Implementing Routine Depression Screening In An Urgent Care Setting: An Implementation Science Project, Lori Conyers

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Identifying patients with depression is essential, and early detection of depression leads to early intervention. Routine screening of patients for depression is the responsibility of the primary care provider, but many patients have not had a primary care visit in the recent past. Those patients without a primary care provider are likely not being screened for depression. Urgent care (UC) may be the best opportunity to screen patients who do not have a medical home. However, the dynamic nature of the urgent care setting may dissuade staff from engaging in routine screening. As a quality improvement (QI) effort, regular PHQ …

After Being Ignored, Autistic Adults Find Their Place On The Spectrum, Leonardo A. Lopez Carreno

Capstones

Autistic adults have been historically ignored by researchers and clinical psychologists when discussing autism spectrum disorder. But the broadening of the diagnosis requirements for the disorder, as well as the perspectives from autistic adults that have been shared on social media, have made it so that autistic adults are being discussed more now than ever before, both in the autism community and among professionals in the field. This project puts together interviews with autistic people who have found communities online and in person, as well as the perspectives of researchers who have published studies about autism.

https://medium.com/@leonardolpezcarreo/after-being-ignored-autistic-adults-find-their-place-on-the-spectrum-6e131fc00796

The Usability And Feasibility Of A Nursing Evidence-Based Comorbidity Educational Website For An Urban Mental Health Assertive Community Treatment (Act) Program, Andrea Brudigan, Laurie Sewell-Muller, Kokuvi Sena Tsogbevi

Doctor of Nursing Practice Projects: College of Nursing

Objective: Serious mental illness (SMI) causes an increased risk for comorbidities like heart disease, obesity, metabolic syndrome, and diabetes. Many times, these comorbidities are due to side effects of antipsychotics and poor self-management from low insight and other symptoms of mental illness. This project aims to enhance client care enrolled in an Assertive Community Treatment (ACT) program by providing evidence-based resources tailored to clients with SMI, providing ACT team members with support to promote healthy behaviors in clients.

Methods: A website was developed that provides printable, easy-to-read, evidence-based resources that address physical comorbidities. The ACT team integrated these resources into …

The Art Of Surviving: Alchemy Of Healing Trauma In Relation To Identity: A Self Study., Rebecca Morgan

Electronic Theses and Dissertations

The following thesis explores trauma’s physical and psychological aspects concerning identity as an artistic practice. Through exploring materials, subject matter, and media, my approach to trauma is based on personal and socially engaged experiences and my attempt to re-conceptualize that experience through the language of contemporary art. Extensively this work is governed by childhood memories and the critical aspect of being raised as a female in a patriarchal society. Being raised female comes with a certain number of expectations and requirements. This work creates a physical and spiritual connection between trauma and the identity of what is female. Discussing these …

An Updated Look At Mental Health Services In American Public And Private Prisons, Lieren E. Tyira

Student Theses

People residing in American prisons have the legal right to mental health care while incarcerated (Justia, 2021). This is important, as the prevalence of mental disorders is high in this population (Prins, 2014), and incarceration is a psychologically damaging experience, which hinders a person’s success at rehabilitation. Numerous of issues related to the mental health services (MHSs) in both public and private prison facilities have been reported in recent years, which warrants systematic exploration. The little existing research comparing the presence of MHSs in these facilities has produced mixed results, it uses out-of-date datasets, and none has explored MHSs in …

Genetic And Transcriptomic Aspects Of Major Depressive Disorder: In Vivo Functional Assays Of Risk-Associated Variation, Candidate Disease Cell Types, And Their Pharmacologic And Sex Interactions, Bernard Mulvey

Arts & Sciences Electronic Theses and Dissertations

Major depressive disorder (MDD) is a debilitating illness that affects hundreds of millions globally, with substantial personal, medical, economic, and societal consequences. While depression occurs more commonly in females, the biology of the brain and sex underlying this skewed prevalence remains unclarified. This body of work explores two aspects of how biological sex may influence the brain at the level of gene expression: through intrinsic sex differences and through sex-mediated effects of depression risk genetics.

The monoamine hypothesis of depression suggests that modulatory neurotransmitters including serotonin and norepinephrine constitute a key axis in development of MDD. Large-scale studies of MDD …

Does The Use Of Mental Health Screenings And Targeted Stress Interventions Improve Mental Health Outcomes In Outpatient Clinic Staff?, Mary Benson

Doctoral Projects

The Perceived Stress Scale (PSS) has been used as a classic stress assessment instrument to evaluate perceived stress across many settings. As stress is the primary phenomenon in this review due to varying stressors, including infectious diseases among healthcare workers, the PSS is the most appropriate scale for evaluating the degree to which a health worker feels stressed. In addition, the PSS is valuable as it encompasses ten items that researchers use to explore how respondents react to stress due to unpredictable events. Thus, this DNP project is based on the postulation that screening with the PSS and applying stress …

Data-Driven Neuroanatomical Subtypes In Various Stages Of Schizophrenia: Linking Cortical Thickness, Glutamate, And Language Functioning, Liangbing Liang

Electronic Thesis and Dissertation Repository

The considerable variation in the spatial distribution of cortical thickness changes has been used to parse heterogeneity in schizophrenia. We aimed to recover a ‘cortical impoverishment’ subgroup with widespread cortical thinning. We applied hierarchical cluster analysis to cortical thickness data of three datasets in different stages of psychosis and studied the cognitive, functional, neurochemical, language and symptom profiles of the observed subgroups. Our consensus-based clustering procedure consistently produced a subgroup characterized by significantly lower cortical thickness. This ‘cortical impoverishment’ subgroup was associated with a higher symptom burden in a clinically stable sample and higher glutamate levels with language impairments in …

Reducing Physical Restraints And Emergency Psychiatric Medications On An Inpatient Psychiatric Unit With The Broset Violence Checklist, Victoria Hernandez

Doctor of Nursing Practice

Background: Physical restraint and psychiatric emergency medication use, especially psychotropic medications, is problematic, negatively impacting patient safety on psychiatric units (Ambwani et al., 2021; Iuppa et al., 2013; Rahman, 2021). The Bröset Violence Checklist (Woods & Almvik, 2002), a short-term violence-predicting tool, has been used in the inpatient setting to predict violent outbursts and determine when high-level violence interventions are needed.

Purpose: The purpose of this project was to recognize signs and symptoms of aggression and agitation early and intervene to reduce the use of physical restraints and emergency restraint medications on an inpatient psychiatric unit, thereby improving patient safety. …

Implementing Evidence-Based Adult Psychiatric Inpatient Depression Assessment, Treatment, And Post-Hospitalization Referral, Lucy Flores

Doctor of Nursing Practice

Purpose: This project was designed to strengthen the quality of depression assessment with evidence-based depression assessment tools in inpatient psychiatric units.

Background: Missed diagnosis and treatment of depressive disorders contribute to the most severe outcome of depression: suicide. A crisis stabilization facility with inpatient psychiatric units had significant opportunities to improve clinical outcomes by screening for depression in adults and to monitor symptoms with evidence-based tools.

Methods: The 12-week quality improvement project included implementation of staff education sessions of evidence-based tools to screen, monitor, interpret scores, and detect risk modifiers. The design and build with Information …

Therapists’ Demonstrated Multicultural Competence In Treating Latinx Immigrants, Dulce Diaz Benitez

Graduate Theses and Dissertations

Studies suggest that health disparities occur when people from marginalized communities receive care that is inadequate based on their cultural needs (USDHHS, 2011). Multicultural competence (MCC) models have been proposed to provide a framework of the competencies that therapists should develop to work with multicultural populations (Sue et al., 1992). Researchers have questioned the validity of measures, which are mostly based on therapist self-report (Cartwright, 2008). The multicultural case conceptualization ability task has been used in previous studies as a measure of demonstrated cultural competence using a vignette to assess case conceptualization abilities (Ladany et al., 1997). However, it has …

A Structural Examination Of The Connection Between The Amygdala And Nucleus Accumbens In Adolescents With Clinical Anxiety, Alyssa Griffith

Biological Sciences Undergraduate Honors Theses

The prominence of anxiety disorders in today’s general population is a major public health concern. Advancing research of the underlying pathophysiology of anxiety disorders can lead to the discovery of effective treatment interventions to treat the mental and physical symptoms of anxiety, and thus improve quality of life. This study aimed to examine two brain areas in the limbic and reward systems, the amygdala and Nucleus Accumbens (NAcc), and the structural white matter connection between them. This neural circuit assigns affective valence to environmental stimuli and motivates behavior to avoid potential harm. This study utilized diffusion Magnetic Resonance Imaging (dMRI) …

Implementing The Depression Screening Tool Phq-9 In The Annual Wellness Exam Of Concierge Family Medicine, Eric Iglesias

Doctor of Nursing Practice

Abstract

Background: Depression has been one of the most common mental health disorders that our population fact but is underdiagnosed and undertreated. Primary care providers are often the first line of defense in detecting depression. Because of this, implementing a depression screening tool in a primary care setting will improve holistic management of care and improve quality of life.

Project Aim: The aim of this project was to increase the number of clients who are evaluated for depression by using the PHQ-9 screening tool during their annual wellness exam and initiate treatment according to the Veteran’s Affairs/Department of Defense Depression …

Tiny Tusks Breastfeeding And Infant Support: Breastfeeding's Effects On Maternal Mental Health, Anna Jacobs

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Breastfeeding has proven to be beneficial for infant health and maternal physical health, but there are variable outcomes for maternal mental health. This literature review explores the relationship between breastfeeding and maternal mental health, a topic that is often disregarded when discussing breastfeeding with mothers. After an internship with Tiny Tusks Breastfeeding and Infant Support, a program to make breastfeeding more accessible at Razorback Athletics events, maternal mental health related to breastfeeding was shown to be a topic in need of more current research. This objective of this literature review was to determine how breastfeeding can impact maternal mental health …

The Impact Of Covid-19 On Recreational Therapists Working In Inpatient Mental Health Settings, Summer Matics

All Dissertations

Since 2020, the novel coronavirus (COVID-19) has impacted the lives of the general public, but healthcare workers including those that work in inpatient mental health settings have seen long-lasting impacts in their workplace. Recreational therapists (CTRSs) are among the mental healthcare workers that have been impacted by the pandemic but there is no existing research that specifically studies their lived experiences. This study used the theoretical foundations and methods of hermeneutic phenomenology in order to describe how COVID-19 has impacted CTRSs’ workplace from a safety perspective, their stress and coping, and also their supervisory duties. Seventeen participants were recruited and …

Utilization Of A Multimodal De-Escalation Class To Improve Staff Confidence When Caring For Behaviorally Escalating Patients, Tara B. Neuner

Graduate Theses, Dissertations, and Capstones

Workplace violence is a common challenge seen in the healthcare settings across the world. This problem is steadily increasing in all types of hospitals, including a level one trauma center located in an urban area. There has been a steady rise in the number of assaults and workplace violence reported from bedside staff at this hospital. The leadership of the organization formed a work group to help combat the workplace violence and staff assaults that were occurring. In this process, a behavior response team was created to help nursing staff with escalating behavior in patients, and to help de-escalate the …

Predictors And Outcomes Of Patient Stigma Perception Appraisal: Developing And Testing Of A Dynamic Stigma Model Of Mental Illness, Sebastian Kwadwo Gyamfi

Electronic Thesis and Dissertation Repository

Background

The psychosocial perspectives of stigma have been explored over the years. However, research that encompasses the study of stigma as a socio-cultural, religious, and moral phenomenon is lacking. This study aimed to develop and test a Dynamic Stigma Model of Mental illness (DYSMO) among a cohort of Outpatients receiving care in Ghana.

Methods

The study examined hypothesized relationships within a newly developed stigma model using structural equation modeling techniques. A non-probabilistic convenience sampling technique was used to recruit 330 participants at the Out-Patient Department of two psychiatric hospitals in Southern Ghana.

Results

Confirmatory factor analysis produced a final model …

The Correlation Between Transformational Leadership And Mental Health Clinician Burnout, Rebekah E. Shutter

Electronic Theses and Dissertations

Mental health clinicians working in a hospital setting are at a high risk of experiencing burnout due to the stressful demands of their caseloads, compassion fatigue, limited resources, and unsupportive leadership. While there is ample research regarding the cause and effect of burnout on clinicians there is a gap in the literature when it comes to the impact leadership has on mental heath clinician burnout. The purpose of this quantitative, correlational study is to determine if and to what extent there is a correlation between Transformational Leadership and mental health clinician burnout. Participants for this study consisted of 200 mental …

Implementation Of Nurse Navigators For Behavioral Health, Theresa Papagna

Seton Hall University Dissertations and Theses (ETDs)

Mental health patients have been notoriously non-adherent with diligent medication conformity, office visit fidelity, candor about side effects, use of illegal substances for self-medication, and truthfulness about co-occurring conditions. This non-adherence makes treatment difficult for psychiatric providers, and all those who participate in the care of patients with mental illness. Patient non-adherence can cause frustration and can lead to provider burnout, which affects patients as well as providers. Also, there are concerning financial implications of excessive time and resources needed to adequately monitor mental health patients. Implications regarding 30- day re-admissions are tantamount to consideration of financial strains put on …

Connecting And Communicating To Support Youth Mental Health, Michele Davide

Seton Hall University Dissertations and Theses (ETDs)

The nation is experiencing a pediatric mental health crisis amid a shortage of pediatric mental health care providers. The Connecting and Communicating project explores a strategy pediatric primary care practitioners can employ to bridge this gap and maximize their impact on supporting youth mental health in a community.

For this project, a pediatric primary care nurse practitioner created a pilot educational video with the dual purpose of educating parents and school staff on the importance of connecting with adolescents using the proven evidence supported communication technique of validating strong emotions without judgement, and partnering with pediatric health stakeholders by requesting …

How To Survive College As An Acoa: The Effectiveness Of University Resources On Helping Acoas Socially And Psychologically Succeed During Their Academic Career, Kelly Buchan

Senior Theses

In 2019, 14.5 million people ages 12 and older had Alcohol Use Disorder (AUD), but only 10% received treatment (National Institute on Alcohol Abuse and Alcoholism [NIAAA], 2022). Parental drinking problems can directly affect children, or “Adult Children of Alcoholics.” Of the few studies targeting ACoAs, results show that ACoAs not only have higher risks of mental illness, but they also have lower GPAs and social health (Schroeder & Kelley, 2008). Thus, this study assessed the extent to which perceptions of the college drinking environment are related to higher depression rates in ACoAs, certain drinking motivations, and reluctance to use …

Hidden Struggles Within The Mental Healthcare Workplace, Tammy V. Smith

USF Tampa Graduate Theses and Dissertations

For decades, the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) have reported on the worldwide pervasiveness and increasing societal costs associated with Adverse Childhood Experiences (ACEs). A recent post on the WHO website cited recent scientific research (2022) indicating the magnitude of harmful effects attributed to ACEs, even classifying them as “violence against children.” Esaki and Larkin (2013) indicate that ACEs are prevalent among many social service professionals, including mental health clinicians.

This study uses mental health clinicians as the sample population to identify the impact of ACEs on job performance. Findings from a volunteer …

Role Of The Default-Mode Network During Narrative Integration In Major Depressive Disorder, Darren Ri-Sheng Liang

Electronic Thesis and Dissertation Repository

How brain activity is synchronized across individuals during narrative comprehension has previously been characterized by functional magnetic resonance imaging (fMRI) in healthy and patient populations. To our knowledge, there has been limited investigation as to how it is affected by major depressive disorder (MDD). We addressed this issue with fMRI through examination of inter-subject synchronization in the default mode network (DMN), brain structures which have previously been implicated in MDD pathology. Twenty-two patients with MDD and 20 matched control participants listened to Intact versus Scrambled versions of an auditory narrative; these experimental conditions differed in the degree of temporal integration …

Standardizing Perinatal Mental Health Interventions: A Guide For The U.S., Maile Lauren Robles

Master's Projects and Capstones

The term perinatal individual refers to women and other individuals who are pregnant or who have been pregnant within the last 12 months. Every year, in the United States there are 700 pregnancy-related deaths and 10% are due to mental health causes including death by suicide. Mental health conditions including but not limited to anxiety, depression, substance use disorders, and post-traumatic stress disorder affect one in five perinatal individuals throughout the United States. This increases perinatal morbidity, hospitalization costs, and economic burden nationwide.

After 43 days postpartum, mental health conditions are the second leading cause of death. The United States …

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 …

The Child Care Crisis: Through The Social Ecological Lens, Jocelyne Saldana

Master's Projects and Capstones

Abstract

Objective - Working mothers face mental strain when returning to work due to the challenges of the current child care system. It is unclear how the instability of the child care sector impacts the mental health of working mothers.

Methods - The systematic review of literature was conducted to identify existing evidence to determine the influence access to quality, dependable, and affordable child care has on maternal mental health outcomes in working mothers. Multiple databases were used including PubMed and Scopus.

Results - Subsidized programs help reduce the cost of child care, however, income eligibility criteria makes it difficult …

Ask Your Doctor About: Prescribing Activism For Eco-Anxiety In Adolescents, Lexi Nutkiewicz

Master's Projects and Capstones

Climate change is an ongoing public health crisis. Efforts to protect future generations' physical and mental health are more urgent than ever. Youth, in particular, are experiencing eco-anxiety, a specific form of anxiety relating to stress or distress caused by environmental changes and one’s knowledge of them due to the climate crisis. This scoping review provides a better understanding of the value of youth climate change activism as a strategy to mitigate eco-anxiety. This review evaluates the current definitions of eco-anxiety, the risk factors for eco-anxiety among adolescents, and considers the benefits and drawbacks of youth activism. To identify relevant …

Occupational Therapy Program For Pace Center For Girls, Natalie Vish

Department of Occupational Therapy Entry-Level Capstone Projects

An occupational therapy handbook was created for future occupational therapy students and occupational therapy assistant students to utilize when completing fieldwork rotations at Pace Center for Girls. The handbook was created to address core occupations through a trauma-informed and gender-sensitive perspective. An occupational therapy program utilizing mindfulness and sensory-based approaches at Pace Center for Girls may provide alternative and effective solutions for this at-risk female adolescent population as literature reveals that survivors of complex trauma often do not respond to traditional psychiatric treatment approaches.

The Effects Of Covid-19 On Mental Health And Injury Occurrence Of Division Iii College Football Players, Evan Kennaley

Masters Theses/Capstone Projects

Objective: The aim of the study was to investigate if with the lockdown of COVID-19 and the reschedule of the Fall 2020 football season caused an increase in injury in a Division Three College football team.

Methods: A 20 question survey was given to the 2022 Spring Otterbein football team. The survey allowed for self reporting of injuries suffered in the 2019,2020, and 2021 football seasons. The survey also looked to examine if there is any anxiety the players suffered from during the lockdown using the Covid Anxiety Scale.

Results: Of the 63 surveys, it was found that the 2021 …

Impact Of Teacher Cognition On The Implementation Of Social- Emotional Learning Practices For El Students, Madeline Bliske

Theses and Dissertations

There is a well-established achievement and graduation rate gap between English Learner (EL) students and their monolingual English-speaking peers (U.S. Department of Education, 2020). The current study focuses on teacher cognition and characteristics that may impact the likelihood that they will implement culturally and linguistically sustaining (CLS) social-emotional learning (SEL) practices for EL students within their classroom. Specifically, I descriptively analyze whether personal, professional, or school characteristics are associated with teachers’ perception of EL students SEL competencies or implementation of CLS SEL practices. Utilizing the Theory of Planned Behavior (TPB), I evaluate whether teacher cognition (i.e., behavioral attitudes, subjective norms, …