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Santiago Papini, PhD

Santiago  Papini, PhD

Santiago Papini, PhD, received his doctorate in clinical psychology from The University of Texas at Austin and completed his internship at the VA San Diego Healthcare System. He joined DOR as a Delivery Science and Clinical Informatics Fellow and is also a recipient of the National Institute of Mental Health T32 grant, Embedded Mental Health Services Postdoctoral Research Training in Health Systems.

His research spans cross clinical trials for PTSD, substance use, and anxiety disorders, and translational research applying neuroimaging, psychophysiology, and experimental models of psychopathology. His NIH-funded dissertation research developed machine learning models of PTSD emergence and treatment response. As a Delivery Science and Clinical Informatics Fellow he aims to apply predictive modeling to facilitate targeted treatment approaches for psychiatric disorders.

Current Positions

  • Postdoctoral Research Fellow

Section Affiliations

Primary Research Interests

  • Machine learning and predictive modeling
  • Anxiety, stress, and substance use disorders
  • Targeted treatment dissemination


Development and validation of a prediction model of time to suicide attempt

Prediction models have the potential to transform targeted prevention strategies for suicide, a leading cause of death in the U.S. The work of our partners in the Mental Health Research Network demonstrated that predictive machine learning algorithms for suicide risk based on electronic health record data can accurately identify individuals with elevated suicide risk. However, a key limitation of current suicide prediction models is that the outcome window of prediction is 90 days post-visit. This means that current models do not necessarily distinguish between someone who is at imminent risk for suicide, and someone whose suicide attempt may occur months after the point of prediction. To address this limitation, we will develop models that predict time to suicide attempt and evaluate their overall performance, as well as performance across racial-ethnic categories where differences in suicide rates have been observed.

Investigator: Papini, Santiago

Funder: Northern California Community Benefit Programs

Detection and Mitigation of Algorithmic Bias in Predictive Models of Suicide Risk

This project will assess the potential impact of algorithmic bias on the allocation of preventive care for suicide and compare the performance of methods designed to mitigate algorithmic bias.

Investigator: Papini, Santiago

Funder: Section Pilot Grants

Predictive modeling of adverse mental health outcomes following acute hospitalizations for serious illness: A machine learning approach with natural language processing

This study addresses predicting risk of post-traumatic stress disorder and other mental health conditions following hospitalization for life-threatening conditions.
We will use an existing, retrospective cohort of 408,377 patients hospitalized with severe illness, including sepsis, to develop and validate predictive models of mental health diagnoses using only electronic health record data, including features extracted with natural language processing from symptoms recorded in clinician notes.

Investigator: Papini, Santiago

Funder: Section Pilot Grants


Performance of a Prediction Model of Suicide Attempts Across Race and Ethnicity

Authors: Papini, Santiago; Hsin, Honor; Kipnis, Patricia; Liu, Vincent X; Lu, Yun; Sterling, Stacy A; Iturralde, Esti

JAMA Psychiatry. 2023 Apr 01;80(4):399-400.

PubMed abstract

Associations of polygenic risk scores with posttraumatic stress symptom trajectories following combat deployment

Authors: Campbell-Sills, Laura; Papini, Santiago; Norman, Sonya B; Choi, Karmel W; He, Feng; Sun, Xiaoying; Kessler, Ronald C; Ursano, Robert J; Jain, Sonia; Stein, Murray B

Psychol Med. 2023 Mar 06:1-10.

PubMed abstract

Posttraumatic stress disorder symptom trajectories in a 16-month COVID-19 pandemic period

Authors: López-Castro, Teresa; Papini, Santiago; Bauer, Alexandria; Swarbrick, Margaret; Paul, Lynn K; Nizzi, Marie-Christine; Stanley, Damian; Team, Covid-Dynamic; Hien, Denise

J Trauma Stress. 2023 Feb;36(1):180-192. Epub 2022-12-26.

PubMed abstract

Use of Cannabidiol (CBD) oil in the treatment of PTSD: Study design and rationale for a placebo-controlled randomized clinical trial

Authors: Telch, Michael J; Fischer, Caitlin M; Zaizar, Eric D; Rubin, Mikael; Papini, Santiago

Contemp Clin Trials. 2022 Nov;122:106933. Epub 2022-09-22.

PubMed abstract

Comparing the effectiveness of a brief intervention to reduce unhealthy alcohol use among adult primary care patients with and without depression: A machine learning approach with augmented inverse probability weighting

Authors: Papini, Santiago; Chi, Felicia W; Schuler, Alejandro; Satre, Derek D; Liu, Vincent X; Sterling, Stacy A

Drug Alcohol Depend. 2022 Oct 01;239:109607. Epub 2022-08-27.

PubMed abstract

Impact of cannabidiol-rich hemp extract oil on reconsolidation disruption of naturalistic interoceptive aversive memory in humans: Protocol for a randomized clinical trial

Authors: Zaizar, Eric D; Papini, Santiago; O'Connor, Patrick; Telch, Michael J

Contemp Clin Trials. 2022 Aug;119:106847. Epub 2022-07-08.

PubMed abstract

Exploratory and Confirmatory Bayesian Networks Identify the Central Role of Non-judging in Symptoms of Depression.

Authors: Rubin M; Papini S; Dainer-Best J; Zaizar ED; Smits JAJ; Telch MJ

Mindfulness (N Y). 2021;12(10):2544-2551. doi: 10.1007/s12671-021-01726-1. Epub 2021 Aug 19.

PubMed abstract

Distinct trajectories of depression symptoms in early and middle adolescence: Preliminary evidence from longitudinal network analysis.

Authors: Rubin M; Bicki A; Papini S; Smits JAJ; Telch MJ; Gray JS

J Psychiatr Res. 2021 Oct;142:198-203. doi: 10.1016/j.jpsychires.2021.07.053. Epub 2021 Aug 4.

PubMed abstract

Singular and combined effects of transcranial infrared laser stimulation and exposure therapy on pathological fear: a randomized clinical trial.

Authors: Zaizar ED; Papini S; Gonzalez-Lima F; Telch MJ

Psychol Med. 2021 Jul 21:1-10. doi: 10.1017/S0033291721002270.

PubMed abstract

Community-based smoking cessation treatment for adults with high anxiety sensitivity: a randomized clinical trial.

Authors: Smits JAJ; Zvolensky MJ; Rosenfield D; Brown RA; Otto MW; Dutcher CD; Papini S; Freeman SZ; DiVita A; Perrone A; Garey L

Addiction. 2021 Nov;116(11):3188-3197. doi: 10.1111/add.15586. Epub 2021 Jun 13.

PubMed abstract

Frustrative nonreward and cannabinoid receptors: Chronic (but not acute) WIN 55,212-2 treatment increased resistance to change in two reward downshift tasks.

Authors: Conrad SE; Davis D; Vilcek N; Thompson JB; Guarino S; Papini S; Papini MR

Pharmacol Biochem Behav. 2022 Feb;213:173320. doi: 10.1016/j.pbb.2021.173320. Epub 2022 Jan 3.

PubMed abstract

The impact of prior and ongoing threat on the false alarm threshold for facial discrimination.

Authors: Papini S; Dunsmoor JE; Smits JAJ

J Behav Ther Exp Psychiatry. 2021 Mar;70:101619. doi: 10.1016/j.jbtep.2020.101619. Epub 2020 Oct 1.

PubMed abstract

Network analysis reveals the associations of past quit experiences on current smoking behavior and motivation to quit.

Authors: Dutcher CD; Papini S; Gebhardt CS; Smits JAJ

Addict Behav. 2021 Feb;113:106689. doi: 10.1016/j.addbeh.2020.106689. Epub 2020 Oct 1.

PubMed abstract

Dose Timing of D-Cycloserine to Augment Exposure Therapy for Social Anxiety Disorder: A Randomized Clinical Trial.

Authors: Smits JAJ; Pollack MH; Rosenfield D; Otto MW; Dowd S; Carpenter J; Dutcher CD; Lewis EM; Witcraft SM; Papini S; Curtiss J; Andrews L; Kind S; Conroy K; Hofmann SG

JAMA Netw Open. 2020 Jun 1;3(6):e206777. doi: 10.1001/jamanetworkopen.2020.6777.

PubMed abstract

Response-to-Treatment for Comorbid Post-Traumatic Stress and Substance Use Disorders: The Value of Combining Person- and Variable-Centered Approaches.

Authors: Allan NP; Lopez-Castro T; Hien DA; Papini S; Killeen TK; Gros DF; Ruglass LM; Barrett E; Back SE

J Psychopathol Behav Assess. 2020 Dec;42(4):725-738. doi: 10.1007/s10862-020-09803-w. Epub 2020 Apr 28.

PubMed abstract

Isradipine enhancement of virtual reality cue exposure for smoking cessation: Rationale and study protocol for a double-blind randomized controlled trial.

Authors: Papini S; Young CC; Gebhardt CS; Perrone A; Morikawa H; Otto MW; Roache JD; Smits JAJ

Contemp Clin Trials. 2020 Jul;94:106013. doi: 10.1016/j.cct.2020.106013. Epub 2020 Apr 24.

PubMed abstract

Pretreatment Posttraumatic Stress Disorder Symptom Network Metrics Predict the Strength of the Association Between Node Change and Network Change During Treatment.

Authors: Papini S; Rubin M; Telch MJ; Smits JAJ; Hien DA

J Trauma Stress. 2020 Feb;33(1):64-71. doi: 10.1002/jts.22379. Epub 2019 Jul 25.

PubMed abstract

Enhancing panic and smoking reduction treatment with D-Cycloserine: A pilot randomized clinical trial.

Authors: Smits JAJ; Zvolensky MJ; Otto MW; Piper ME; Baird SO; Kauffman BY; Lee-Furman E; Alavi N; Dutcher CD; Papini S; Rosenfield B; Rosenfield D

Drug Alcohol Depend. 2020 Mar 1;208:107877. doi: 10.1016/j.drugalcdep.2020.107877. Epub 2020 Jan 22.

PubMed abstract

Effect of d-cycloserine on fear extinction training in adults with social anxiety disorder.

Authors: Hofmann SG; Papini S; Carpenter JK; Otto MW; Rosenfield D; Dutcher CD; Dowd S; Lewis M; Witcraft S; Pollack MH; Smits JAJ

PLoS One. 2019 Oct 17;14(10):e0223729. doi: 10.1371/journal.pone.0223729. eCollection 2019.

PubMed abstract

Immersive 3D exposure-based treatment for spider fear: A randomized controlled trial.

Authors: Minns S; Levihn-Coon A; Carl E; Smits JAJ; Miller W; Howard D; Papini S; Quiroz S; Lee-Furman E; Telch M; Carlbring P; Xanthopoulos D; Powers MB

J Anxiety Disord. 2019 Jan;61:37-44. doi: 10.1016/j.janxdis.2018.12.003. Epub 2018 Dec 21.

PubMed abstract

Bias-contingent attention bias modification and attention control training in treatment of PTSD: a randomized control trial.

Authors: Lazarov A; Suarez-Jimenez B; Abend R; Naim R; Shvil E; Helpman L; Zhu X; Papini S; Duroski A; Rom R; Schneier FR; Pine DS; Bar-Haim Y; Neria Y

Psychol Med. 2019 Oct;49(14):2432-2440. doi: 10.1017/S0033291718003367. Epub 2018 Nov 12.

PubMed abstract

Ensemble machine learning prediction of posttraumatic stress disorder screening status after emergency room hospitalization.

Authors: Papini S; Pisner D; Shumake J; Powers MB; Beevers CG; Rainey EE; Smits JAJ; Warren AM

J Anxiety Disord. 2018 Dec;60:35-42. doi: 10.1016/j.janxdis.2018.10.004. Epub 2018 Oct 30.

PubMed abstract

Lagged effects of substance use on PTSD severity in a randomized controlled trial with modified prolonged exposure and relapse prevention.

Authors: Hien DA; Smith KZ; Owens M; Lopez-Castro T; Ruglass LM; Papini S

J Consult Clin Psychol. 2018 Oct;86(10):810-819. doi: 10.1037/ccp0000345.

PubMed abstract

Exposure-based therapy changes amygdala and hippocampus resting-state functional connectivity in patients with posttraumatic stress disorder.

Authors: Zhu X; Suarez-Jimenez B; Lazarov A; Helpman L; Papini S; Lowell A; Durosky A; Lindquist MA; Markowitz JC; Schneier F; Wager TD; Neria Y

Depress Anxiety. 2018 Oct;35(10):974-984. doi: 10.1002/da.22816. Epub 2018 Sep 10.

PubMed abstract

Immersive 3D exposure-based treatment for spider fear: A randomized controlled trial.

Authors: Minns S; Levihn-Coon A; Carl E; Smits JAJ; Miller W; Howard D; Papini S; Quiroz S; Lee-Furman E; Telch M; Carlbring P; Xanthopoulos D; Powers MB

J Anxiety Disord. 2018 Aug;58:1-7. doi: 10.1016/j.janxdis.2018.05.006. Epub 2018 Jun 4.

PubMed abstract

Effect of cognitive bias modification-memory on depressive symptoms and autobiographical memory bias: two independent studies in high-ruminating and dysphoric samples.

Authors: Vrijsen JN; Dainer-Best J; Witcraft SM; Papini S; Hertel P; Beevers CG; Becker ES; Smits JAJ

Cogn Emot. 2019 Mar;33(2):288-304. doi: 10.1080/02699931.2018.1450225. Epub 2018 Mar 15.

PubMed abstract

Emotion dysregulation moderates the effect of cognitive behavior therapy with prolonged exposure for co-occurring PTSD and substance use disorders.

Authors: Hien DA; Lopez-Castro T; Papini S; Gorman B; Ruglass LM

J Anxiety Disord. 2017 Dec;52:53-61. doi: 10.1016/j.janxdis.2017.10.003. Epub 2017 Oct 16.

PubMed abstract

A randomized controlled study of power posing before public speaking exposure for social anxiety disorder: No evidence for augmentative effects.

Authors: Davis ML; Papini S; Rosenfield D; Roelofs K; Kolb S; Powers MB; Smits JAJ

J Anxiety Disord. 2017 Dec;52:1-7. doi: 10.1016/j.janxdis.2017.09.004. Epub 2017 Sep 18.

PubMed abstract

Effects of acute exercise on fear extinction in rats and exposure therapy in humans: Null findings from five experiments.

Authors: Jacquart J; Roquet RF; Papini S; Powers MB; Rosenfield D; Smits JAJ; Monfils MH

J Anxiety Disord. 2017 Aug;50:76-86. doi: 10.1016/j.janxdis.2017.05.010. Epub 2017 Jun 4.

PubMed abstract

Concurrent Treatment with Prolonged Exposure for Co-Occurring Full or Subthreshold Posttraumatic Stress Disorder and Substance Use Disorders: A Randomized Clinical Trial.

Authors: Ruglass LM; Lopez-Castro T; Papini S; Killeen T; Back SE; Hien DA

Psychother Psychosom. 2017;86(3):150-161. doi: 10.1159/000462977. Epub 2017 May 11.

PubMed abstract

Identifying attendance patterns in a smoking cessation treatment and their relationships with quit success.

Authors: Jacquart J; Papini S; Davis ML; Rosenfield D; Powers MB; Frierson GM; Hopkins LB; Baird SO; Marcus BH; Church TS; Otto MW; Zvolensky MJ; Smits JAJ

Drug Alcohol Depend. 2017 May 1;174:65-69. doi: 10.1016/j.drugalcdep.2017.01.007. Epub 2017 Mar 6.

PubMed abstract

Impact of Cannabis Use on Treatment Outcomes among Adults Receiving Cognitive-Behavioral Treatment for PTSD and Substance Use Disorders.

Authors: Ruglass LM; Shevorykin A; Radoncic V; Smith KM; Smith PH; Galatzer-Levy IR; Papini S; Hien DA

J Clin Med. 2017 Feb 7;6(2). pii: jcm6020014. doi: 10.3390/jcm6020014.

PubMed abstract

Altered resting state functional connectivity of fear and reward circuitry in comorbid PTSD and major depression.

Authors: Zhu X; Helpman L; Papini S; Schneier F; Markowitz JC; Van Meter PE; Lindquist MA; Wager TD; Neria Y

Depress Anxiety. 2017 Jul;34(7):641-650. doi: 10.1002/da.22594. Epub 2016 Dec 28.

PubMed abstract

A cross species study of heterogeneity in fear extinction learning in relation to FKBP5 variation and expression: Implications for the acute treatment of posttraumatic stress disorder.

Authors: Galatzer-Levy IR; Andero R; Sawamura T; Jovanovic T; Papini S; Ressler KJ; Norrholm SD

Neuropharmacology. 2017 Apr;116:188-195. doi: 10.1016/j.neuropharm.2016.12.023. Epub 2016 Dec 23.

PubMed abstract

Chronic cannabis use is associated with impaired fear extinction in humans.

Authors: Papini S; Ruglass LM; Lopez-Castro T; Powers MB; Smits JA; Hien DA

J Abnorm Psychol. 2017 Jan;126(1):117-124. doi: 10.1037/abn0000224. Epub 2016 Nov 3.

PubMed abstract

Neural changes in extinction recall following prolonged exposure treatment for PTSD: A longitudinal fMRI study.

Authors: Helpman L; Marin MF; Papini S; Zhu X; Sullivan GM; Schneier F; Neria M; Shvil E; Malaga Aragon MJ; Markowitz JC; Lindquist MA; Wager T; Milad M; Neria Y

Neuroimage Clin. 2016 Oct 10;12:715-723. doi: 10.1016/j.nicl.2016.10.007. eCollection 2016.

PubMed abstract

Greater hippocampal volume is associated with PTSD treatment response.

Authors: Rubin M; Shvil E; Papini S; Chhetry BT; Helpman L; Markowitz JC; Mann JJ; Neria Y

Psychiatry Res Neuroimaging. 2016 Jun 30;252:36-39. doi: 10.1016/j.pscychresns.2016.05.001. Epub 2016 May 4.

PubMed abstract


Authors: Helpman L; Papini S; Chhetry BT; Shvil E; Rubin M; Sullivan GM; Markowitz JC; Mann JJ; Neria Y

Depress Anxiety. 2016 May;33(5):384-91. doi: 10.1002/da.22471. Epub 2016 Feb 10.

PubMed abstract

Pathways to change: Use trajectories following trauma-informed treatment of women with co-occurring post-traumatic stress disorder and substance use disorders.

Authors: Lopez-Castro T; Hu MC; Papini S; Ruglass LM; Hien DA

Drug Alcohol Rev. 2015 May;34(3):242-51. doi: 10.1111/dar.12230. Epub 2015 Mar 4.

PubMed abstract

Combining seeking safety with sertraline for PTSD and alcohol use disorders: A randomized controlled trial.

Authors: Hien DA; Levin FR; Ruglass LM; Lopez-Castro T; Papini S; Hu MC; Cohen LR; Herron A

J Consult Clin Psychol. 2015 Apr;83(2):359-69. doi: 10.1037/a0038719. Epub 2015 Jan 26.

PubMed abstract

Linguistic characteristics in a non-trauma-related narrative task are associated with PTSD diagnosis and symptom severity.

Authors: Papini S; Yoon P; Rubin M; Lopez-Castro T; Hien DA

Psychol Trauma. 2015 May;7(3):295-302. doi: 10.1037/tra0000019. Epub 2014 Dec 22.

PubMed abstract

Toward a translational approach to targeting the endocannabinoid system in posttraumatic stress disorder: a critical review of preclinical research.

Authors: Papini S; Sullivan GM; Hien DA; Shvil E; Neria Y

Biol Psychol. 2015 Jan;104:8-18. doi: 10.1016/j.biopsycho.2014.10.010. Epub 2014 Nov 4.

PubMed abstract

At the crossroads: the intersection of substance use disorders, anxiety disorders, and posttraumatic stress disorder.

Authors: Ruglass LM; Lopez-Castro T; Cheref S; Papini S; Hien DA

Curr Psychiatry Rep. 2014 Nov;16(11):505. doi: 10.1007/s11920-014-0505-5.

PubMed abstract

Psychometric Properties of the Modified Posttraumatic Stress Disorder Symptom Scale among Women with Posttraumatic Stress Disorder and Substance Use Disorders Receiving Outpatient Group Treatments.

Authors: Ruglass LM; Papini S; Trub L; Hien DA

J Trauma Stress Disord Treat. 2014;4(1). doi: 10.4172/2324-8947.1000139. Epub 2014 Oct 28.

PubMed abstract

Identifying profiles of recovery from reward devaluation in rats.

Authors: Papini S; R Galatzer-Levy I; Papini MR

Behav Brain Res. 2014 Dec 15;275:212-8. doi: 10.1016/j.bbr.2014.09.006. Epub 2014 Sep 10.

PubMed abstract

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