Psychiatry and Psychology Commons^™

Biopsychosocial Impacts Of Social Distancing Due To Covid-19 In People Over 65: A Literature Review, Nicole Lacap

Rowan-Virtua Research Day

Background: Since the beginning of the Covid-19 pandemic in January 2020, elderly populations aged 65+ have been deemed at-risk for severe symptoms and poor prognosis. Because it is important to protect this vulnerable population, policies such as social distancing and shelter-in-place orders have been implemented in the United States in order to prevent the spread of Covid-19. However, many older citizens may live alone or may not have access to technology, and therefore may be limited in their ability to maintain important relationships and social interactions throughout shelter-in-place orders and social distancing. Therefore, it is important to understand the cost …

Improving Depression Screening Completion Rates For Medicare Patients In A Primary Care Setting, Kenneth J. Haluska

Evidence-Based Practice Project Reports

The United States Preventative Services Task Force recommends screening the general adult population for depression (Siu et al., 2016). Despite increasing clinical practice guidelines recommending depression screening, only 40-50% of depressed older adults are recognized and treated (Phoh et al., 2017). The purpose of this evidence-based practice (EBP) project was to implement a medical assistant (MA) depression screening protocol, using the PHQ-9 and staff education, to improve depression screening completion rates in Medicare patients in a primary care setting. An exhaustive literature search of eight databases yielded 14 pieces of evidence that made recommendations for best practice. The evidence was …

Psychosocial Mediators Of Perceived Stigma And Suicidal Ideation Among Transgender Women, Krishna Kiran Kota, Laura F. Salazar, Rachel E. Culbreth, Richard A. Crosby, Jamal Jones

Health, Behavior & Society Faculty Publications

BACKGROUND: Transgender women (TGW) in the U.S. experience high rates of stigma, depression, and elevated rates of suicide. This study examined correlates of suicidal ideation and estimated the conditional indirect effects of perceived stigma and psychosocial mediators on suicidal ideation.

METHODS: Using a cross-sectional study design, TGW (N = 92) were recruited through snowball sampling in Atlanta, Georgia. Structured interviews were conducted. Suicidal ideation was assessed by combining two variables that measured suicidal thoughts. Logistic regression models were performed to identify the potential risk and protective factors for suicidal ideation. We examined hypothesized psychosocial factors, including anxiety, depression, psychosocial impact …

Functional Human Grin2b Promoter Polymorphism And Variation Of Mental Processing Speed In Older Adults, Yang Jiang, Ming Kuan Lin, Gregory A. Jicha, Xiuhua Ding, Sabrina L. Mcilwrath, David W. Fardo, Lucas S. Broster, Frederick A. Schmitt, Richard J. Kryscio, Robert H. Lipsky

Behavioral Science Faculty Publications

We investigated the role of a single nucleotide polymorphism rs3764030 (G > A) within the human GRIN2B promoter in mental processing speed in healthy, cognitively intact, older adults. In vitro DNA-binding and reporter gene assays of different allele combinations in transfected cells showed that the A allele was a gain-of-function variant associated with increasing GRIN2B mRNA levels. We tested the hypothesis that individuals with A allele will have better memory performance (i.e. faster reaction times) in older age. Twenty-eight older adults (ages 65-86) from a well-characterized longitudinal cohort were recruited and performed a modified delayed match-to-sample task. The rs3764030 polymorphism was …

Buprenorphine Physician Supply: Relationship With State-Level Prescription Opioid Mortality, Hannah K. Knudsen, Jennifer R. Havens, Michelle R. Lofwall, Jamie L. Studts, Sharon L. Walsh

Behavioral Science Faculty Publications

Background: Buprenorphine is an effective treatment for opioid use disorder but the supply of buprenorphine physicians is currently inadequate to address the nation’s prescription opioid crisis. Perception of need due to rising opioid overdose rates is one possible reason for physicians to adopt buprenorphine. This study examined associations between rates of growth in buprenorphine physicians and prescription opioid overdose mortality rates in US states.

Methods: The total buprenorphine physician supply and number of physicians approved to treat 100 patients (per 100,000 population) were measured from June 2013 to January 2016. States were divided into two groups: those with rates of …

Mental Health Treatment Seeking Patterns And Preferences Of Appalachian Women With Depression, Claire Snell-Rood, Emily Hauenstein, Carl G. Leukefeld, Frances Feltner, Amber Marcum, Nancy E. Schoenberg

Behavioral Science Faculty Publications

This qualitative study explored social-cultural factors that shape treatment seeking behaviors among depressed rural, low-income women in Appalachia—a region with high rates of depression and a shortage of mental health services. Recent research shows that increasingly rural women are receiving some form of treatment and identifying their symptoms as depression. Using purposive sampling, investigators recruited 28 depressed low-income women living in Appalachian Kentucky and conducted semistructured interviews on participants’ perceptions of depression and treatment seeking. Even in this sample of women with diverse treatment behaviors (half reported current treatment), participants expressed ambivalence about treatment and its potential to promote recovery. …

Statin Discontinuation In Nursing Home Residents With Advanced Dementia, Jennifer Tjia, Sarah Cutrona, Daniel Peterson, George Reed, Susan Andrade, Susan Mitchell

Jennifer Tjia

OBJECTIVES: To describe patterns of, and factors associated with, statin use and discontinuation in nursing home (NH) residents progressing to advanced dementia and followed for at least 90 days.

DESIGN: Retrospective inception cohort using a dataset linking 2007 to 2008 Minimum Data Set (MDS) to Medicare denominator and Part D files.

SETTING: All NHs in five states (Minnesota, Massachusetts, Pennsylvania, California, Florida).

PARTICIPANTS: NH residents with dementia.

MEASUREMENTS: Residents who developed advanced dementia were observed from baseline (date of progression to very severe cognitive impairment with eating problems) and followed for at least 90 days to statin discontinuation or death. …

Treatment Preferences Among Problem Drinkers In Primary Care., Daniel Z Lieberman, Anne Cioletti, Suena H Massey, Rochelle S Collantes, Brad B Moore

Psychiatry and Behavioral Sciences Faculty Publications

OBJECTIVE: Alcohol misuse is common among primary care patients, yet many do not receive treatment because doctors believe problem drinkers are "in denial," or are unwilling to change their drinking habits. The real problem, however, may be that patients are being offered treatment modalities that do not meet their needs. This study was designed to measure the acceptability of various treatment options among drinkers who were currently not receiving treatment.

METHOD: Patients in a primary care clinic were given a self-report questionnaire that included: (1) the Alcohol Use Disorders Questionnaire, (2) a measure of readiness to change drinking behavior, and …

Insurance Status And Length Of Stay For Involuntarily Hospitalized Patients, William Fisher, Paul Barreira, Alisa Lincoln, Lorna Simon, Andrew White, Kristen Roy-Bujnowski, Marylou Sudders

Alisa Lincoln

General and private psychiatric hospitals are becoming increasingly common as sites for involuntary hospitalization. Unlike the public facilities that these settings are supplanting, these hospitals must pay strict attention to issues associated with reimbursement, insurance status, and managed care. This article examines the effects of insurance status on length of stay for involuntarily hospitalized patients in general and private hospitals in Massachusetts. Using a two-stage sampling procedure, data on episodes of involuntary hospitalization were gathered and assessed using multiple regression. The primary effect was found between patients with Medicare, who had the longest stays, and individuals who were uninsured, who …

Ask A Different Question, Get A Different Answer: Why Living Wills Are Poor Guides To Care Preferences At The End Of Life., Laraine Winter, Susan M Parks, James J Diamond

Center for Applied Research on Aging and Health Research Papers

CONTEXT: Living wills have a poor record of directing care at the end of life, as a copious literature attests. Some speculation centers on the questionable correspondence between the scenario described in living wills versus the real-life circumstances that typically arise at the end of life.

OBJECTIVE: To assess the strength of association between responses to a standard living will question and preferences for treatments in six end-of-life scenarios.

DESIGN: Cross-sectional.

SETTING: Telephone interviews.

PARTICIPANTS: Two hundred two community-dwelling men and women 70 years of age or older in the greater Philadelphia area.

MAIN OUTCOME MEASURES: Strength of preferences for …

Depressive Symptoms And Marital Satisfaction In The Context Of Chronic Disease: A Longitudinal Dyadic Analysis, Rachel Pruchno, Maureen Wilson-Genderson, Francine P Cartwright

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

These analyses examined the longitudinal relationships between depressive symptoms and marital satisfaction over a 2-year period as experienced by 315 patients with end-stage renal disease and their spouses. Using multilevel modeling, the authors examined both individual and cross-partner effects of depressive symptoms and marital satisfaction on patients and spouses, testing bidirectional causality. Results indicate that mean and time-varying depressive symptoms of both patients and spouses were associated with their own marital satisfaction. Although mean marital satisfaction was associated with own depressive symptoms for both patients and spouses, time-varying marital satisfaction did not affect depressive symptoms for either patients or spouses. …