Medicine and Health Sciences Commons^™

Comparative Analysis Of Acceptance And Commitment Therapy’S Effectiveness In An Intensive Outpatient Program Setting, Efrain Frank Ellin Iii

Electronic Theses and Dissertations

This thesis presents a comparative analysis of acceptance and commitment therapy (ACT) and treatment as usual (TAU) within an intensive outpatient program setting, evaluating their effectiveness in enhancing various dimensions of psychological well-being. Guided by two main research questions, the study investigates whether ACT demonstrates greater or equal effectiveness compared to TAU and if it provides more immediate effects on psychological well-being within three weeks. Utilizing a quasi-experimental design, the research incorporates a comprehensive array of measurement tools to assess outcomes related to anxiety, depression, stress, psychological flexibility, cognitive flexibility, emotion regulation, mindfulness self-efficacy, and life satisfaction among participants. The …

On-Campus Mental Health Service Use Among College Students With Autism: A Case Study Applying The Andersen Behavioral Model Of Health Services Use, Estella C. Lilyquist

Electronic Theses and Dissertations

The unique set of impairments and limitations presented by students with autism spectrum disorder (ASD) make the accessing of campus-based nonacademic resources more difficult and complicated than their typically developed peers. Each year, the rate of students entering college with disabilities continues to grow, but their mental well-being is relatively poor. The purpose of this qualitative case study was to apply the conceptual framework of the Andersen behavioral model of health services use (ABMHSU) to the experiences of college students with ASD to understand and predict their utilization of campus-provided mental health resources. The participants were seven college students with …

Racial Differences In Depression Indicators Before And After 2008 Financial Crisis In A Sample Of Older Adults, Angelina E. Jackson

Electronic Theses and Dissertations

The present study was designed to examine patterns of mental health outcomes in older Black and White adults after the national 2008 financial crisis. The data was acquired from the University of Michigan Health and Retirement Study, a publicly available dataset. This longitudinal study has obtained data from a representative sample of approximately 20,000 older adults in America, aged 55 and older. The hypotheses were (1) rates of mental health indicators related to symptoms of depression will increase after the 2008 financial crisis and (2) that increase will be significantly higher in Black respondents compared to White respondents. The analysis …

The Relationship Between Urban Green Space Perception And Use Within The Adolescent Population: A Focused Ethnography, Rachel Lyons

Electronic Theses and Dissertations

Introduction: Greenspace is beneficial for improving adolescent mental health, yet we still do not understand the connection between the built environment and subjective mental wellbeing. We also lack understanding of how this population uses greenspace and how they feel when in it. Purpose: The purpose of this qualitative study was threefold: to understand why adolescents use greenspace, to identify how they use greenspace, and to explore how they feel when they are in greenspace. Methods: participated in a focused ethnography that utilized auto photography for photo elicitation. Braun and Clark's (2006), six phases of thematic analysis were used to guide …

A Life Lived With Schizophrenia: When Mother’S Love Is Kept In The Dark Exploring Maternal Communication And Attachment Organization In Families With Schizophrenia, Myrsini Stefanidou Marini

Electronic Theses and Dissertations

In recent years, research into the transgenerational transmission of attachment styles has shown that a mother’sattachment style often predicts the attachment style of her infant. Fearsome parental behavior has been found to predict disorganized attachment in infants, which is further associated with a range of mental health disturbances in adolescence. Furthermore, regular patterns of disturbed communication between mother and child have also been found to lead to ‘schizophrenic’ thinking and behavior in the child’s life. While acknowledging that genetic and other biological factors contribute to the emergence of schizophrenia, this study focused on disorganized attachment and disturbed communication between mother …

Double Consciousness And Unhealthy Weight Control Behaviors In Young Black And White Adults, Priscillia Ihionkhan

Electronic Theses and Dissertations

The present study examined the previously understudied notion that Black individuals are buffered against being dissatisfied with their bodies and in turn developing unhealthy eating and weight control behaviors. Double consciousness, a racially/ethnically sensitive measure of body dissatisfaction, was tested as a mediator of the relation between ethnic identity and unhealthy eating and weight control behaviors in Black and White adults. It was anticipated that unhealthy weight control behaviors would be more common in Black women compared to White women and that double consciousness would mediate the association between ethnic identity and unhealthy weight control behaviors among Black women, but …

Economic Insecurity, Poverty, And Parental Alcohol Misuse, Joey Tucciarone

Electronic Theses and Dissertations

Because parental alcohol misuse is associated with numerous negative outcomes for drinkers and other family members, it is important to examine factors predictive of alcohol misuse patterns among parents living with at least one child under the age of 18. Two possible factors include economic insecurity and poverty. This study sought to address whether measures of economic insecurity (i.e., housing and/or food insecurity in the past 12 months) and a dichotomous measure of poverty predict parental binge drinking and parental heavy alcohol consumption in a large population-based sample. It was hypothesized that economic insecurity and poverty, analyzed separately, would predict …

Perceptions Of Executive Functions And Self-Care Actions In Major Depressive Disorder., Melanie G. Walters

Electronic Theses and Dissertations

This dissertation encompasses a study of the effect of impaired executive functions on decision-making and self-care of depressive illness. The first chapter provides an introduction and summarizes the body of literature on the executive functions and its association with depressive symptoms. The second chapter contains the second of two systematic reviews which examines conceptualizations of executive functions, classical and current measures used to assess the executive functions, and challenges and limitations related to current methods of assessment. The third chapter describes the development of a vignette technique and its use in a study to examine the association of depressive symptoms …

Determining The Effectiveness Of A Peer Support Person In Individuals With Depression Symptoms, Donna K. Reeves

Electronic Theses and Dissertations

Abstract

This study’s aim was to evaluate the effectiveness of an existing peer support program as an adjunct treatment for patients with depression. This retrospective evaluation analyzed the total scores of 110 patients with depression on the PHQ-9 questionnaire at the initial assessment (Time 1), at 6-weeks (Time 2), and then at 12-weeks (Time 3). The participants were divided into two groups, those who enrolled in a peer support program (n = 55) and those without peer support (n = 55). PHQ-9 total scores for each time interval were compared for the two groups utilizing independent sample t-tests …

Serious Mental Illness And Rural Primary Care: Provider Training, Attitudes, And Opinions, Lydia Eisenbrandt

Electronic Theses and Dissertations

Healthcare resources are especially limited in rural regions of the US. The lack of Primary Care Providers (PCPs) and mental/behavioral health services is problematic, as there are high rates of behavioral and medical concerns within rural populations. Special populations, such as rural persons with Serious Mental Illness (SMI), are medically complex and represent a vulnerable and underserved population. Healthcare outcomes for persons with SMI are poor compared to the general population and commonly lead to premature death. Various barriers prevent this population from accessing optimal healthcare, especially in rural areas, due to negative perceptions/stigma, a lack of understanding from PCPs, …

Discovery Of Distinct Mechanisms Underlying The Relationship Between Drug Taking And Predisposing Behaviors, Tyler A. Roy

Electronic Theses and Dissertations

Drug addiction is a heritable disease characterized by compulsive drug use. The biological mechanisms driving addiction remain largely unknown.¹ Previous studies show shared genetic mechanisms underlying addiction risk phenotypes such as anxiety, depression, and novelty/sensation seeking.^2,3 Therefore, high-throughput behavioral screening of these traits in single gene knockout mice can allow for the rapid detection of addiction risk candidate genes and mechanisms. Many of these traits are represented in the Knock-Out Mouse Program (KOMP) phenotyping pipeline. Of the initial two hundred twenty-one strains screened in this program, we tested nineteen phenodeviant knock-out mouse strains with C57BL/6NJ controls (N = …

A Meta-Analytic Review Of Cognitive Functioning In Negative And Positive Symptoms Of Schizophrenia, Tiffany Forsythe

Electronic Theses and Dissertations

The purpose of the study was to conduct two meta-analytic reviews examining cognitive functioning and schizophrenia. The first review examined the literature comparing the cognitive functioning of schizophrenic patients to healthy controls. A second review examined the cognitive functioning within schizophrenic patients, examining the differences between individuals with primarily positive symptomatology and those with primarily negative symptomatology. The first meta-analysis included 19 studies which assessed 861 schizophrenic patients and 858 healthy volunteers overall. The second meta-analysis included 10 studies comparing the cognitive functioning of 1,263 schizophrenics across positive and negative symptoms. Results of the first review indicated that healthy controls …

The Effects Of Two Novel Anti-Inflammatory Compounds On Prepulse Inhibition And Neural Microglia Cell Activation In A Rodent Model Of Schizophrenia, Heath W. Shelton

Electronic Theses and Dissertations

Recent studies have shown elevated neuroinflammation in a large subset of individuals diagnosed with schizophrenia. A pro-inflammatory cytokine, tumor necrosis factor-alpha (TNFα), has been directly linked to this neuroinflammation. This study examined the effects of two TNFα modulators (PD2024 and PD340) produced by our collaborators at P2D Bioscience, Inc., to alleviate auditory sensorimotor gating deficits and reduce microglial cell activation present in the polyinosinic:polycytidylic (Poly I:C) rodent model of schizophrenia. Auditory sensorimotor gating was assessed using prepulse inhibition and microglial activation was examined and quantified using immunohistochemistry and confocal microscopy, respectively. Both PD2024 and PD340 alleviated auditory sensorimotor gating deficits …

The Efficacy Of Equine Assisted Therapy In The Treatment Of Autism Spectrum Disorders, Amy Hofmann

Electronic Theses and Dissertations

This study examines the effects of equine-assisted psychotherapies in children with an autism spectrum disorder. The CARS-2 and Children’s Sleep Habits Questionnaire parent-report questionnaires were used for evaluation, as well open-ended questions. A single researcher contacted and visited many PATH-certified centers in the United States. Facilities that participated were all located in the Mid-Atlantic to Northeast region. There were 16 participants, from 11 different farms, that completed both the initial and follow-up questionnaires which were given 7 weeks apart. A $25 Amazon gift card was used as an incentive to increase participation. Participating facilities also completed a questionnaire.

Overall, results …

The Association Between Medication Adherence In Mental Illness And Substance Use Disorder Relapse In Patients With Dual Diagnosis, Tyler Dunn

Electronic Theses and Dissertations

Objectives: The aims of the study were to (1) identify personal, social, and clinical history for patients with substance use disorder (SUD) and mental illness, (2) measure agreeance between patient self-report versus facility record history for mental illness, substance abuse, and psychotropic medication, (3) investigate the specific role of medication adherence and barriers to use for psychotropic medications upon SUD relapse, and (4) assess follow-up changes in mental illness severity and medication adherence in dual diagnosis patients enrolled in a substance abuse rehabilitation program.

Methods: The pilot study utilized a mixed methodology. Inclusion criteria included male patients at least 18 …

Exploring A Multifactorial, Clinical Model Of Thought Disorder : Application Of A Dimensional, Transdiagnostic Approach., Mara Ann Hart

Electronic Theses and Dissertations

Background: Bleuler saw thought disorder as the core defining feature of psychotic phenomena, reflective of the “splitting of the psychic functions” that occurred when, in the process of thinking, one’s ideas and feelings disconnect, becoming fragmented and competing functions. Unfortunately, interest in thought disorder as the conceptual core of psychosis was lost with rise of the modern DSM system, paralleling the shift towards a more simplistic, categorical way of defining psychiatric disorders. Aims: This study examined thought disorder from a dimensional perspective, with the aim of disentangling qualitative heterogeneity and diverse sources of influence. Analyses were based on …

An Analysis Of Neurogenesis In A Mouse Model Of Chemotherapy Related Cognitive Impairment, Maxwell A. Hennings

Electronic Theses and Dissertations

Cancer patients treated with adjuvant chemotherapy often experience cognitive decline following treatment. This phenomenon, often dubbed “chemo brain” or “chemo fog” is usually temporary, but for a subset of survivors, these cognitive impairments can be long-lasting (>10 years) and negatively affect patients’ quality of life, career performance, and social fulfillment. While it is unclear what neurobiological mechanisms underlie chemotherapy related cognitive impairment, the majority of the animal literature has focused on adult neurogenesis. One process important for neurogenesis is the proliferation of new neurons within the dentate gyrus of the hippocampus. It is evident that many chemotherapy agents can …

Phenomenological Study Of The Lived Experiences Of Appalachian Spouses Of Combat Veterans With Post Traumatic Stress Disorder, Janice E. Greene

Electronic Theses and Dissertations

This study was conducted to identify gaps in existing knowledge regarding impacts of combat-related PTSD on the spouse and to gain an understanding of the lived experience of Appalachian Spouses of combat veterans with PTSD. A systematic literature review was conducted to identify research and findings on the impacts of combat-related PTSD on spouses of veterans and a qualitative study was conducted to gain an understanding of the lives of Appalachian spouses of combat veterans with PTSD.

The systematic review identified 16 qualitative studies conducted between 1988 and 2016 in five countries spanning five wars. Regardless of the country of …

The Relationship Between Traumatic Events And Psychological Symptomatology And The Moderating Role Of Mentalization, Sean Fowler

Electronic Theses and Dissertations

Traumatic events can lead to a number of disparate psychological responses. Ranging from diagnosable psychological symptomatology to little or no distress, the outcomes of potentially traumatic events are difficult to narrow down. Research on individual differences has indicated the potential for a number of characteristics that influence the relationship between traumatic events and psychological well-being. Some researchers have proposed that one of these factors, an individual’s ability to mentalize, can influence the onset of psychological symptoms after a traumatic event. Mentalization is seen as one’s ability to maintain a sense of self, which enables understanding and differentiating between one’s own …

The Effects Of Alpha Stimulation On Induced Anxiety, Nolan Thomas Hill

Electronic Theses and Dissertations

Anxiety is defined as an emotional and physical reaction that prepares us to confront a feared stimulus. Among the many measureable changes induced by anxiety are changes in facial electromyography (EMG), heart rate (HR), and sweat gland activity (EDG). At a pathological level anxiety interferes with cognitive processes. Currently, when anxiety crosses into the pathological level, it is treated with a variety of therapies that share in their use of periods of exposure to anxiety-inducing stimuli. Several devices have been developed to alter brain activity by transcranial electrical stimulation (TCES). One such device, Alpha-Stim^®, has been shown to …

Mental Health Referral In Primary Care: Influence Of A Screening Instrument And A Brief Educational Intervention, Michael T. Miesner

Electronic Theses and Dissertations

Although less than half of all patients with mental disorders seek mental health treatment per se, approximately 80% of all people will visit their primary care physician (PCPs) within a year (Strosahl, 1998). However, it is not well understood how to best handle patients presenting with mental health issues in primary care practices. The purpose of this project was to implement an intervention involving a screening measure for anxiety and mood disorders in a primary care setting to increase the volume of anxiety and mood disorder screening, to increase the accuracy of disorder detection, and to also enhance PCPs patterns …

Genome-Wide Association Analysis Of Major Depressive Disorder And Its Related Phenotypes., Nagesh Ramarao Aragam

Electronic Theses and Dissertations

Major Depressive Disorder (MDD) is a complex and chronic disease that ranks fourth as cause of disability worldwide. Thirteen to 14 million adults in the U.S. are believed to have MDD and an estimated 75% attempt suicide making MDD a major public health problem. Recently several genome-wide association (GWA) studies of MDD have been reported; however, few GWA studies focus on the analysis for MDD related phenotypes such as neuroticism and age at onset of MDD. The purpose of this study is to determine risk factors for MDD, identify genome-wide genetic variants affecting neuroticism and age at onset as quantitative …

Elucidating The Role Of The Α7 Nicotinic Receptor In The Etiology Of Schizophrenia., Michelle Johnson Chandley

Electronic Theses and Dissertations

The α7 subunit of the nicotinic receptor, a ligand gated ion channel with an affinity for nicotine, has long been implicated in the pathophysiology of schizophrenia due to the extremely high rate of smoking within the patient population. However, the exact role of the receptor has never fully been determined. In the following studies, various functions the receptor may assume in disease state are evaluated. There is a strong relationship between the immune system and schizophrenia, with the α7 subunit possibly serving as the link between the two. One of the following studies looks at the possibility of the receptor …

An Epidemiological Study Of Maternal Depression: Findings From The National Institute Of Child Health And Human Development Study Of Early Child Care And Youth Development., Liang Wang

Electronic Theses and Dissertations

This study examined maternal depression status from month 1 to 36 after birth using data from the NICHD Study of Early Child Care and Youth Development. Maternal depression was assessed with the Center of Epidemiological Studies Depression Scale. The prevalence of maternal depression was highest at 1 month, decreased at 6 months, and then kept fairly stable to 36 months. The prevalence was higher in blacks than other races, in 18-24 than 25-46 years old, and in single mothers than non-single mothers. Mothers with better physical health, social support, or employed had a lower prevalence than their counterparts. Mothers in …

The Effects Of Nicotine Conditioned Place Preference In D2 Primed Adolescent Rats: Age-Related And Gender Effects., Yoko Emily Ogawa

Electronic Theses and Dissertations

This study investigated nicotine conditioned place preference (CPP) in two different ages of adolescence using a rodent model of schizophrenia. Both 2- and 3-chambered CPP apparatuses were used to test whether the CPP was due to an aversion to the white chamber. Animals were neontally treated with the dopamine D₂/D₃ agonist, quinpirole, or saline and raised to either early postweanling age (P 22) or adolescence (P 29). Rats were conditioned to prefer the white chamber using nicotine. Results showed that nicotine induced CPP and appeared to alleviate an increased stress response in D₂ primed animals, which …

An Analysis Of Nicotine Exacerbation Of Reductions In Ppi In A Rodent Model Of Schizophrenia., Amanda Marie Maple

Electronic Theses and Dissertations

Prepulse inhibition (PPI) is an operational measure of sensorimotor gating and is known to be reduced when the dopamine D² receptor is activated. We used a rodent model of psychosis in which increases in dopamine D_{2 receptor sensitivity are produced through neonatal quinpirole (a dopamine D2 / D3 agonist) treatment to rats. Rats were administered quinpirole (1mg/kg) or saline from postnatal day (P) 1-21. Rats were raised to adulthood and tested on PPI. Results showed that neonatal quinpirole treatment produced a significant reduction in PPI, and nicotine exacerbated this reduction. This reduction was partially blocked by …}

Nicotine Sensitization In A Rodent Model Of Schizophrenia: A Comparison Of Adolescents, Adults, And Neurotrophic Factors., Marla Kay Perna

Electronic Theses and Dissertations

The behavioral effects of nicotine on locomotor activity in a rodent model of psychosis were analyzed. This model is based on neonatal quinpriole treatment (a dopamine D2/D3 agonist) which causes increased D2 receptor sensitivity, a phenomenon known as D2 priming that is common in schizophrenia. D2-primed adolescent rats did not demonstrate nicotine-induced hypoactivity early in training, and males demonstrated more rapid sensitization to nicotine as compared to controls administered nicotine. D2-primed females administered nicotine demonstrated increased stereotypic behavior. D2-primed adult rats given nicotine demonstrated significantly more robust sensitization to nicotine than controls given nicotine. Brain-derived neurotrophic factor (BDNF) was analyzed …