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Joseph Wielgosz, Ph.D. is a postdoctoral research fellow at the Sierra Pacific MIRECC, VA Palo Alto Healthcare System and Stanford University. His research focuses on using digital health and neuroscience-informed approaches to improve evidence-based treatment of PTSD and related emotion disorders, as well as mindfulness-based interventions for emotional health.

Professional Education

  • Doctor of Philosophy, University of Wisconsin Madison (2018)
  • Bachelor of Arts, Washington University (1998)

Research & Scholarship

Lab Affiliations


All Publications

  • Mindfulness Meditation and Psychopathology ANNUAL REVIEW OF CLINICAL PSYCHOLOGY, VOL 15 Wielgosz, J., Goldberg, S. B., Kral, T. A., Dunne, J. D., Davidson, R. J., Widiger, T., Cannon, T. D. 2019; 15: 285?316
  • Early changes in neural circuit function engaged by negative emotion and modified by behavioural intervention are associated with depression and problem-solving outcomes: A report from the ENGAGE randomized controlled trial. EBioMedicine Goldstein-Piekarski, A. N., Wielgosz, J., Xiao, L., Stetz, P., Correa, C. G., Chang, S. E., Lv, N., Rosas, L. G., Lavori, P. W., Snowden, M. B., Venditti, E. M., Simmons, J. M., Smyth, J. M., Suppes, T., Lewis, M. A., Ajilore, O., Ma, J., Williams, L. M. 2021; 67: 103387


    BACKGROUND: Depression exerts a staggering toll that is worsened with co-occurring chronic conditions such as obesity. It is imperative to develop more effective interventions for depression and to identify objective and biological plausible neural mechanisms to understand intervention outcomes. The current study uses functional neuroimaging to determine whether a behavioural intervention changes the negative affect circuit and whether these changes relate to subsequent improvements in both symptom and problem-solving outcomes in depressed patients with co-occurring obesity.METHODS: This study ('ENGAGE') was a pre-planned element of the randomized controlled trial, 'RAINBOW' ( NCT02246413). 108 depressed patients with obesity were randomized to receive an integrated collaborative care intervention (I-CARE) or usual care. Participants underwent functional neuroimaging using an established facial emotion task at baseline and two months (coinciding with the first two months of intervention focused on problem-solving therapy ('PST')). Amygdala, insula and anterior cingulate cortex activation was extracted using pre-planned definitions and standardized methods. The primary health and behavioural outcomes were depression symptom severity and problem-solving ability respectively, assessed at baseline, the main 6-month outcome point and at 12-month follow up. Mediation analyses used an intent-to-treat approach.FINDINGS: PST, relative to usual care, reduced amygdala activation engaged by threat stimuli at two months. This reduction mediated subsequent improvements in depression severity in an intervention-dependent manner. PST did not change insula activation at two months but did temper the strength of the relationship between insula activation and improvements in problem-solving ability.INTERPRETATION: The negative affect circuit may be an important neural target and potential mediator of PST in patients with comorbid obesity.FUNDING: US National Institutes of Health/National Heart Lung and Blood Institute R01 HL119453 and UH2/UH3 HL132368.

    View details for DOI 10.1016/j.ebiom.2021.103387

    View details for PubMedID 34004422

  • The ENGAGE-2 study: Engaging self-regulation targets to understand the mechanisms of behavior change and improve mood and weight outcomes in a randomized controlled trial (Phase 2). Contemporary clinical trials Lv, N., Ajilore, O. A., Ronneberg, C. R., Venditti, E. M., Snowden, M. B., Lavori, P. W., Xiao, L., Goldstein-Piekarski, A. N., Wielgosz, J., Wittels, N. E., Barve, A., Patel, A. S., Eckley, T. L., Stetz, P., Gerber, B. S., Smyth, J. M., Simmons, J. M., Rosas, L. G., Williams, L. M., Ma, J. 2020: 106072


    Despite evidence for effective integrated behavior therapy for treating comorbid obesity and depression, treatment response is highly variable and the underlying neurobiological mechanisms remain unknown. This hampers efforts to identify mechanistic targets in order to optimize treatment precision and potency. Funded within the NIH Science of Behavior Change (SOBC) Research Network, the 2-phased ENGAGE research project applies an experimental precision medicine approach to address this gap. The Phase 1 study focused on demonstrating technical feasibility, target engagement and potential neural mechanisms of responses to an integrated behavior therapy. This therapy combines a video-based behavioral weight loss program and problem-solving therapy for depression, with as-needed intensification of antidepressant medications, and its clinical effectiveness was demonstrated within a parent randomized clinical trial. Here, we describe the ENGAGE Phase 2 (ENGAGE-2) study protocol which builds on Phase 1 in 2 ways: (1) pilot testing of an motivational interviewing-enhanced, integrated behavior therapy in an independent, primarily minority patient sample, and (2) evaluation of a priori defined neural targets, specifically the negative affect (threat and sadness) circuits which demonstrated engagement and malleability in Phase 1, as mediators of therapeutic outcomes. Additionally, the Phase 2 study includes a conceptual and methodological extension to explore the role of microbiome-gut-brain and systemic immunological pathways in integrated behavioral treatment of obesity and depression. This protocol paper documents the conceptualization, design and the transdisciplinary methodologies in ENGAGE-2, which can inform future clinical and translational research in experimental precision medicine for behavior change and chronic disease management. Trial registration: #NCT03841682.

    View details for DOI 10.1016/j.cct.2020.106072

    View details for PubMedID 32621905

  • Altered Anterior Insula Function Precedes Improved Problem Solving in a Mechanistic Treatment Trial for Depression Wielgosz, J., Goldstein-Piekarski, A., Stetz, P., Xiao, L., Lv, N., Suppes, T., Lavori, P., Ma, J., Williams, L. ELSEVIER SCIENCE INC. 2020: S248?S249
  • Reduced Nonconscious Reactivity to Threat in Amygdala Mediates Physical Activity and Energy Expenditure in Integrated Behavior Therapy for Adults With Obesity and Comorbid Depression Ma, J., Lv, N., Xiao, L., Goldstein-Piekarski, A., Wielgosz, J., Lavori, P., Stetz, P., Rosas, L., Venditti, E., Snowden, M., Smyth, J., Lewis, M., Suppes, P., Ajilore, O., Lefferts, W., Williams, L. LIPPINCOTT WILLIAMS & WILKINS. 2020
  • No Detectable Electroencephalographic Activity After Clinical Declaration of Death Among Tibetan Buddhist Meditators in Apparent Tukdam, a Putative Postmortem Meditation State. Frontiers in psychology Lott, D. T., Yeshi, T., Norchung, N., Dolma, S., Tsering, N., Jinpa, N., Woser, T., Dorjee, K., Desel, T., Fitch, D., Finley, A. J., Goldman, R., Bernal, A. M., Ragazzi, R., Aroor, K., Koger, J., Francis, A., Perlman, D. M., Wielgosz, J., Bachhuber, D. R., Tamdin, T., Sadutshang, T. D., Dunne, J. D., Lutz, A., Davidson, R. J. 2020; 11: 599190


    Recent EEG studies on the early postmortem interval that suggest the persistence of electrophysiological coherence and connectivity in the brain of animals and humans reinforce the need for further investigation of the relationship between the brain's activity and the dying process. Neuroscience is now in a position to empirically evaluate the extended process of dying and, more specifically, to investigate the possibility of brain activity following the cessation of cardiac and respiratory function. Under the direction of the Center for Healthy Minds at the University of Wisconsin-Madison, research was conducted in India on a postmortem meditative state cultivated by some Tibetan Buddhist practitioners in which decomposition is putatively delayed. For all healthy baseline (HB) and postmortem (PM) subjects presented here, we collected resting state electroencephalographic data, mismatch negativity (MMN), and auditory brainstem response (ABR). In this study, we present HB data to demonstrate the feasibility of a sparse electrode EEG configuration to capture well-defined ERP waveforms from living subjects under very challenging field conditions. While living subjects displayed well-defined MMN and ABR responses, no recognizable EEG waveforms were discernable in any of the tukdam cases.

    View details for DOI 10.3389/fpsyg.2020.599190

    View details for PubMedID 33584435

  • Best Practices for Approaching Cognitive Processing Therapy and Prolonged Exposure During the COVID-19 Pandemic. Journal of traumatic stress Hagerty, S. L., Wielgosz, J. n., Kraemer, J. n., Nguyen, H. V., Loew, D. n., Kaysen, D. n. 2020


    The COVID-19 pandemic presents major challenges for mental health care providers. In particular, providers who treat posttraumatic stress disorder (PTSD) are now tasked with determining whether to initiate trauma-focused therapy during the pandemic and, if so, whether and how to adapt treatment. The purpose of this communication is to identify and organize key considerations for whether and how to deliver commonly used evidence-supported therapy protocols for trauma treatment-specifically, cognitive processing therapy (CPT) and prolonged exposure (PE) therapy-during the ongoing COVID-19 pandemic for adults who currently meet the criteria for PTSD. Based on relevant public health and clinical literature, we present a structured guide that can be used by treatment teams and individual providers to evaluate whether initiating CPT or PE is indicated given a particular patient-provider pair and system context amidst pandemic conditions. In addition, we suggest appropriate action steps, including problem-solving strategies, evidence-informed modifications to CPT and PE, and alternative intervention approaches.

    View details for DOI 10.1002/jts.22583

    View details for PubMedID 32865850

  • A common neural substrate for elevated PTSD symptoms and reduced pulse rate variability in combat-exposed veterans PSYCHOPHYSIOLOGY Grupe, D. W., Imhoff-Smith, T., Wielgosz, J., Nitschke, J. B., Davidson, R. J. 2020; 57 (1)

    View details for DOI 10.1111/psyp.13352

    View details for Web of Science ID 000612200900005

  • Amygdala Activity to Threat Mediates Depression Outcomes of Integrated Collaborative Care for Comorbid Depression and Obesity Goldstein-Piekarski, A., Wielgosz, J., Stetz, P., Xiao, L., Ma, J., Williams, L. NATURE PUBLISHING GROUP. 2019: 242?43
  • Anterior Insula Sensitivity to Negative Stimuli is Associated With Adaptive Changes in Problem-Solving Style During Integrated Collaborative Care for Comorbid Depression and Obesity Wielgosz, J., Goldstein-Piekarski, A., Stetz, P., Xiao, L., Ma, J., Williams, L. NATURE PUBLISHING GROUP. 2019: 456
  • Elevated perceived threat is associated with reduced hippocampal volume in combat veterans. Scientific reports Grupe, D. W., Hushek, B. A., Davis, K., Schoen, A. J., Wielgosz, J., Nitschke, J. B., Davidson, R. J. 2019; 9 (1): 14888


    Reduced hippocampal volume is frequently observed in posttraumatic stress disorder (PTSD), but the psychological processes associated with these alterations remain unclear. Given hippocampal involvement in memory and contextual representations of threat, we investigated relationships between retrospectively reported combat exposure, perceived threat, and hippocampal volume in trauma-exposed veterans. T1-weighted anatomical MRI scans were obtained from 56 veterans (4 women, 52 men; 39 with elevated PTSD symptoms, "PTSS" group) and hippocampal volume was estimated using automatic segmentation tools in FreeSurfer. Hippocampal volume was regressed on self-reported perceived threat from the Deployment Risk and Resilience Inventory, and combat exposure from the Combat Exposure Scale. As a secondary analysis, hippocampal volume was regressed on Clinician-Administered PTSD Scale (CAPS) symptoms. In veterans with elevated PTSD symptoms, hippocampal volume was inversely related to perceived threat while deployed while controlling for self-reported combat exposure. Hippocampal volume was also inversely correlated with avoidance/numbing CAPS symptoms. Future research should clarify the temporal milieu of these effects and investigate whether individual differences in hippocampal structure and function contribute to heightened threat appraisal at the time of trauma vs. subsequently elevated appraisals of traumatic events.

    View details for DOI 10.1038/s41598-019-51533-x

    View details for PubMedID 31624305

  • A common neural substrate for elevated PTSD symptoms and reduced pulse rate variability in combat-exposed veterans. Psychophysiology Grupe, D. W., Imhoff-Smith, T., Wielgosz, J., Nitschke, J. B., Davidson, R. J. 2019: e13352


    Previous studies have identified reduced heart rate variability (HRV) in post-traumatic stress disorder (PTSD), which may temporally precede the onset of the disorder. A separate line of functional neuroimaging research in PTSD has consistently demonstrated hypoactivation of the ventromedial prefrontal cortex (vmPFC), a key aspect of a descending neuromodulatory system that exerts inhibitory control over heart rate. No research to date, however, has simultaneously investigated whether altered vmPFC activation is associated with reduced HRV and elevated PTSD symptoms in the same individuals. Here, we collected fMRI data during alternating conditions of threat of shock and safety from shock in 51 male combat-exposed veterans with either high or low levels of PTSD symptoms. Pulse rate variability (PRV)-a HRV surrogate calculated from pulse oximetry-was assessed during a subsequent resting scan. Correlational analyses tested for hypothesized relationships between reduced vmPFC activation, lower PRV, and elevated PTSD symptomatology. We found that PTSD re-experiencing symptoms were inversely associated with high-frequency (HF)-PRV, thought to primarily reflect parasympathetic control of heart rate, in veterans with elevated PTSD symptoms. Reduced vmPFC activation for the contrast of safety-threat was associated both with lower HF-PRV and elevated PTSD re-experiencing symptoms. These results tie together previous observations of reduced HRV/PRV and impaired vmPFC function in PTSD and call for further research on reciprocal brain-body relationships in understanding PTSD pathophysiology.

    View details for PubMedID 30793774

  • Does the Five Facet Mindfulness Questionnaire Measure What We Think It Does? Construct Validity Evidence From an Active Controlled Randomized Clinical Trial PSYCHOLOGICAL ASSESSMENT Goldberg, S. B., Wielgosz, J., Dahl, C., Schuyler, B., MacCoon, D. S., Rosenkranz, M., Lutz, A., Sebranek, C. A., Davidson, R. J. 2016; 28 (8): 1009?14


    The current study attempted a rigorous test of the construct validity of a widely used self-report measure of dispositional mindfulness, the Five Facet Mindfulness Questionnaire (FFMQ), within the context of an active controlled randomized trial (n = 130). The trial included three arms: mindfulness-based stress reduction (MBSR), an active control condition that did not include instruction in mindfulness meditation (Health Enhancement Program [HEP]), and a waitlist control condition. Partial evidence for the convergent validity of the FFMQ was shown in correlations at baseline between FFMQ facets and measures of psychological symptoms and psychological well-being. In addition, facets of the FFMQ were shown to increase over the course of an MBSR intervention relative to a waitlist control condition. However, the FFMQ failed to show discriminant validity. Specifically, facets of the FFMQ were shown to increase over the course of the HEP intervention relative to the waitlist control condition. MBSR and HEP, in contrast, did not differ in changes in FFMQ score over time. Implications of these findings for the measurement and theory of mindfulness and MBSR are discussed. (PsycINFO Database Record

    View details for PubMedID 26460893

    View details for PubMedCentralID PMC4829487

  • Neurobiological correlates of distinct post-traumatic stress disorder symptom profiles during threat anticipation in combat veterans PSYCHOLOGICAL MEDICINE Grupe, D. W., Wielgosz, J., Davidson, R. J., Nitschke, J. B. 2016; 46 (9): 1885?95


    Previous research in post-traumatic stress disorder (PTSD) has identified disrupted ventromedial prefrontal cortex (vmPFC) function in those with v. without PTSD. It is unclear whether this brain region is uniformly affected in all individuals with PTSD, or whether vmPFC dysfunction is related to individual differences in discrete features of this heterogeneous disorder.In a sample of 51 male veterans of Operation Enduring Freedom/Operation Iraqi Freedom, we collected functional magnetic resonance imaging data during a novel threat anticipation task with crossed factors of threat condition and temporal unpredictability. Voxelwise regression analyses related anticipatory brain activation to individual differences in overall PTSD symptom severity, as well as individual differences in discrete symptom subscales (re-experiencing, emotional numbing/avoidance, and hyperarousal).The vmPFC showed greater anticipatory responses for safety relative to threat, driven primarily by deactivation during threat anticipation. During unpredictable threat anticipation, increased PTSD symptoms were associated with relatively greater activation for threat v.However, simultaneous regression on individual symptom subscales demonstrated that this effect was driven specifically by individual differences in hyperarousal symptoms. Furthermore, this analysis revealed an additional, anatomically distinct region of the vmPFC in which re-experiencing symptoms were associated with greater activation during threat anticipation.Increased anticipatory responses to unpredictable threat in distinct vmPFC subregions were uniquely associated with elevated hyperarousal and re-experiencing symptoms in combat veterans. These results underscore the disruptive impact of uncertainty for veterans, and suggest that investigating individual differences in discrete aspects of PTSD may advance our understanding of underlying neurobiological mechanisms.

    View details for DOI 10.1017/S0033291716000374

    View details for Web of Science ID 000378716200008

    View details for PubMedID 26979659

    View details for PubMedCentralID PMC4900910

  • Long-term mindfulness training is associated with reliable differences in resting respiration rate SCIENTIFIC REPORTS Wielgosz, J., Schuyler, B. S., Lutz, A., Davidson, R. J. 2016; 6: 27533


    Respiration rate is known to correlate with aspects of psychological well-being, and attention to respiration is a central component of mindfulness meditation training. Both traditional contemplative systems and recent empirical evidence support an association between formal mindfulness practice and decreased respiration rate. However, the question of whether long-term mindfulness training is associated with stable, generalized changes in respiration has yet to be directly investigated. We analyzed respiration patterns across multiple time points, separated by two months or more, in a group of long-term mindfulness meditation practitioners (LTMs, n?=?31) and a matched group of non-meditators (Controls, n?=?38). On average, LTMs showed slower baseline respiration rate (RR) than Controls. Among LTMs, greater practice experience was associated with slower RR, independently of age and gender. Furthermore, this association was specific to intensive retreat practice, and was not seen for routine daily practice. Full days of meditation practice did not produce detectable changes in baseline RR, suggesting distal rather than immediate effects. All effects were independent of physiological characteristics including height, weight, body-mass index and waist-hip ratio. We discuss implications for continued study of the long-term effects of mindfulness training on health and well-being.

    View details for PubMedID 27272738

  • Specifying the non-specific factors underlying opioid analgesia: expectancy, attention, and affect PSYCHOPHARMACOLOGY Atlas, L. Y., Wielgosz, J., Whittington, R. A., Wager, T. D. 2014; 231 (5): 813?23


    Psychological processes such as expectancy, attention, and affect directly influence clinical outcomes. These factors are grouped together as "nonspecific" factors, or placebo effects, in the medical literature, and their individual contributions are rarely considered. The pain-reducing effects of analgesic treatments may reflect changes in these psychological factors, rather than pure drug effects on pain. Furthermore, drug effects may not be isolated by drug vs. placebo comparisons if drugs interact with relevant psychological processes.We sought to determine whether the analgesic effects of opioid and placebo treatment are mediated by changes in attention, expectancy, or affect.We crossed intravenous administration of a potent opioid analgesic, remifentanil, with information about drug delivery (treatment expectancy or placebo) using a balanced placebo design. We measured drug and treatment expectancy effects on pain, attention, and responses to emotional images. We also examined interactions with cue-based expectations about noxious stimulation or stimulus expectancy.Pain was additively influenced by treatment expectancy, stimulus expectancy, and drug concentration. Attention performance showed a small but significant interaction between drug and treatment expectancy. Finally, remifentanil enhanced responses to both positive and negative emotional images.The pain-relieving effects of opioid drugs are unlikely to be mediated by changes in threat or affective processing. Standard open-label opioid administration influences multiple clinically relevant cognitive and emotional processes. Psychological factors can combine with drug effects to influence multiple outcomes in distinct ways. The influence of specific psychological factors should be considered when developing and testing pharmacological treatments.

    View details for DOI 10.1007/s00213-013-3296-1

    View details for Web of Science ID 000331719100002

    View details for PubMedID 24096537

    View details for PubMedCentralID PMC3945427

  • Dissociable Influences of Opiates and Expectations on Pain JOURNAL OF NEUROSCIENCE Atlas, L. Y., Whittington, R. A., Lindquist, M. A., Wielgosz, J., Sonty, N., Wager, T. D. 2012; 32 (23): 8053?64


    Placebo treatments and opiate drugs are thought to have common effects on the opioid system and pain-related brain processes. This has created excitement about the potential for expectations to modulate drug effects themselves. If drug effects differ as a function of belief, this would challenge the assumptions underlying the standard clinical trial. We conducted two studies to directly examine the relationship between expectations and opioid analgesia. We administered the opioid agonist remifentanil to human subjects during experimental thermal pain and manipulated participants' knowledge of drug delivery using an open-hidden design. This allowed us to test drug effects, expectancy (knowledge) effects, and their interactions on pain reports and pain-related responses in the brain. Remifentanil and expectancy both reduced pain, but drug effects on pain reports and fMRI activity did not interact with expectancy. Regions associated with pain processing showed drug-induced modulation during both Open and Hidden conditions, with no differences in drug effects as a function of expectation. Instead, expectancy modulated activity in frontal cortex, with a separable time course from drug effects. These findings reveal that opiates and placebo treatments both influence clinically relevant outcomes and operate without mutual interference.

    View details for DOI 10.1523/JNEUROSCI.0383-12.2012

    View details for Web of Science ID 000305091800029

    View details for PubMedID 22674280

    View details for PubMedCentralID PMC3387557

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