Digital Commons Network^™

Reframing Emergency Medicine (And Healthcare) Wellness Measures: The Case For Adding Measures Of Physiological Sustainability, Exercise, Restoration, And Meaning, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background

Physician wellness measurement in Emergency Medicine (EM) in particular and in healthcare in general has largely focused on identifying distress states such as emotional exhaustion and depersonalization. Instruments such as the Maslach Burnout Inventory and related derivative surveys have been well-validated and  have played a central role in identifying the scope of burnout across healthcare systems.

Conceptual Framing

While current measures of distress are essential, they may not fully characterize the spectrum of clinician health. In many fields outside healthcare—including occupational health, resilience research, and positive psychology—assessment of well-being includes behaviors and experiences associated with sustained health, such as …

Case Study: 46-Year-Old Female With Auditory Hallucinations, Ahmed Aly, Tayeb Ahamed, Chien Y. Cepeda, Apn

Rowan-Virtua Research Day

The case study discusses a patient seen at a voluntary psychiatric unit. Patient has been prescribed benzodiazepine and bupropion; she became dependent on the benzodiazepine due to social difficulties that have not been addressed by her prescriber. The study highlights the dependency of benzodiazepine while being offered bupropion (which lowers seizure threshold), which can be deadly if accompanied with benzodiazepine withdrawal

Comparative Efficacy Of Cognitive Behavioral Therapy And Intranasal Oxytocin In Adolescent Anorexia Nervosa, Nikhila P. Archakam, Akhila P. Archakam, Wesley A. Kim, Harshal Parmar, Iram Fatima

Rowan-Virtua Research Day

Anorexia nervosa (AN) is a severe and potentially life-threatening psychiatric disorder with the highest mortality rate among psychiatric illnesses affecting adolescents.¹ It is characterized by extreme restriction of caloric intake driven by an intense fear of weight gain or negative body image perception.¹ Mortality results from medical complications of starvation and an increased prevalence of suicide risk.¹ Although AN can occur at any point across the lifespan, it most commonly first presents during adolescence.¹ This developmental period is marked by significant hormonal, biological, and psychosocial changes. Early-onset AN is associated with stunted growth, pubertal delay, and long-term cognitive and emotional …

Impostor Phenomenon In Healthcare: Prevalence, Implications, And Educational Responses, James Espinosa, Robin Lahr, Sergey Medlenov, Swet Patel, Nicholas Tomasello, James Lee, Neel Parikh, Alan Lucerna, Henry Schuitema

Rowan-Virtua Research Day

The impostor phenomenon describes persistent self-doubt and fear of being exposed as a fraud despite objective evidence of competence. The term 'impostor phenomenon' is preferred over the term "imposter syndrome" because it is not a psychiatric diagnosis and avoids pathologizing normal developmental uncertainty. The original authors used the term 'phenomenon' (Clance & Imes, 1978), and contemporary scholarship increasingly adopts this terminology.

First described by Clance and Imes (1978), the construct has since been studied across diverse professional domains, including medicine, nursing, and academic leadership. Subsequent research demonstrates that impostor experiences occur across genders, training levels, and healthcare roles (Bravata et …

When Individual Implicit Bias Meets Ed System Turbulence: Expanding The Implicit Bias And Cultural Bias Conceptual Frame To Support Reflective Decision Making Through Both Individual Bias Reduction Strategies As Well As System-Level Design Approaches, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background

Cultural and implicit bias have been widely studied as contributors to disparities in healthcare delivery. Prior literature has largely conceptualized bias as an individual-level cognitive phenomenon occurring within clinician–patient interactions. However, emergency departments (EDs) function as complex adaptive systems (CAS), characterized by time pressure, uncertainty, cognitive load, and environmental noise. These conditions may contribute to the expression of implicit bias in clinical care.

Objective

To reframe cultural and implicit bias in the ED as both an individual cognitive property as well as a system-dependent and modulated  phenomenon and to propose that the operational state of the ED influences the …

In School Age Children With Autism Spectrum Disorder, Does Academic Achievement And Social Development Improve In Inclusive Classroom Environments?, Ashley A. Macquaid

Rowan-Virtua Research Day

Autism Spectrum Disorder (ASD) is a developmental disorder characterized by difficulties in social skills, communication, and sensory processing 1. ASD affects approximately 1 in 100 children internationally 2. With the growing prevalence, classroom inclusivity of individuals with autism has emerged as a priority in education. However, current literature presents a range of positive and negative factors without clear indication of effective classroom placement for students' specific needs. This research aims to determine if inclusive classroom environments improve academic achievement and social development for school-age children with ASD. A systematic search on PubMed, Embase, and Cochrane databases yielded studies published between …

Mental Health Comorbidities And Ibd Outcomes On Anti-Tnf Therapy, Jashanveer S. Johal, Mahmoud Al-Bataineh, Archana Salek, Bianca Patel, Om Patel, Jason Hyman, Yecheskel Schneider, Abdallah Hussein

Rowan-Virtua Research Day

Background: Depression and anxiety are prevalent in inflammatory bowel disease (IBD) and may adversely affect biologic therapy outcomes. We evaluated the impact of comorbid mood disorders on clinical outcomes among IBD patients treated with anti-TNF agents.

Methods: Using a global de-identified electronic health record network, adults with Crohn's disease or ulcerative colitis initiating an anti-TNF agent between 2018–2023 were identified. Cohort 1 included patients with a documented mood disorder (depression and/or anxiety) at or prior to anti-TNF initiation; Cohort 2 included those without mood disorders. Propensity score matching (1:1) on demographics and comorbidities yielded 9,605 patients per cohort. Primary outcomes …

Effect Of Pcos Treatment On Mental Health Outcomes, Audriti Mazumder, Aubrey Olson

Rowan-Virtua Research Day

Abstract (250 words)

Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with a range of physical symptoms, including hirsutism, acne, weight gain, insulin resistance, and infertility. While its metabolic and reproductive manifestations are well characterized, the impact of PCOS on mental health remains underexplored. This study aims to evaluate the relationship between PCOS and mental health outcomes, with a particular focus on changes in symptoms following treatment and the influence of demographic factors.

A survey-based study was conducted using a Qualtrics questionnaire distributed via QR code and social media platforms. Questions were modeled after validated screening tools, including …

Impact Of A Caregiver Wellness Workshop On Well-Being And Mental Health, Keertana Jonnalagadda, Morgan Yacoe

Rowan-Virtua Research Day

Family caregivers provide care for loved ones by addressing their activities of daily living (ADLs), instrumental activities of daily living (IADLs), and psychological needs. These demands impact a caregiver’s time and overall well-being. To address burnout and improve education regarding caregiver wellness, a workshop was created to build an effective support system for caregivers and teach them practical self-care strategies. Activities using visual art were designed to reduce caregiver anxiety and stress. Results from validated scales such as Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS), WHO-5 Well-Being Index (WHO-5), and a unique caregiver wellness survey (CWS) in a small sample showed …

Cultural Influences In Psychiatry, Kavita Bhavsar, Mayuri Patel

Rowan-Virtua Research Day

The patient is a 26-year-old female presenting with unspecified hallucinations, delusional thinking, concerns for catatonia and potential sex-trafficking. This case study highlights the importance of approaching each patient through their unique cultural lens while examining and minimizing our own biases while navigating each patient holistically and individually.

Co-Active Therapeutic Filmmaking: A Methodology Pilot Project, Blair Webber

Expressive Therapies Theses

This pilot project examined the intersection of drama therapy and filmmaking. Drawing on the Co-Active Therapeutic Theater model from drama therapy and digital storytelling and participatory video methods from social work research, this methodology designed and delivered a co-created filmmaking intervention at a residential treatment center for adult men with co-occurring mental health and substance use disorder. Four participants made a seven-minute-long short fictional film based on their definition of active recovery and a theme of recovery they wished to share with an audience. It was screened at the treatment center for staff and their fellow residents. Data collection was …

Harness The Darkness! Blackout Poetry And Drama Therapy For Systemic Existential Dread: A Proposed Methodology, Kerry Sullivan

Expressive Therapies Theses

This thesis explores the intersection of drama therapy and blackout poetry as a therapeutic intervention to address systemic existential dread (SED) among emerging adults. The proposed methodology is titled "Bringing Blackout Poetry to Life" and consists of five sessions designed to explore the participants’ SED and generate poetry, culminating in a public performance. By integrating elements from psychodrama and drama therapy with the therapeutic process of blackout poetry, the intervention intends to aid processing on all levels of the expressive therapies continuum (ETC), strengthen tolerance for uncertainty, and facilitate sustainable community action. This theoretical framework is supported by a wide-ranging …

Knowledge Of Advance Care Planning And Advance Directives Among Us Adults: Implications For Health Policy And Practice, Anisah Bagasra, Gretchen Agans

Faculty Articles

Background:

Objectives:

A Cross-Cultural Investigation Of Consumer Hoarding Behavior During Covid-19: Differences Between Sweden And The United States, Christy M. Cook, Pia A. Albinsson, James E. Stoddard

Atlantic Marketing Journal

This study is a cross-cultural exploration of consumer hoarding behavior during Covid-19; specifically, a comparison between Sweden and the United States. This research analyzes whether Swedish and American consumer hoarding behavior factors of prosocial orientation, consumer resilience and consumer risk-taking propensity reflect identical relationships during less predictable environmental forces (i.e., Covid-19 or global pandemic). Results from Partial Least Squares-Structural Equation Modeling (PLS-SEM) show that consumer prosocial orientation is negatively related to consumer hoarding and prosocial orientation is positively related to consumer resilience. In turn, both prosocial orientation and consumer resilience exhibit a positive relationship towards consumer hoarding. Consumer resilience is …

Understanding And Measuring Functional Communication In Adults Living With Alzheimer's Disease And Related Dementias, Sarah Toledo

Honors Capstones

Functional communication declines across all stages of dementia and directly affects quality of life, yet traditional standardized assessments may not fully capture everyday communication abilities. This capstone examines how functional communication in older adults living with dementia can be conceptualized and measured beyond standard tools. The study analyzes previously recorded video conversations between adults with dementia and student partners. Conversations are transcribed and coded using two observational measures: the Verbal and Nonverbal Interaction Scale–Care Recipient (VNVIS-CR) and the Adapted Measure of Participation in Conversation for Dementia (MPC-D). Gestures, facial expressions, responsiveness, and engagement are included in the analysis, and double …

A Retrospective Look At Self-Reported Mental Health Prevalence In Division Iii Student-Athletes, Jacob F. Neri

Masters Theses/Capstone Projects

Mental health concerns among collegiate athletes have gained increased attention, but there has been limited research focus on Division III student-athletes. This study aimed to examine the self-reported prevalence of anxiety, depression, anger, stalking/harassment, abuse/assault, alcohol/substance abuse, self-harm, suicide ideation, and suicide attempt to identify contributing factors amongst this population. A retrospective, cross-sectional study was conducted looking at data collected from the student-athlete mental health history & well-being questionnaire that was administered as part of their pre-participation exam (PPE) prior to the beginning of each academic year. A total of 554 Division III student-athletes were included in the study. Results …

Investigating The Prevalence Of Eating Disorder Risk And Body Image Dissatisfaction Among Division Iii Track And Field Athletes, Ravyn S. Goodson

Masters Theses/Capstone Projects

Context: Eating disorder (ED) risk, and body image dissatisfaction (BID) are increasingly recognized concerns in collegiate athletes due to sport-specific and sociocultural pressures. However, limited research has looked at these factors within NCAA Division III track and field athletes.

Objective: To examine the prevalence of eating disorder risk and body image dissatisfaction among division III track and field athletes and explore differences based on gender and event group Design A quantitative, cross-sectional survey design

Setting: NCAA division III athletic program within the Ohio Athletic Conference (OAC), during the 2025-2026 competitive season.

Participants: A total of 32 NCAA Division III track …

Exploring Identity Through Clay: A Humanistic Art Therapy Case Study With A Blind Chinese Adoptee, Virginia Jade Leicht

Expressive Therapies Theses

This qualitative case study explored how working with clay in art therapy can help support a blind man’s identity exploration. This paper addresses the problem of many traditional therapeutic approaches within the art therapy realm: They rely too heavily on visual engagement, which can limit the accessibility and opportunities for self-exploration and identity development for those who are blind. The study was grounded in current research and foundational theories based on the humanistic art therapy approach. Clay is considered an accessible medium that engages multiple senses and allows for emotional exploration and meaning making, specifically through tactile and sensory-based engagement …

How Nutrition And Physical Activity Shape Your Well-Being, Stacy Phillips

EFNEP

This publication will explore the link among nutrition, physical activity, physical health, and mental health and how it impacts whole-body well-being. Understanding how multiple aspects of a person's lifestyle can affect an individual's overall well-being is essential to providing better education on how to make better choices to improve their well-being.

The Burnout Machine: Finding The Guide Between Burnout And Meaning Making Using Ifs And Role Theory For Mental Health Professionals (An Integrative Literature Review), Jade Ahneman

Expressive Therapies Theses

Burnout is a syndrome in which compounded stress leads sufferers to feel physical and mental exhaustion, mental distancing, cognitive and emotional impairment, depressed mood, psychological distress, and psychosomatic complaints. Originally thought of as a phenomenon affecting only individuals in helping roles (i.e., mental health workers, teachers, nurses, and police officers), research on burnout and its effective management has become increasingly important since the 1980s, highlighting its pervasiveness across occupational and personal realms. This integrative literature review focused on understanding the effects of burnout on master 's-level counseling students, investigating how Internal Family Systems theory (IFS) and drama therapy’s role theory …

Art Therapy And A Strength-Based Approach For Working With Children With Emotional And Behavioral Challenges: A Qualitative, Arts-Based Study, James D. Wyld

Expressive Therapies Theses

Abstract

            Children with emotional and behavioral challenges represent a vulnerable population that needs more attention and innovative forms of treatment. The behavior of these young people is often marked by impulsive behaviors and intense emotions in the process of getting their basic needs met. The current study explores how a combination of art therapy and a strength-based approach is beneficial and appropriate for children in a behavioral based therapeutic school. Progress was traced through one singular client in both group and individual settings over the course of 6 months. Interventions varied with the goals of increasing self-awareness, fostering autonomy, increasing …

Targeting The Dorsolateral Prefrontal Cortex With Transcranial Direct Current Stimulation To Improve Depression And Anxiety In Parkinson’S Disease, Brock Renicks

Poster Presentations

Around 40% of people with Parkinson’s Disease experience depression and anxiety (Zhao et al, 2025). Depression and Anxiety have been said to be localized to the dorsolateral prefrontal cortex (Brunoni et al, 2016). Transcranial Direct current stimulation (tDCS) has been shown to modulate depression and anxiety by targeting the dorsolateral prefrontal cortex (Sreeraj et al, 2023). It is beneficial due to its cost, portability, and simplicity of use. Thus we will be assessing the efficacy of tDCS in reducing depression and anxiety in individuals with Parkinson’s Disease.

A Pilot Study Of A Culturally Responsive Cognitive-Behavioral Intervention For Black American High School Students With Social Anxiety, Hannah Thomas

Theses, Dissertations and Culminating Projects

Cognitive-behavioral interventions have been shown to be effective for treating social anxiety, yet few have been evaluated for racially and ethnically minoritized youth, including Black American adolescents. These interventions also do not address sociocultural factors, including racial discrimination and mental health stigma, that may shape the experience of social anxiety among Black American youth and serve as barriers to care. Therefore, the aim of this study was to conduct a pilot evaluation of the feasibility, acceptability, and preliminary outcomes of Interacting and Changing Our Narratives (ICON), a culturally-responsive, school-based cognitive-behavioral group intervention for Black American high school students with social …

Toward An Understanding Of Social Marketing’S Influence On Alcohol-Related Behaviors In College Students: Health Promotion Strategies For College Campuses, Lily K. Richards

Honors Theses

Alcohol use among college students remains a persistent public health concern, influenced by a complex interaction of social, environmental, and behavioral factors. This literature review examines the prevalence of alcohol consumption in college populations, the associated short-term and long-term health consequences, and the role of social norms, peer influence, and environmental context in shaping drinking behaviors. Research consistently demonstrates that alcohol use is deeply embedded within college culture, where normative misperceptions and peer dynamics contribute to increased consumption. (Perkins, 2002; Borsari & Carey, 2001; Hingson et al., 2017). In addition, environmental factors such as alcohol availability and targeted marketing further …

Grace Under Pressure: An Analysis Of School Administrator Personal And Professional Stress And Self-Efficacy, Andrew Mcdaniel

All-Inclusive List of Electronic Theses and Dissertations

Indiana public school administrators are one of the most important factors for a school’s academic success. If those administrators are effective, they can help maintain an excellent school’s academic success or perhaps even turnaround a failing school. Without a doubt, their performance is critical for a school’s success. If they have confidence in their ability to help create positive outcomes, their school can achieve great things. Unfortunately, assistant principals and principals are facing significant challenges, not only from schools, but also at home. How do these personal and professional stressors affect their sense of self-efficacy? The purpose of this study …

Cultivating Connection: A Culturally Responsive Mental Wellbeing Curriculum For Latine Youth In Santa Cruz County, Suzzy Landeros

Capstone Projects and Master's Theses

Latine adolescents experience high rates of stress, depression, and stigma surrounding mental health, in part due to limited access to culturally responsive support and safe spaces for connection. The purpose of this internship project was to develop and implement a trauma-informed, culturally responsive, mental wellbeing curriculum to address barriers related to stigma, limited culturally responsive support, and disconnection, while supporting emotional awareness, connection, and use of grounding strategies among youth. The project was implemented through United Way Santa Cruz County in partnership with Watsonville High School and Soquel High School and served high school-aged youth. Development of the curriculum included …

Digital Outreach For Environmental Equity: Bridging The Nature Gap In Castroville, California Through Social Media, Phoebe C. Deacon

Capstone Projects and Master's Theses

Too many low-income residents of Castroville are not spending enough time in nature, causing negative impacts on both physical and mental health. Ventana Wildlife Society provides programs including after-school programs, Single Day Adventures, and summer camps for youth and families in Monterey County, particularly those from underserved communities. This project focused on the Castroville program. Castroville is a low-income, agricultural, isolated pocket of Monterey County, one of the communities where Ventana allocates its resources. This project implemented an outreach and educational intervention through use of social media by updating the Instagram page for Ventana’s North County Outdoor Program and posting …

The Physiological And Psychological Effects Of Social Media Addiction: A Mixed Methods Study, Ella M. Roper

Biological Sciences Undergraduate Honors Theses

Abstract

Objectives: This study sought to examine the physiological and psychological effect of social media addiction displayed through sleep quality, cortisol levels, heart rate, and emotional affect in students at the University of Arkansas.

Methods: Seven adults (Age range = 18-21; 100% female) participated in a mixed-methods study investigating social media addiction across a two-week period. Sleep quality and duration were assessed using the Pittsburgh Sleep Quality Index (PSQI). Participants provided saliva samples which were used to quantify cortisol levels. For two weeks, participants were asked to spend at least ten minutes on social media daily and to report their …

Exploring Exercise Motivation And Mental Well-Being In College Students, Elaine M. Lindesmith, Anqi Deng Dr

Health, Human Performance and Recreation Undergraduate Honors Theses

This study examined the relationship between physical activity, exercise motivation, and mental well-being among 48 undergraduate students at the University of Arkansas. Guided by Self-Determination Theory, the study used survey data to measure depression, anxiety, physical activity, and open-ended exercise motivation responses. Motivation responses were coded as autonomous or controlled.

Results showed that physical activity was weakly and negatively related to depression and anxiety, but these relationships were not statistically significant. There were also no significant differences in mental health between autonomous and controlled motivation groups, and motivation did not significantly predict mental health outcomes in regression analyses. Overall, the …

Systemic Barriers To Educational And Employment Attainment Among Individuals With Substance Use Disorders, Mollie B. Mccann Poblocki

Creativity and Change Leadership Graduate Student Master's Projects

Substance use disorders (SUDs) and opioid use disorder (OUD) represent one of the most pressing yet poorly understood public health crises in the United States. Despite decades of clinical intervention, recovery outcomes remain deeply unequal, not because individuals lack motivation, but because the structural systems surrounding them are fundamentally broken. This project explored that reality through a comprehensive literature review examining how systemic barriers across educational systems, labor markets, poverty dynamics, and healthcare infrastructure shape vulnerability, treatment access, and recovery outcomes for individuals with SUDs. Major findings revealed a consistent socioeconomic gradient of harm: individuals with lower educational attainment, unstable …