Medicine and Health Sciences Commons^™

Social Dominance Alters Stress-Induced Neural Activity And Generates Individual Differences In Stress Vulnerability, Jenna Lee Laymon

Masters Theses

Identifying the physiological and behavioral mechanisms that underlie stress vulnerability is a crucial step toward identifying novel targets for the prevention and treatment of stress-related disorders. Social status is a key environmental factor that contributes to individual variations in stress vulnerability. In particular, achieving a subordinate social status has been shown to produce susceptibility to anxiety-like and depressive-like behavior. In this project, our aim was to identify neural ensembles regulating how dominance status modulated stress-induced changes in avoidant behavior in male and female Syrian hamsters. Using a viral vector that codes for robust activity marker (RAM), we investigated whether stress-induced …

Cost Effectiveness Of Buprenorphine When Used Long Term Versus Short Term Use, Ty Hudgens

MUSC Theses and Dissertations

Since 1999, nearly 841,000 people have died from a drug overdose (CDC, 2022), and substance use disorder (SUD) continues to be a crisis that faces communities across the country. As the crisis continues across communities, the need for medication-assisted opioid use disorder (MOUD) therapy continues to surge.

This was a retrospective analysis of archival data from large national data sources. We constructed well-matched cohorts of patients with short and long-term use of MOUD using propensity score matching of 3 months of baseline data. To measure the cost effectiveness of short-term buprenorphine use verse long-term buprenorphine use.

Role Of Nucleus Accumbens Dopamine Receptor Signaling In The Suppression Of Punished Reward Seeking, Grace M. Joyner, Anna Caroline Toburen

Senior Theses

Previous studies have shown that within the nucleus accumbens (NAc), a brain region associated with motivation and reinforcement learning, activity of neurons expressing the dopamine D2 receptor (D2R neurons) act as a “break” on risky behavior associated with negative outcomes. Moreover, when these neurons are stimulated, rats were found to become more risk averse. However, the impact of dopamine signaling through NAc D2R neurons in risk avoidance is still unclear. To further explore the role of NAc dopamine signaling in punished reward-seeking, we tested rats in a novel punished food-seeking paradigm in which subjects are trained to choose between a …

Burnout In Medical Assistants In Primary Care: Can Mindfulness Be A Solution?, Natalee D. Calais

Electronic Theses and Dissertations

Burnout is described as feelings associated with emotional exhaustion, depersonalization of patients, and a loss of sense of personal accomplishment and it is unique to healthcare workers. Current research highlights this condition among physicians, nurses, and mid-level providers; however, insufficient research exists regarding the effects of burnout on medical assistants. Research led to mindfulness as a possible solution defined as an intentional regulation of attention and awareness of the present moment. This project sought to see if mindfulness practices could be utilized to mitigate the effects of burnout in medical assistants. It was hypothesized that mindfulness could be a solution. …

Binge Drinking In College: A Phenomenological Study, Kristin Andrews

Murray State Theses and Dissertations

This phenomenological research study examined the personal experiences, habits, and perceptions of post-secondary students who binge drink. This study was guided by 3 research questions as well as pre-existing research into collegiate binge drinking. The experiences shared by participants showed that despite serious negative outcomes, students binge drink because they feel negatives are far outweighed by the positive social interactions and fun drinking creates. While all of the participants in this study are considered binge drinkers who abuse alcohol, none of the participants considered their drinking to be problematic. The participants shared their intent to stop their current drinking patters …

Implicit Beliefs About Anxiety And The Relationship With Competitive Anxiety Intensity And Direction, Luca M. Ziegler

Electronic Theses and Dissertations

During the Fall of 2021, 45% of male and 72% of female student-athletes reported overwhelming anxiety at least once a month (NCAA, 2021). In addition to affecting an individual’s well-being, anxiety may negatively impact athletic performance (Edwards & Hardy, 1996). To better understand the impact of anxiety on athletic performance and develop effective interventions, both the intensity and direction of symptoms experienced must be considered. Incremental beliefs have been shown to be related to desirable performance outcomes and increased well-being in various populations (Danthony et al., 2020; Dweck, 2008), and may provide an effective intervention to interpret anxiety as more …

Assessing 4-H And Its Circle Of Courage In A Psychiatric Residential Treatment Facility: A Case Study, Elizabeth Steering

Theses and Dissertations--Family Sciences

This 4-H case study takes place in a psychiatric residential treatment facility (PRTF) in Kentucky. The PRTF provides clinical services to youth that are not able to be safely maintained in their homes due to having demonstrated unsafe or harmful behaviors. Youth admitted to the PRTF stay for an average of three to six months while they receive intensive therapeutic and psychiatric care as well as medical treatment and public schooling. The current case study incorporates programming from 4-H, which is the youth development program of the Cooperative Extension System (CES) and the National Institute of Food and Agriculture (NIFA), …

Psychopathy And Insight Within An Incarcerated Population, Courtney Steinorth

MSU Graduate Theses

The clinical construct of psychopathy has been researched extensively relative to incarceration. Cognitive insight has shown to be related to prognosis and treatment outcomes with severe psychopathologies. There has been, however, limited research on both psychopathy and cognitive insight in relation to incarceration. The purpose of the present study was to examine the moderation of cognitive insight levels on rates of incarceration (the number of times someone has been incarcerated in a government detention facility) based on their level of self-reported psychopathic traits. A brief demographic questionnaire, the Beck Cognitive Insight Scale, and the Levenson Self-Report Psychopathy Scale were administered …

Implementation Of A Death Anxiety Screening Protocol Specific To Patients With Advanced Cancer In An Outpatient Palliative Care Setting, Olivia M. Sasdi

DNP Projects

Abstract

Background: Recent studies have shown that upwards of 80% of patients with advanced cancer suffer from death anxiety resulting in increased physical and psychological suffering. Despite death anxiety’s ubiquitous nature and negative impact, the literature regarding this condition consistently indicates that it remains under-identified and undertreated in patients with advanced cancer. The “Death and Dying Distress Scale” (DADDS) is a clinically validated tool used to identify, measure, and guide effective treatment modalities for death anxiety specifically in patients with advanced cancer, but is scarcely used routinely in practice. Incorporating this screening tool to be used regularly could improve identification …

Effects Of Social Isolation And Adolescent Ethanol Exposure On Adult Drinking And Nicotine Co-Use, Jakob Shaykin

Theses and Dissertations--Psychology

Alcohol use often begins in adolescence and can lead to increased susceptibility to AUD in adulthood. Stress in the form of social isolation during adolescence can also prompt substance use disorders later in adulthood. This thesis determined if exposure to ethanol (EtOH) during adolescence and social isolation alters the trajectory of alcohol and nicotine intake during adulthood. In Experiment 1, adolescent male and female Sprague-Dawley rats were administered intermittent injections of EtOH (2g/kg 20% EtOH, IP) or saline (PND 28-41). EtOH consumption was measured in adulthood (PND 49-55) using a 2-bottle choice procedure where one bottle contained a 0.2% saccharin/15% …

Multilingualism And Memory: Investigating Possible Differences In The Abilities Of Monolingual And Multilingual College Students, Clara E. Barned

Honors Projects

This study investigated whether there is a difference in the memories of monolingual and multilingual undergraduate students using simple memorization tasks. There were 46 participants, 30 of which were monolingual (only knew one language) and 16 of which were multilingual (knew two or more languages). There was found to be no significant difference between the performance of the two groups, with the data generating a p-value of 0.557. This study further suggests related avenues of research and ways in which the study could be improved in the future.

Investigating The Income Academic Achievement Gap: An Exploration Of The Roles Of Mindfulness And Self-Concept Clarity In Low-Income College Students., Natalie Burke

Electronic Theses and Dissertations

The purpose of the current study was to examine whether linguistic patterns previously associated with trait mindfulness and self-concept clarity in low-income college students’ application essays are associated with academic performance and psychosocial variables. The aims of the study were as follows: 1) Explore relations between linguistic markers that have been previously associated with higher mindfulness/self-concept clarity and GPA and 2) Explore relations between linguistic markers that have been previously associated with higher mindfulness/self-concept clarity and anxiety/depression. Participants were 54 undergraduate students in the Cardinal Covenant program (a scholarship program for students from low-income families) who began college in the …

Hiv And Early Life Stress On Neuroimaging And Risky Behavior, Paola Garcia Egan

Dissertations

This study examined the interactive effects of early life stress (ELS) and HIV on brain morphometry, diffusion-basis-spectrum-imaging (DBSI), risky decision-making, and sex-risk behavior. 122 people with HIV (PWH) and 113 people without HIV (PWoH), free of major psychiatric illness and neurological confounds, were stratified into high (≥ 3 events) vs. low (< 3 events) ELS [PWoH/low ELS (n = 57), PWoH/high ELS (n =56), PWH/low ELS (n = 43), PWH/high ELS (n = 79)] and underwent structural magnetic resonance imaging, DBSI, neuropsychological, and risky-behavior assessment; all PWH were virologically controlled. Compared to PWoH, PWH had smaller orbitofrontal cortex (OFC), parietal lobes, insula, caudate and anterior cingulate. No ELS effects were detected in volumetric measures. Significant interactions were found between HIV serostatus and ELS on the OFC and on cellularity of the inferior fronto-occipital fasciculus after multiple comparisons adjustment. Specifically, PWH/high ELS exhibited significantly smaller OFC and PWoH/high ELS show significantly larger OFC than the other groups. PWoH/high ELS exhibited higher DBSI cellularity (neuroinflammation proxy) of the inferior-occipital-fasciculus compared to PWoH/high ELS. Regardless of HIV status, executive function moderated the relationship between the OFC and sex-risk behavior such that individuals within the sample who performed above average on a measure of executive function and had a larger OFC reported fewer sex partners in past six months than individuals with smaller volumes. No interaction was found between HIV serostatus and ELS on risky behavior measures. Clustering analyses defined ELS subgroups in PWH that were determined by demographic characteristics, duration of infection, recent CD4+ T-cell count, nadir CD4+ T-cell count and high/low ELS.Even in PWH that are virologically controlled, without major current psychiatric comorbidities, there is evidence of a synergistic impact of ELS and HIV on OFC volumes. Higher volumes in the OFC were detrimental when associated with lower executive function scores or advantageous when associated with higher executive function. Findings suggest that ELS is associated with different brain signatures among PWoH and virally suppressed PWH. However, ELS was not directly associated with risky behaviors, and subgroups in PWH were characterized by demographic variables, past substance use and HIV clinical variables.

Improving Patient Outcomes In Substance Use Disorder Through Behavioral Therapy In Depression Development And Impacts Of Social Determinants Of Health During And After Substance Use Treatment, Jerry Ryan Armstrong, Chyanne Napp

Doctoral Projects

Substance Use Disorder (SUD) is a growing problem in the United States (U.S.) and worldwide and relapse is a common occurrence among those facing SUD. Limited scholarly research has been published addressing evidence-based treatment improvement strategies. This study focused on improving SUD treatment through the incorporation of depression tracking from admission to and discharge from inpatient treatment, as well as the incorporation of social determinants of health education during treatment, with an evaluation of relapse rates 30-days after inpatient treatment discharge. Results indicated a significant improvement in depression scores from admission to discharge. Results also revealed improved knowledge regarding social …

The Impossible Situation? Impasse As Psychotherapeutic Paralysis, Possibility, And Progress, Leo Cancelmo

Dissertations, Theses, and Capstone Projects

Psychotherapeutic impasse has long been understood in the clinical literature as treatment stagnation and even failure, both from one-person and two-person psychodynamic perspectives. However, there is a dearth of empirical research that delves deeper to understand this complex and rich phenomenon. Using semi-structured interviews with nine psychodynamic therapists speaking about individual adult patients, this study examined experiences of impasse to better understand treatments that become embroiled in a kind of paralysis. Qualitative analyses revealed dyads where patients were conceptualized as struggling chronically with negative feelings about themselves and others, and who experienced traumatic personal histories. Impasse in and of itself …

The Effect Of Propionic Acid On The Habituation To Social And Non-Social Odour Cues In Adult Male Rats, Cashmeira-Dove P. Tyson

Electronic Thesis and Dissertation Repository

The enteric bacterial metabolite, propionic acid (PPA), elicits physiological and behavioural changes in rodents reminiscent of autism spectrum disorder (ASD). This includes abnormal sensory processing and social behaviour. ASD may contribute to social deficits through impaired habituation; therefore, the present study examined the effects of intraperitoneal PPA on the habituation to social and non-social odours. Adult male rats were injected daily with PPA or the vehicle control, and for 3 days, habituated to a conspecific odour or vanilla extract for 10 minutes. On day 4, rats were exposed to a novel conspecific odour or almond extract for 10 minutes to …

The Purple Heart And Suicidal Behaviors In Post-9/11 U.S. Army Combat Veterans With A Traumatic Brain Injury: A Mixed Methods Study, Jayna Moceri-Brooks

Electronic Theses and Dissertations

Military suicide rates remain high, despite years of targeted efforts to prevent suicide. Specifically, Army Combat Veterans who sustained a traumatic brain injury (TBI) while deployed in support of the Global War on Terrorism are at the highest risk for suicide. This dissertation highlights possible causes for suicidal behaviors within this unique group and provides specific military suicide prevention recommendations. The dissertation is organized into three publishable manuscripts: The first manuscript (Chapter 1) is a mixed-methods dissertation research proposal written according to the National Institute of Health proposal guidelines. The second manuscript (Chapter 2) is an integrative review of the …

Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz

Electronic Theses and Dissertations

Purpose: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of young adults who identify as LGBTQ+ and sought emergency care for suicidality when they were adolescents.

Methods: Heideggerian hermeneutics phenomenology is the research method used in this study. Youth, ages 18-25 years, who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents (13-17 years) were recruited to participate;fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described …

Reducing The No-Show Rate At A Community Mental Health Organization., Philip E. Pippen

Doctor of Nursing Practice Papers

Relative to other outpatient healthcare specialties, appointment nonattendance (no-shows) is most prevalent in psychiatric settings. Upon meeting with a community-based mental health organization in Louisville, KY (LCMHO), referral no-shows for intake appointments were identified as a significant issue. LCMHO’s intake appointment no-show rate, estimated at 25 – 40%, exceeded nonattendance trends in the literature. The purpose of this evidence-based practice (EBP) project was to develop and implement a referral engagement reminder intervention for improving intake appointment attendance. A systematic approach guided by the Model for Improvement was applied to foster this evidence-supported practice change. The project’s findings included a 16% …

Supporting Post-Secondary Implementation Of Recovery-Oriented Practice In A Stepped Care Model, Janis Campbell

The Dissertation in Practice at Western University

Student mental health has been a growing concern for higher education communities for many years. Campuses have been struggling to keep up with the increasing demand for services which has been complicated further by the COVID-19 pandemic. A Stepped Care model (SCM) developed at a Canadian university has been offering new ways of organizing mental health resources based on open access, student choice, and recovery principles. There are diverse definitions of recovery in the literature and are usually based on values such as empowerment, respect, and self-determination. SCMs have been shown to increase access to resources and reduce or eliminate …

Individual Differences In The Criminogenic Effects Of Discrimination: An Exploration Of The Role Of Impulse Control And Callous-Unemotional Traits, Toni Walker

LSU Doctoral Dissertations

The association between perceived discrimination and engagement in criminal offending has been well studied, especially in samples of minority (predominantly Black, Hispanic, and Latinx) adolescents. Several theories have been developed (Social Schematic Theory) and adapted (General Strain Theory) in an attempt to explain how harmful, discriminatory experiences may have an effect on an individual’s behavior. There may be variability in how an individual responds to perceived discrimination, however, but the moderating role of personality characteristics has not been explored. Impulse control and callous-unemotional (CU) traits are both established predictors of offending and may also relate to the mechanisms that theories …

Utility Of The Motivation To Change Lifestyle And Health Behaviors For Dementia Risk Reduction Scale (Mclhb-Drr) Based On A North American Sample, Angelina E. Witbeck

Dissertations

As the population ages, the prevalence rates of dementia continue to increase. Without a cure or promising treatment for dementia, the best course of lowering the prevalence rates of dementia is through preventative measures. Through an electronic survey, the study utilized the MCLHB-DRR scale to determine whether (1) gender, age, educational background, and socioeconomic status will impact the motivational factors to change lifestyle and health behaviors to reduce the risk of developing dementia and (2) direct experiences with individuals that have a dementia diagnosis are likely to impact one's motivational factors to change lifestyle and health behaviors to reduce the …

The Life Story Analysis Of Those Suffering From Autoimmune Thyroiditis, Azalea Di Nardi

Dissertations

The purpose of this study was to understand the pervasive impacts of autoimmune thyroiditis, specifically Hashimoto’s and Graves’ disease. To accomplish this, the life story methodology was utilized to gather individual experiences from 11 participants diagnosed with Hashimoto’s or Graves’ disease. The participants completed a background and general health questionnaire and 45- to-100-minute virtual interview disclosing their journey from the onset of symptoms, through diagnosis, to their most recent state. Themes were compiled from the interviews, which allowed identification of the largest areas of impact, needs, and future implications for practitioners and providers. Major themes identified were decreased quality of …

Accessing The Ecosphere: An Indoor Nature-Based Community Expressive Arts Therapy (Exat) Exploration Project, Heather Powers

Expressive Therapies Capstone Theses

This capstone thesis posits that when humans connect and maintain a relationship with nature, their mental health improves. Humans have developed from and within Earth’s ecosystem, making our relationship with nature a necessary acknowledgement that the self is more than a corporeal body but is, in fact, embedded within the natural world around us. The current overwhelming dependence on electronic advancements and the development of urban areas have led people to become more distant in their relationship to nature, putting the overall well-being of the planet in jeopardy. This thesis points out that the more separation we feel from nature, …

Healing Our Connection With Nature: An Expressive Arts Community Engagement Project, Meghan Mccrillis

Expressive Therapies Capstone Theses

A community engagement project was created and implemented, comprised of two events for which the author facilitated nature-based expressive arts experiences to explore the integration of nature and expressive arts therapy. The events were offered to two different groups of community members, one for nature-curious adults held outdoors on the trails of a local conservation trust, and another for young children at a local library. The healing impact of nature connection and nature connection experiences are explored through a literature review, event methods, and the author’s personal experiences of the project via artmaking. The results include an emphasis on nature …

Touch In Drama Therapy: A Literature Review, Sara Hood

Expressive Therapies Capstone Theses

This article is a cursory look at how touch is perceived in the field of drama therapy. Touch is integral to our experience as humans and can be present in drama therapy sessions. Ethical guidelines for touch in the literature are identified and relevant drama therapy texts and articles describing touch are discussed. While drama therapy has a clear voice when it comes to ethically engaging in touch with a client, very little research was found exploring the intention and outcome of touch in a drama therapy session. Other therapeutic modalities, specifically Developmental Transformations and dance/movement therapy, are identified as …

The Lived Experience Of Second Victim Crnas, Michael Neft

Electronic Theses and Dissertations

A second victim is a health care provider who has been involved in a critical event. A

critical event is a clinical situation in which an unforeseen clinical outcome occurs, or

the clinical deterioration of the patient takes place for many different reasons. The

patient and his/her family are the first victims. The health care provider(s) involved in

the event are second victims. After such an event, the healthcare provider may

experience a constellation of negative emotions, such as guilt, sadness, depression,

somatic symptoms, hypervigilance, and fear. Most second victims require support to

cope with the adverse clinical situation. Second …

Content Analysis Of Vitiligo Portrayal On Social Media, Mary Miller

Honors Theses

Given that vitiligo affects a small percentage of the world population, and its affects are not widely known, there is an increasing need to learn of its effects on those with vitiligo, both physical and psychological. Social media has become an influential platform to spread awareness and build confidence in those with vitiligo. This study aims to find how vitiligo is portrayed through social media using content analysis procedures. This is a cross-sectional content analysis that utilized a codebook to analyze Instagram posts. The results were analyzed by interrater reliability and frequency for each coder. The findings of this content …

“In The Skin I’M In…I Represent A Different Version Of What Help Looks Like:” Black Women Sport Psychology Professional’S Experiences In Applied Sport Psychology, Sharon R. Couch

Doctoral Dissertations

Black Feminist Applied Sport Psychology (BFASP) is a culturally inclusive theoretical framework for centering Black women’s experiences in applied sport psychology (Carter et al., 2020; Couch et al., 2022). For the past two decades, (White) Feminist applied sport psychology professionals (FASPPs) described the experiences of Black women as unique but were overlooked in research and participant pools due to the prioritization of White women's and Black male sport experiences. (Carter & Davila, 2017; Carter & Prewitt-White, 2014; Gill, 2020; Hyman et al., 2021). The purpose of this study was to explore the life and work experiences of BASPPs (i.e., faculty, …

Behavioral Code Team, Daniel Mcgrath

Student Scholarly Projects

Practice Problem: The organization lacked an evidence-based intervention for behavioral emergencies within the inpatient acute care setting, leading to increased mechanical restraints. A security-driven paradigm was the organization's primary tool for addressing behavioral crises and lacked a more patient-centered treatment and support paradigm.

PICOT: The PICOT question that guided this project was In the Veteran patient population admitted to acute inpatient services (P), how does having a behavioral code team respond to behavioral emergencies (I) compared to the current practice (C) affect the prevalence of mechanical restraint usage (O) within an eight week period (T).

Evidence: Seven …