Lujan C, Patterson OV, DuVall SL, Maguen S. Cognitive Processing Therapy for Veterans with Posttraumatic Stress Disorder: What is the Median Effective Dose? Journal of affective disorders 2020. PMID: 32560937


  44. Maguen S, Holder N, Li Y, Madden E, Neylan TC, Seal KH, Lujan C, Patterson OV, DuVall SL, Shiner B. Factors associated with PTSD symptom improvement among Iraq and Afghanistan veterans receiving evidenced-based psychotherapy. Journal of affective disorders 2020. PMID: 32421589


  45. Peralta CA, Frigaard M, Rolon L, Seal K, Tuot D, Senyak J, Lo L, Powe N, Scherzer R, Chao S, Chiao P, Lui K, Shlipak MG, Rubinsky AD. Screening for CKD To Improve Processes of Care among Nondiabetic Veterans with Hypertension: A Pragmatic Cluster-Randomized Trial. Clinical journal of the American Society of Nephrology : CJASN 2020. PMID: 32034070


  46. Maguen S, Holder N, Madden E, Li Y, Seal KH, Neylan TC, Lujan C, Patterson OV, DuVall SL, Shiner B. Evidence-based psychotherapy trends among posttraumatic stress disorder patients in a national healthcare system, 2001-2014. Depression and anxiety 2019. PMID: 31850650


  47. Seal KH, Rife T, Li Y, Gibson C, Tighe J. Opioid Reduction and Risk Mitigation in VA Primary Care: Outcomes from the Integrated Pain Team Initiative. Journal of general internal medicine 2019. PMID: 31848861


  48. Byers AL, Li Y, Barnes DE, Seal KH, Boscardin WJ, Yaffe K. A national study of TBI and risk of suicide and unintended death by overdose and firearms. Brain injury 2019. PMID: 31822136


  49. Rosen RC, Cikesh B, Fang S, Trachtenberg FL, Seal KH, Magnavita AM, Bovin MJ, Green JD, Bliwise DL, Marx BP, Keane TM. Posttraumatic Stress Disorder Severity and Insomnia-Related Sleep Disturbances: Longitudinal Associations in a Large, Gender-Balanced Cohort of Combat-Exposed Veterans. Journal of traumatic stress 2019. PMID: 31800135


  50. Gibson CJ, Li Y, Huang AJ, Rife T, Seal KH. Menopausal Symptoms and Higher Risk Opioid Prescribing in a National Sample of Women Veterans with Chronic Pain. Journal of general internal medicine 2019. PMID: 31414358


  51. Holder N, Shiner B, Li Y, Madden E, Neylan TC, Seal KH, Lujan C, Patterson OV, DuVall SL, Maguen S. Timing of evidence-based psychotherapy for posttraumatic stress disorder initiation among Iraq and Afghanistan war veterans in the Veterans Health Administration. Psychological trauma : theory, research, practice and policy 2019. PMID: 31343206


  52. Pyne JM, Kelly PA, Fischer EP, Miller CJ, Wright P, Zamora K, Koenig CJ, Stanley R, Seal K, Fortney JC. Development of a Perceived Access Inventory for Community Care Mental Healthcare Services for Veterans. Military medicine 2019. PMID: 30690462


  53. Gibson CJ, Li Y, Bertenthal D, Huang AJ, Seal KH. Menopause symptoms and chronic pain in a national sample of midlife women veterans. Menopause (New York, N.Y.) 2019. PMID: 30839364


  54. Joyce C, Greasley P, Weatherhead S, Seal K. Beyond the Revolving Door: Long-Term Lived Experience of Eating Disorders and Specialist Service Provision. Qualitative health research 2019. PMID: 31165677


  55. Purcell N, Zamora K, Gibson C, Tighe J, Chang J, Grasso J, Seal KH. Patient Experiences With Integrated Pain Care: A Qualitative Evaluation of One VA's Biopsychosocial Approach to Chronic Pain Treatment and Opioid Safety. Global advances in health and medicine 2019. PMID: 31041143


  56. Maguen S, Li Y, Madden E, Seal KH, Neylan TC, Patterson OV, DuVall SL, Lujan C, Shiner B. Factors associated with completing evidence-based psychotherapy for PTSD among veterans in a national healthcare system. Psychiatry research 2019. PMID: 30784780


  57. Seal KH, Borsari B, Tighe J, Cohen BE, Delucchi K, Morasco BJ, Li Y, Sachs E, Abadjian L, Watson EC, Manuel JK, Vella L, Trafton J, Midboe A. Optimizing pain treatment interventions (OPTI): A pilot randomized controlled trial of collaborative care to improve chronic pain management and opioid safety-Rationale, methods, and lessons learned. Contemporary clinical trials 2018. PMID: 30572163


  58. Gibson CJ, Li Y, Inslicht SS, Seal KH, Byers AL. Gender Differences in Cardiovascular Risk Related to Diabetes and Posttraumatic Stress Disorder. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry 2018. PMID: 30314941


  59. Barnes DE, Byers AL, Gardner RC, Seal KH, Boscardin WJ, Yaffe K. Association of Mild Traumatic Brain Injury With and Without Loss of Consciousness With Dementia in US Military Veterans. JAMA neurology 2018. PMID: 29801145


  60. Pyne JM, Kelly PA, Fischer EP, Miller CJ, Wright P, Zamora K, Koenig CJ, Stanley R, Seal K, Burgess JF, Fortney JC. Development of the Perceived Access Inventory: A patient-centered measure of access to mental health care. Psychological services 2018. PMID: 30024190


  61. Bertenthal D, Yaffe K, Barnes DE, Byers AL, Gibson CJ, Seal KH. Do postconcussive symptoms from traumatic brain injury in combat veterans predict risk for receiving opioid therapy for chronic pain? Brain injury 2018. PMID: 29985653


  62. Seal KH, Bertenthal D, Barnes DE, Byers AL, Gibson CJ, Yaffe K. Traumatic Brain Injury and Receipt of Prescription Opioid Therapy for Chronic Pain in Iraq and Afghanistan Veterans: Do Clinical Practice Guidelines Matter? The journal of pain : official journal of the American Pain Society 2018. PMID: 29597083


  63. Brailey K, Mills MA, Marx BP, Proctor SP, Seal KH, Spiro A, Ulloa EW, Vasterling JJ. Prospective Examination of Early Associations of Iraq War Zone Deployment, Combat Severity, and Posttraumatic Stress Disorder with New Incident Medical Diagnoses. Journal of traumatic stress 2018. PMID: 29513919


  64. Samuelson KW, Abadjian L, Jordan JT, Bartel A, Vasterling J, Seal K. The Association Between PTSD and Functional Outcome Is Mediated by Perception of Cognitive Problems Rather Than Objective Neuropsychological Test Performance. Journal of traumatic stress 2017. PMID: 29030878


  65. Abraham TH, Koenig CJ, Zamora K, Hill C, Uddo M, Kelly AP, Hamilton MF, Curran GM, Pyne JM, Seal KH. Situating mental health work in place: Qualitative findings from interviews with Veterans in Southeastern Louisiana and Northern California. Volume 47. Health & place 2017. PMID: 28755653


  66. Seal KH, Bertenthal D, Barnes DE, Byers AL, Strigo I, Yaffe K. Association of Traumatic Brain Injury With Chronic Pain in Iraq and Afghanistan Veterans: Effect of Comorbid Mental Health Conditions. Archives of physical medicine and rehabilitation 2017. PMID: 28455190


  67. Peralta CA, Frigaard M, Rubinsky AD, Rolon L, Lo L, Voora S, Seal K, Tuot D, Chao S, Lui K, Chiao P, Powe N, Shlipak M. Implementation of a pragmatic randomized trial of screening for chronic kidney disease to improve care among non-diabetic hypertensive veterans. Volume 18 of Issue 1. BMC nephrology 2017. PMID: 28399844


  68. Seal K, Becker W, Tighe J, Li Y, Rife T. Managing Chronic Pain in Primary Care: It Really Does Take a Village. Journal of general internal medicine 2017. PMID: 28337689


  69. Metrik J, Jackson K, Bassett SS, Zvolensky MJ, Seal K, Borsari B. The mediating roles of coping, sleep, and anxiety motives in cannabis use and problems among returning veterans with PTSD and MDD. Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors 2016. PMID: 27786514


  70. Seal KH, Maguen S, Bertenthal D, Batki SL, Striebel J, Stein MB, Madden E, Neylan TC. Observational Evidence for Buprenorphine's Impact on Posttraumatic Stress Symptoms in Veterans With Chronic Pain and Opioid Use Disorder. The Journal of clinical psychiatry 2016. PMID: 27035058


  71. Koenig CJ, Abraham T, Zamora KA, Hill C, Kelly PA, Uddo M, Hamilton M, Pyne JM, Seal KH. Pre-Implementation Strategies to Adapt and Implement a Veteran Peer Coaching Intervention to Improve Mental Health Treatment Engagement Among Rural Veterans. Volume 32 of Issue 4. The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association 2016. PMID: 27509291


  72. Breyer BN, Fang SC, Seal KH, Ranganathan G, Marx BP, Keane TM, Rosen RC. Sexual Health in Male and Female Iraq and Afghanistan U. S. War Veterans With and Without PTSD: Findings From the VALOR Cohort. Journal of traumatic stress 2016. PMID: 27128485


  73. Lau KM, Madden E, Neylan TC, Seal KH, Maguen S. Assessing for mild TBI among Iraq and Afghanistan veterans: Outcomes of injury severity and neurological factors. Brain injury 2016. PMID: 26910483


  74. Seal KH, Bertenthal D, Samuelson K, Maguen S, Kumar S, Vasterling JJ. Association between mild traumatic brain injury and mental health problems and self-reported cognitive dysfunction in Iraq and Afghanistan Veterans. Journal of rehabilitation research and development 2016. PMID: 27148692


  75. Koo KH, Hebenstreit CL, Madden E, Seal KH, Maguen S. Race/ethnicity and gender differences in mental health diagnoses among Iraq and Afghanistan veterans. Psychiatry research 2015. PMID: 26282226


  76. Maguen S, Madden E, Cohen BE, Bertenthal D, Neylan TC, Seal KH. Suicide risk in Iraq and Afghanistan veterans with mental health problems in VA care. Journal of psychiatric research 2015. PMID: 26228410


  77. Cohen BE, Shi Y, Neylan TC, Maguen S, Seal KH. Antipsychotic prescriptions in Iraq and Afghanistan veterans with posttraumatic stress disorder in Department of Veterans Affairs healthcare, 2007-2012. The Journal of clinical psychiatry 2015. PMID: 25845036


  78. Maguen S, Madden E, Neylan TC, Cohen BE, Bertenthal D, Seal KH. Timing of mental health treatment and PTSD Symptom improvement among Iraq and Afghanistan veterans. Psychiatric services (Washington, D.C.) 2014. PMID: 25082217


  79. Oliva EM, Midboe AM, Lewis ET, Henderson PT, Dalton AL, Im JJ, Seal K, Paik MC, Trafton JA. Sex differences in chronic pain management practices for patients receiving opioids from the Veterans Health Administration. Pain medicine (Malden, Mass.) 2014. PMID: 25039721


  80. O'Donovan A, Cohen BE, Seal KH, Bertenthal D, Margaretten M, Nishimi K, Neylan TC. Elevated risk for autoimmune disorders in iraq and afghanistan veterans with posttraumatic stress disorder. Biological psychiatry 2014. PMID: 25104173


  81. Koenig CJ, Maguen S, Monroy JD, Mayott L, Seal KH. Facilitating culture-centered communication between health care providers and veterans transitioning from military deployment to civilian life. Volume 95 of Issue 3. Patient education and counseling 2014. PMID: 24742536


  82. Samuelson KW, Koenig CJ, McCamish N, Choucroun G, Tarasovsky G, Bertenthal D, Seal KH. Web-based PTSD training for primary care providers: a pilot study. Volume 11 of Issue 2. Psychological services 2013. PMID: 24364595


  83. Grossbard JR, Hawkins EJ, Lapham GT, Williams EC, Rubinsky AD, Simpson TL, Seal KH, Kivlahan DR, Bradley KA. Follow-up care for alcohol misuse among OEF/OIF veterans with and without alcohol use disorders and posttraumatic stress disorder. Journal of substance abuse treatment 2013. PMID: 23906670


  84. Maguen S, Madden E, Lau KM, Seal KH. Service utilization among Iraq and Afghanistan veterans screening positive for traumatic brain injury. Journal of neurotrauma 2013. PMID: 23327186


  85. Maguen S, Madden E, Cohen B, Bertenthal D, Neylan T, Talbot L, Grunfeld C, Seal K. The relationship between body mass index and mental health among Iraq and Afghanistan veterans. Volume 28 Suppl 2. Journal of general internal medicine 2013. PMID: 23807066


  86. Seal KH, Stein MB. Preventing the pain of PTSD. Science translational medicine 2013. PMID: 23740896


  87. Grossbard JR, Lehavot K, Hoerster KD, Jakupcak M, Seal KH, Simpson TL. Relationships among veteran status, gender, and key health indicators in a national young adult sample. Psychiatric services (Washington, D.C.) 2013. PMID: 23450338


  88. Maguen S, Madden E, Cohen B, Bertenthal D, Seal K. Association of mental health problems with gastrointestinal disorders in Iraq and Afghanistan veterans. Depression and anxiety 2013. PMID: 23494973


  89. Jakupcak M, Hoerster KD, Blais RK, Malte CA, Hunt S, Seal K. Readiness for change predicts VA Mental Healthcare utilization among Iraq and Afghanistan war veterans. Journal of traumatic stress 2013. PMID: 23319359


  90. Maguen S, Madden E, Cohen BE, Bertenthal D, Seal KH. Time to treatment among veterans of conflicts in Iraq and Afghanistan with psychiatric diagnoses. Psychiatric services (Washington, D.C.) 2012. PMID: 23070131


  91. Cohen BE, Maguen S, Bertenthal D, Shi Y, Jacoby V, Seal KH. Reproductive and other health outcomes in Iraq and Afghanistan women veterans using VA health care: association with mental health diagnoses. Women's health issues : official publication of the Jacobs Institute of Women's Health 2012. PMID: 22944901


  92. Koenig CJ, Maguen S, Daley A, Cohen G, Seal KH. Passing the baton: a grounded practical theory of handoff communication between multidisciplinary providers in two Department of Veterans Affairs outpatient settings. Volume 28 of Issue 1. Journal of general internal medicine 2012. PMID: 22868947


  93. Maguen S, Cohen B, Cohen G, Madden E, Bertenthal D, Seal K. Eating disorders and psychiatric comorbidity among Iraq and Afghanistan veterans. Women's health issues : official publication of the Jacobs Institute of Women's Health 2012. PMID: 22749199


  94. Maguen S, Lau KM, Madden E, Seal K. Factors associated with completing comprehensive traumatic brain injury evaluation. Military medicine 2012. PMID: 22808886


  95. Spelman JF, Hunt SC, Seal KH, Burgo-Black AL. Post deployment care for returning combat veterans. Journal of general internal medicine 2012. PMID: 22648608


  96. Seal KH, Abadjian L, McCamish N, Shi Y, Tarasovsky G, Weingardt K. A randomized controlled trial of telephone motivational interviewing to enhance mental health treatment engagement in Iraq and Afghanistan veterans. General hospital psychiatry 2012. PMID: 22632925


  97. Seal KH, Shi Y, Cohen G, Cohen BE, Maguen S, Krebs EE, Neylan TC. Association of mental health disorders with prescription opioids and high-risk opioid use in US veterans of Iraq and Afghanistan. JAMA 2012. PMID: 22396516


  98. Maguen S, Cohen B, Cohen G, Madden E, Bertenthal D, Seal K. Gender differences in health service utilization among Iraq and Afghanistan veterans with posttraumatic stress disorder. Journal of women's health (2002) 2012. PMID: 22313026


  99. Maguen S, Madden E, Lau KM, Seal K. The impact of head injury mechanism on mental health symptoms in veterans: do number and type of exposures matter? Journal of traumatic stress 2012. PMID: 22354503


  100. Maguen S, Lau KM, Madden E, Seal K. Relationship of screen-based symptoms for mild traumatic brain injury and mental health problems in Iraq and Afghanistan veterans: Distinct or overlapping symptoms? Journal of rehabilitation research and development 2012. PMID: 23341283


  101. Maguen S, Cohen B, Ren L, Bosch J, Kimerling R, Seal K. Gender differences in military sexual trauma and mental health diagnoses among Iraq and Afghanistan veterans with posttraumatic stress disorder. Women's health issues : official publication of the Jacobs Institute of Women's Health 2011. PMID: 21907590


  102. Seal KH, Cohen G, Bertenthal D, Cohen BE, Maguen S, Daley A. Reducing barriers to mental health and social services for Iraq and Afghanistan veterans: outcomes of an integrated primary care clinic. Journal of general internal medicine 2011. PMID: 21647750


  103. Seal KH, Cohen G, Waldrop A, Cohen BE, Maguen S, Ren L. Substance use disorders in Iraq and Afghanistan veterans in VA healthcare, 2001-2010: Implications for screening, diagnosis and treatment. Drug and alcohol dependence 2011. PMID: 21277712


  104. Maguen S, Ren L, Bosch JO, Marmar CR, Seal KH. Gender differences in mental health diagnoses among Iraq and Afghanistan veterans enrolled in veterans affairs health care. American journal of public health 2010. PMID: 20966380


  105. Maguen S, Lucenko BA, Reger MA, Gahm GA, Litz BT, Seal KH, Knight SJ, Marmar CR. The impact of reported direct and indirect killing on mental health symptoms in Iraq war veterans. Journal of traumatic stress 2010. PMID: 20104592


  106. Seal KH, Maguen S, Cohen B, Gima KS, Metzler TJ, Ren L, Bertenthal D, Marmar CR. VA mental health services utilization in Iraq and Afghanistan veterans in the first year of receiving new mental health diagnoses. Journal of traumatic stress 2010. PMID: 20146392


  107. Maguen S, Metzler TJ, Litz BT, Seal KH, Knight SJ, Marmar CR. The impact of killing in war on mental health symptoms and related functioning. Journal of traumatic stress 2009. PMID: 19842160


  108. Cohen BE, Gima K, Bertenthal D, Kim S, Marmar CR, Seal KH. Mental health diagnoses and utilization of VA non-mental health medical services among returning Iraq and Afghanistan veterans. Journal of general internal medicine 2009. PMID: 19787409


  109. Seal KH, Metzler TJ, Gima KS, Bertenthal D, Maguen S, Marmar CR. Trends and risk factors for mental health diagnoses among Iraq and Afghanistan veterans using Department of Veterans Affairs health care, 2002-2008. American journal of public health 2009. PMID: 19608954


  110. Tsui JI, Whooley MA, Monto A, Seal K, Tien PC, Shlipak M. Association of hepatitis C virus seropositivity with inflammatory markers and heart failure in persons with coronary heart disease: data from the Heart and Soul study. Volume 15 of Issue 5. Journal of cardiac failure 2009. PMID: 19477406


  111. Hu Y, Grau LE, Scott G, Seal KH, Marshall PA, Singer M, Heimer R. Economic evaluation of delivering hepatitis B vaccine to injection drug users. American journal of preventive medicine 2008. PMID: 18541174


  112. Seal KH, Bertenthal D, Maguen S, Gima K, Chu A, Marmar CR. Getting beyond "Don't ask; don't tell": an evaluation of US Veterans Administration postdeployment mental health screening of veterans returning from Iraq and Afghanistan. American journal of public health 2008. PMID: 18309130


  113. Seal KH, Monto A, Dove L, Shen H, Vittinghoff E, Tracy D, Miller E, Lau E, Wright TL. The association of human immunodeficiency virus infection with spontaneously resolved hepatitis C virus infection and level of viremia among injection drug users. Volume 52 of Issue 12. Digestive diseases and sciences 2007. PMID: 17443407


  114. Seal KH, Currie SL, Shen H, Anand BS, Bini EJ, Brau N, Jeffers L, Wright TL. Hepatitis C treatment candidacy and outcomes among 4318 US veterans with chronic hepatitis C virus infection: does a history of injection drug use matter? Journal of clinical gastroenterology 2007. PMID: 17245220


  115. Tsui JI, Pletcher MJ, Vittinghoff E, Seal K, Gonzales R. Hepatitis C and hospital outcomes in patients admitted with alcohol-related problems. Journal of hepatology 2005. PMID: 16226823


  116. Seal KH, Thawley R, Gee L, Bamberger J, Kral AH, Ciccarone D, Downing M, Edlin BR. Naloxone distribution and cardiopulmonary resuscitation training for injection drug users to prevent heroin overdose death: a pilot intervention study. Journal of urban health : bulletin of the New York Academy of Medicine 2005. PMID: 15872192


  117. Seal KH, Kral AH, Lorvick J, McNees A, Gee L, Edlin BR. A randomized controlled trial of monetary incentives vs. outreach to enhance adherence to the hepatitis B vaccine series among injection drug users. Drug and alcohol dependence 2003. PMID: 12927650


  118. Pfeiffer RM, Tanaka Y, Yeo AE, Umemura T, Seal KH, Shih JW, Alter HJ, Edlin BR, O'Brien TR. Prevalence of SEN viruses among injection drug users in the San Francisco Bay area. The Journal of infectious diseases 2003. PMID: 12825166


  119. Seal KH, Downing M, Kral AH, Singleton-Banks S, Hammond JP, Lorvick J, Ciccarone D, Edlin BR. Attitudes about prescribing take-home naloxone to injection drug users for the management of heroin overdose: a survey of street-recruited injectors in the San Francisco Bay Area. Journal of urban health : bulletin of the New York Academy of Medicine 2003. PMID: 12791805


  120. Atkinson J, Edlin BR, Engels EA, Kral AH, Seal K, Gamache CJ, Whitby D, O'Brien TR. Seroprevalence of human herpesvirus 8 among injection drug users in San Francisco. The Journal of infectious diseases 2003. PMID: 12660944


  121. Seal KH, Kral AH, Gee L, Moore LD, Bluthenthal RN, Lorvick J, Edlin BR. Predictors and prevention of nonfatal overdose among street-recruited injection heroin users in the San Francisco Bay Area, 1998-1999. American journal of public health 2001. PMID: 11684613


  122. Bluthenthal RN, Kral AH, Gee L, Lorvick J, Moore L, Seal K, Edlin BR. Trends in HIV seroprevalence and risk among gay and bisexual men who inject drugs in San Francisco, 1988 to 2000. Journal of acquired immune deficiency syndromes (1999) 2001. PMID: 11694834


  123. Edlin BR, Seal KH, Lorvick J, Kral AH, Ciccarone DH, Moore LD, Lo B. Is it justifiable to withhold treatment for hepatitis C from illicit-drug users? The New England journal of medicine 2001. PMID: 11463019


  124. Ochoa KC, Hahn JA, Seal KH, Moss AR. Overdosing among young injection drug users in San Francisco. Addictive behaviors 2001. PMID: 11436937


  125. Lorvick J, Kral AH, Seal K, Gee L, Edlin BR. Prevalence and duration of hepatitis C among injection drug users in San Francisco, Calif. American journal of public health 2001. PMID: 11189823


  126. Seal KH, Ochoa KC, Hahn JA, Tulsky JP, Edlin BR, Moss AR. Risk of hepatitis B infection among young injection drug users in San Francisco: opportunities for intervention. The Western journal of medicine 2000. PMID: 10695436


  127. Brailey, K, Mills, MA, Marx, BP, Proctor, SP, Seal, KH, Spiro, A, III, Ulloa, E. W., & Vasterling, J. J.. Prospective examination of early associations of Iraq warzone deployment, combat severity, and PTSD with new incident medical diagnoses Journal of traumatic stress . PMID: