Mental and Social Health Commons^™

Hippocampal Volume And The Detection Of Mild Cognitive Impairment In An Older Adult Population: Assessing Performance On Cognitive Screeners Administered In-Person And Electronically, Kristen Fabrizi

Dissertations

The present study investigated how performance on in-person and electronic neuropsychological assessment measures predicted subcortical hippocampal volume and cognitive decline consistent with mild cognitive impairment. It was hypothesized that the Montreal Cognitive Assessment would display better predictive strength than the Cogstate Brief Battery when evaluating subcortical hippocampal volume measured via structural magnetic resonance imaging. It was further hypothesized that the Montreal Cognitive Assessment would be more sensitive to predicting group membership to the diagnostic classification of mild cognitive impairment compared to the Cogstate Brief Battery. The sample included 445 older adult participants selected from the Alzheimer’s Disease Neuroimaging Initiative 3. …

Evidence-Based Practices And Self-Efficacy: A Quantitative Study Of Mental Health Counselors Treating Clients With Substance Use Disorder, Carl Bastien

Dissertations

Substance use disorder affects a substantial number of individuals in the United States. The specific problem of this research is that it was not known to what extent their use of evidence-based practices is driven by their sense of self-efficacy. The purpose of this quantitative correlational research was to examine to what extent the use of evidence-based practices covary with a sense of self-efficacy for mental health counselors treating individuals diagnosed with a substance use disorder. The study population was 121 mental health counselors who specialized in substance use disorder treatment who completed a digital survey. The study findings did …

Single-Case Pilot Study For Longitudinal Analysis Of Referential Failures And Sentiment In Schizophrenic Speech From Client-Centered Psychotherapy Recordings, Travis A. Musich

Dissertations

Though computational linguistic analyses have revealed the presence of distinctly characteristic language features in schizophrenic disordered speech, the relative stability of these language features in longitudinal samples is still unknown. This longitudinal pilot study analyzed schizophrenic disordered speech data from the archival therapy audio recordings of one patient spanning 23 years. End-to-end Neural Coreference Resolution software was used to analyze transcribed speech data from three therapy sessions to identify ambiguous pronouns, referred to as referential failures, which were reviewed and confirmed by multiple raters. Speech samples were analyzed using Google Cloud Natural Language API software for sentiment variables (i.e., score, …

Evaluating Sbirt In A Behavioral Health Urgent Care, Christina L. Williams

Dissertations

Background: Adolescent substance use (SU) is a major health concern. Most youth who engage in alcohol and other SU do not meet criteria for SU disorder (SUD). Nonetheless, evidence shows SU during adolescence impacts cognitive, social, and emotional development, increases risk of physical injury, and may progress to SUD in adulthood. Only half of clinicians properly screen adolescents for SU; those identified with SUD often receive no intervention. Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based intervention to address this problem. The purpose of this project was to evaluate implementation of SBIRT using CRAFFT 2.1+N, a SU …

Visualizing Depressive Symptom Improvement: Implementing The 17-Item Hamilton Depression Rating Scale, Briana Raterman

Dissertations

Visualizing Depressive Symptom Improvement: Implementing the 17-Item Hamilton Depression Rating Scale

Abstract

Problem

Depression, a mental health diagnosis, has affected about 18.5% of adults (Villarroel & Terlizzi, 2020). Ketamine, a medication initially used as an anesthetic, has improved depressive symptoms in individuals struggling with treatment-resistant depression.

Method

This quality improvement (QI) project used the 17-item Hamilton Depression Rating Scale questionnaire to assess depressive symptom changes in patients receiving intramuscular ketamine for treatment-resistant depression. The questionnaire was administered to patients pre-and post-intramuscular ketamine administration. The data was collected on injections one, three, and six on each participant’s set schedule of injections …

Evaluating Patient Health Questionnaire-9 (Phq-9) Use In Burn Survivors, Chelsey Friend

Dissertations

Problem: A burn injury affects both psychological and physical health, resulting in a greater than 50% major depressive disorder morbidity. The purpose of this quality improvement (QI) project is to evaluate the use of the Patient Health Questionnaire-9 (PHQ-9) in adult burn survivors, with an aim to increase the use of the screening tool.

Methods: A mixed-methods pre/post-survey design with an educational component was utilized to assess nurse knowledge, confidence, willingness, and barriers to completion of the PHQ-9. Aggregate data were collected to determine PHQ-9 completion rates for patients admitted to and discharged from the unit during the two months …

Examining Treatment Acceptability Of An Eight-Week Mindfulness-Based Stress Reduction Protocol, Blake William Palmer

Dissertations

The goal of this study is to examine whether levels of perceived stress, experiential avoidance, personality traits including openness to experience and agreeableness, and demographic variables will predict the treatment acceptability (indicated by responses on the Treatment Acceptability and Adherence Scale) of an eight-week Mindfulness-Based Stress Reduction (MBSR) program. This study collected data in the Spring of 2019. The final number of participants in the study was 116 (40 females, 76 males, Mage = 36, age range: 22-69 years). Participants completed measures including the Perceived Stress Scale (PSS), Acceptance and Action Questionnaire-II (AAQ-II), the agreeableness and openness to Experience domains …

Comparison Study: Trauma-Focused Cognitive Behavioral Therapy And Acceptance And Commitment Therapy For Trauma, Colleen Marie Kirsch Hiltz White

Dissertations

There is a need for more evidenced based treatments for adolescents with trauma related disorders. Currently, Trauma Focused Cognitive Behavioral Therapy (TF CBT) is the gold standard, but clients and clinician need the ability to choose between effective treatments. This study completed a direct comparison between six weeks of treatment in Acceptance and Commitment Therapy for Trauma and TF CBT via telehealth during the COVID-19 pandemic. Treatments were measured using the Clinician Administered PTSD Scale and the Child PTSD Symptom Scale. Both treatments were found to be effective in reducing trauma related symptoms in two 12-year-old females.

Bridging The Gap: Understanding Non-Offending Parental Responses To Their Children's Sexual Abuse., Jennifer Latreill, Psy.D.

Dissertations

The parental response to children's disclosure of childhood sexual abuse (CSA) is the most critical and important factor regarding the child's post trauma trajectory and overall trauma resolution. Understanding parental responses and the factors that prompt acceptance versus disbelief among the non-offending parent (NOP) is vital to children's success following disclosure given the weight of the NOPs response and its impact on long-term consequences of CSA. This literature review provides a comprehensive summary of what may deter the NOP from recognizing intrafamilial sexual abuse, factors that may contribute to the NOPs disbelief following disclosure, and possible clinical implications of such …

Exploration Of Physician Attitudes About Self-Care And Personal Mental Health: Possible Barriers To Physician Well Being, Candich Farrar

Dissertations

The present study was designed to examine physicians’ mental health, attitudes, and behaviors toward self-care and the utilization of mental health services. As the medical field can be very demanding and exhausting, it is believed that many physicians suffer from mental illnesses such as anxiety and depression. However, it was theorized that many physicians do not engage in adequate self-care regimes or seek support and suppress their symptoms, which may further exacerbate their illnesses. A thorough literature review was performed to explore the following: possible barriers to physicians seeking mental health services to address high rates of mental illnesses, physicians …

Improving Access To Mental Health Care With Nurse Practitioners, Jessica Whelan

Dissertations

Problem: Over 40% of those with mental illness are untreated since the supply of psychiatrists does not meet the demand. The psychiatric mental health nurse practitioner (PMHNP) may be an adjunct in providing those services. The purpose of this quality assurance study was to evaluate outcomes of care between a PMHNP and a psychiatrist (medical doctor [MD]).

Methods: An observational, descriptive design with a retrospective medical record review of adult patients over a six-month period in a suburban, Midwestern, privately owned psychiatric practice.

Results: A total of 787 individual patients encountered at least one visit (N=787) although 3,679 …

The Predictors Of Juvenile Recidivism: Testimonies Of Adult Students 18 Years And Older Exiting From Alternative Education, La Toshia Palmer

Dissertations

Purpose: The purpose of this descriptive, qualitative study was to identify and describe the importance of the predictors of juvenile recidivism and the effectiveness of efforts to prevent/avoid juvenile recidivism as perceived by previously detained, arrested, convicted, and/or incarcerated adult students 18 years of age and older exiting from alternative education in Northern California. A second purpose was to explore the types of support provided by alternative schools and the perceived importance of the support to avoid recidivism according to adult students 18 years of age and older exiting from alternative education.

Methodology: This qualitative, descriptive research design identified …

Implementation Of The National Asthma Guidelines In A Residential Pediatric Clinic, Patricia A. Foster-Staples

Dissertations

Abstract

Purpose: Foster care children admitted to residential facilities are a unique and vulnerable group, many presenting with undiagnosed or poorly managed asthma. The alarming rate of residents admitted to a particular residential primary care clinic with a diagnosis of asthma led to the project question: “Based on record reviews, does staff education about the importance of utilizing the national guidelines for asthma education influence the implementation of such guidelines in a residential pediatric clinic?” The purpose of this quality improvement project was to implement a systematic process to influence practice change. The project was conducted over a period …

Factors Affecting Mental Health Seeking Behaviors Of Law Enforcement Officers, Vincent M. Haecker

Dissertations

The intent of this study was to elicit perspectives from law enforcement counselors, clinicians, chaplains, and peer group leaders for factors affecting law enforcement officer’s (LEOs) seeking mental health assistance. The law enforcement and mental health communities have gone to great lengths to ensure assistance is available to LEOs in an effort to counter the stress and trauma associated with the policing profession. Past studies attempted to elicit LEOs attitudes on mental health services, generating mixed results and were unable to establish why available services were underutilized. This study employed a qualitative methodology to elicit perspectives on this phenomena from …

The Associations Among Expressed Emotion, Relationship Satisfaction, Ptsd Symptoms, Alcohol Use, And Depression: A Longitudinal Investigation With A Military Sample, Laci Lee Zawilinski

Dissertations

PTSD in military personnel is highly prevalent and accompanied by elevated rates of additional issues such as depression, problematic alcohol use, and interpersonal relationship problems. Family members and spouses of military personnel have also been shown to be negatively impacted by PTSD symptoms. Previous research has indicated that family members and spouses’ expressed emotion regarding the PTSD patients’ symptoms negatively impacts treatment outcome in civilian populations. However, studies have yet to investigate the effect of expressed emotion on the course of PTSD symptoms and associated problems in military personnel. Therefore, the purpose of the present investigation was to examine the …

Increasing Physical Activity In Young Adults With Autism Spectrum Disorder, Katherine B. Lalonde

Dissertations

Experts recommend that individuals walk 10,000 steps or more per day and doing so has been shown to have several health benefits. Unfortunately, many people fall short of 10,000 steps per day. Exercise levels are characteristically lower in people with Autism Spectrum Disorders (ASD) than in people without ASD. The present study comprised two experiments that used goal setting and reinforcement to increase physical activity in young adults with ASD. The first study employed a multiple-baseline-across-participants design in combination with a reversal design to determine the effects of a treatment package on the number of daily steps taken by young …

Effectiveness Of A Motivational Enhancement Group Treatment In A Community Treatment Program With A Substance Abusing Population, Matthew S. Willerick

Dissertations

Motivational interviewing (MI) is a directive, client-centered intervention to elicit behavior change by assisting clients in the exploration and resolution of ambivalence toward change. MI-inspired approaches have been used in an attempt to facilitate change in a wide variety of domains including alcohol and drug abuse, safe water handling practices, dual diagnoses, gambling, spousal abuse, health related areas, mood and anxiety disorders, and parental engagement. MI seeks to resolve ambivalence in the direction of change by increasing the client's self-efficacy. This is accomplished by combining clientcentered (e.g., reflective listening) and directive strategies (e.g., attending selectively to change statements). The origins …

Evaluation Of Medication Effects On Academic Performance, Sleep, And Core Adhd Symptoms In Children, Tina K. Head

Dissertations

Idiosyncratic effects of Vyvanse™ (lisdexamfetamine dimesylate) and placebo were evaluated in a double-blind alternating treatments experimental design in this 4-week study. Direct, objective measures were combined with traditional behavior ratings to provide data sets to assess whether or not the prescribed stimulant medication showed detectable therapeutic effects for a child whose positive response to medication was not obvious via traditional subjective methods. Effects of medication on core ADHD symptoms, academic performance, and sleep in four children ages 10-12 with attention deficit/ hyperactivity disorder. Potential side effects were also measured. Daily measures included parent rating scales, side effects checklist, sleep journal …

A Descriptive Multiple Case Study Of Caucasian Female Suicide Attempters: Risk And Protective Factors, Janice Johnson Browne

Dissertations

Problem

Suicide is a problem globally and in the United States. Suicide rates for youth have remained particularly high. Caucasian men complete more suicidal acts than women, but women are more frequent suicide attempters. To gain information about the phenomenon of female suicide attempting, it is important to study the attempter. Awareness of risk and protective factors is necessary to intervene and prevent future incidences of suicide and suicide attempting.

Methodology

For this research a descriptive case study design was utilized. Three suicide attempters who had attempted suicide one or more times in the past was the sample population for …

Refugee Experiences Of Trauma And Ptsd Effects On Psychological, Physical, And Financial Well-Being, Karen J. Cusack

Dissertations

No abstract provided.

The Kinetic Family Drawing As A Measure Of Minuchin's Structural Family Concepts Among Hispanic American Families With Substance-Abusing And Nonsubstance-Abusing Adolescents, José Osorio-Braña

Dissertations

Problem. There is a need for validation of new cultural-sensitive tests for assessing the Hispanic population in the United States that will take into account their cultural competence in the psychological evaluation practice. The purpose of this study was to explore the suitability of the Kinetic Family Drawings as a measure of Minuchin's Structural Family Theory among Hispanic American families with substance-abusing and nonsubstance-abusing adolescents.

Method. The Kinetic Family Drawing (KFD), the Structural Family Interaction Scale-Revised (SFIS-R), and the Family Adaptability and Cohesion Scales (FACES II) were administered to 141 families, 74 with an adolescent with substance-abusing problems and 67 …

Reducing Emg And Cardiovascular Reactivity With Cue-Controlled Relaxation, Janel Kay Harris

Dissertations

The present study compared cue-controlled relaxation (CCR) to progressive muscle relaxation (PMR) as possible methods of reducing reactivity to active stressors (math and anagram tasks). The CCR training entailed practicing relaxation during exposure to the active stressors, while the PMR training did not. Ten cardiac rehabilitation patients served in an experiment which used a repeated-measures ANOVA to assess changes in frontal EMG, skin conductance level (SCL), systolic (SBP) and diastolic (DBP) blood pressure, and pulse-rate reactivity across three experimental conditions. These were: baseline, progressive muscle relaxation, and cue-controlled relaxation. The results indicated that CCR led to reduced EMG, SBP, and …