Digital Commons Network^™

Evaluating The Emotional Accuracy Of Ai-Generated Facial Expressions In Neurotypical Individuals, Antonio Pagán, Katherine A Loveland, Ronald Acierno

Faculty, Staff and Student Publications

This study examines the ability of generative artificial intelligence to produce facial expressions representing basic emotions in a neutral context using black-and-white cartoon imagery. Mentalization, the capacity to recognize and interpret one’s own and others’ mental states, is critical for social interaction and emotional regulation. We explored the emotional validation of artificial intelligence (AI)-generated images by assessing the agreement between human interpretations of emotions and those generated by an AI model. Thirty-four participants evaluated images depicting six basic emotions: sadness, anger, happiness, surprise, fear, and disgust. Our findings revealed significant variability in human agreement, with higher concordance for sadness, anger, …

Anhedonia Links Sleep Problems And Suicidal Thoughts: An Intensive Longitudinal Study In High-Risk Adolescents, Kinjal K. Patel, Jaclyn C. Kearns, Dan Foti, Wilfred R. Pigeon, Evan M. Kleiman, Catherine R. Glenn

Psychology Faculty Publications

Growing research indicates that sleep problems are a robust independent risk factor for suicidal thoughts and behaviors among youth. However, relatively little is known about how this risk is conferred. This study used an intensive longitudinal design to investigate anhedonia as a mechanism linking sleep problems and next-day suicidal thoughts in a clinically high-risk sample of adolescents. Adolescents (N = 48; M_age=14.96; 77.1% white, 64.6% female) completed an ecological momentary assessment (EMA) study design for 28 days following discharge from acute psychiatric care for suicide risk. Daily sleep diaries were used to assess prior night total sleep …

Approval Of Parent-Child Aggression As A Mediator Of Intergenerational Child Abuse Risk: An Evaluation Of Racial Differences, Casie H. Morgan, Christina M. Rodriguez, Doris F. Pu, Zoe O. Elkins

Psychology Faculty Publications

Purpose

Personal history of parent-child aggression (PCA) can predict future parenting behavior, but some effects may differ between racial groups. Black parents in the U.S. are more likely to encounter discrimination and personally experience and approve of PCA, which may account for previously reported group differences. This study examined whether personal PCA history predicted later parental child abuse risk mediated by PCA approval across the transition to parenthood, and whether effects differed by race.

Methods

Expectant parents (non-Hispanic White sample: 95 mothers with 86 fathers; Black sample: 94 mothers with 85 fathers) participated in a prospective longitudinal study, assessed prenatally …

Exploring Differences In Cannabis Use And Harm Perceptions Among Sexual Minority And Heterosexual Females: A Brief Report, Sarah J. Ehlke, Samantha A. Fitzer, Kendra Rigney

Psychology Faculty Publications

Objective: Sexual minority women (SMW) have higher rates of cannabis use compared to heterosexual women, which may be partially attributed to lower harm perceptions. However, no study has examined if the association between harm perceptions and cannabis use is stronger for SMW than heterosexual women. This study examined if sexual identity (SMW vs. heterosexual woman) moderated the association between harm perceptions and past 30-day cannabis use among a sample of female young adults (18-25 years old). Method: Participants were 949 (29.8% SMW; Mean age = 24.33; 92.1% non-Hispanic White) females (99.3% cisgender) recruited from Amazon Mechanical Turk who reported weekly …

Using Mindfulness To Manage Moral Injury In Veterans: Feasibility And Satisfaction Of A Pilot Randomized Controlled Trial, Michelle L. Kelley, Adrian J. Bravo, Elizabeth E. Burgin, Susan A. Gaylord, Christine Vinci, Megan Strowger, Jeffrey M. Gabelmann, Joseph M. Currier

Psychology Faculty Publications

Objective

The present study assessed program feasibility and satisfaction among recent-era veterans who participated in Mindfulness to Manage Moral Injury (MMMI), a live facilitated web-based 7-week mindfulness-based program targeting moral injury among veterans.

Method

In total, 56 post-9/11 veterans were recruited with 28 randomized to the MMMI condition and 28 to the Education and Support (ES) condition. Most participants identified as being White (71.4%), male (66.1%), and had a reported mean age of 41.50 years (Median = 39.50, SD = 9.26).

Results

Among the 56 participants, 82.1% attended at least one treatment session and 44.6% completed all seven sessions. There …

Pregnant Adults' Interest In Physical And Mental Health Behavior Change Interventions Using Mobile Technology, Natalie M. Yarish, Cassidy M. Sandoval, Alicia Moulder, Meredith I. Turner, Danielle Symons Downs, Kristin E. Heron

Psychology Faculty Publications

Improving the health and well-being of pregnant adults is an important public health priority in the USA, and mobile health (mHealth) interventions may provide a scalable strategy to disseminate behavior change programs to pregnant adults. This study assessed pregnant people’s use of mobile technology, interest in making health behavior changes during and after pregnancy, and their willingness to use mHealth interventions. Participants were 133 pregnant adults (M_age = 27.86; 81% White) living across the USA recruited from social media to complete an online survey. Measures assessed mobile technology use and beliefs about improving mental/physical health in pregnancy and postpartum …

Evaluation Of A 20-Item Version Of The Trauma-Related Drinking To Cope Questionnaire, Sage E. Hawn, Lauren Smith, Kaytlin Armitage, Selah Ball, Cathy Lau-Barraco, Abigail Powers, Ananda B. Amstadter

Psychology Faculty Publications

Objectives: This study sought to develop and psychometrically evaluate an expanded version of the Trauma-Related Drinking to Cope (TRD) scale, a four-item self-report tool, which was developed to address a crucial gap in self-medication research. Before the development of the TRD, no measures existed which assessed alcohol use for coping with symptoms of posttraumatic stress disorder (PTSD) specifically. Previous work showed that the TRD has strong psychometric properties and clinical utility in its ability to identify individuals with PTSD who may be at risk for developing comorbid alcohol use disorder (AUD). The aim of the present study was to develop …

Vagally Mediated Heart Rate Variability Modulates The Association Between The Perceived Workload And The Stroop Effect On Behavioral Performance, Xiao Yang, Michael Gazzanigo, Fang Fang, Spencer House

Psychology Faculty Publications

Vagally mediated heart rate variability (vmHRV) reflects top-down cognitive processes involved in emotion-cognition integration. Using cognitive control can be effortful and increase negative affect. However, this intrinsic affective component of cognitive control has not been well studied, and the role of vmHRV in the association between subjective experience in using cognitive control and behavioral performance remains unknown. The current study aimed to examine the relationship of vmHRV with cognitive control and perceived workload in a cognitive task. Eighty-one participants performed the Stroop interference task. Participants rated subjective workload using the NASA Task Load Index (NASA-TLX) scale for congruent and incongruent …

The Perceived Internalized Sexual Stigma Measure (Prissm): A New Sexual Stigma Measure For Lesbian, Gay, And Bisexual Individuals, Miguel A. Padilla, Lacey M. Schlappi, Evelyn S. Chiang

Psychology Faculty Publications

Society has long held negative beliefs and attitudes, in the form of sexual stigma, towards sexual minorities (e.g., lesbian, gay, and bisexual; LGB). Sexual stigma can be adopted and internalized by LGB individuals as their own beliefs and attitudes. In LGB individuals, internalized sexual stigma can result in psychological distress such as low self-esteem, depression, shame, and feelings of rejection. However, an instrument to assess internalized sexual stigma specifically developed for LGB individuals is lacking. The present study focuses on the development of a new instrument, the Perceived Internalized Sexual Stigma Measure (PrISSM), that is inclusive of LGB individuals who …

A Multilevel Framework For The Promotion Of Maternal Mental Health And Well-Being During The Perinatal Period, Jenn A. Leiferman, Jessica Walls Wilson, Charlotte V. Farewell, Chelsea Walker-Mao, James F. Paulson

Psychology Faculty Publications

Background: Depression and anxiety are prevalent in the perinatal period and may contribute to adverse maternal and child health outcomes. A focus on multilevel protective factors may be effective in promoting well-being and increasing quality of life (QOL) in the perinatal period while simultaneously reducing or preventing depression and anxiety symptoms. We tested a conceptual model that posits specific personal, social, and community factors affecting depression, anxiety, and QOL among pregnant and postpartum individuals.

Methods: Four hundred and thirty-eight pregnant or postpartum individuals completed a 121-item cross-sectional survey composed of validated tools that assessed multilevel protective factors, health behaviors, and …

How Marriage And Family Therapy Graduate Programs Awaken, Develop, And Teach Clinical Intuition: A Hermeneutic Qualitative Phenomenological Study, Jessica Fountas

Antioch University Dissertations & Theses

This research explored how marriage and family therapy graduate programs awaken, develop, and teach clinical intuition. Using criterion-based sampling and snowball sampling, six licensed marriage and family therapists participated in a two-step hermeneutic phenomenological study consisting of individual semistructured interviews and a follow-up focus group. Requirements for participation were licensed marriage and family therapists who were in clinical practice, had experienced the phenomenon of clinical intuition and awakening of clinical intuition, and used clinical intuition in therapy with clients and in systemic supervision with supervisees. The research findings highlighted 14 themes: Reflection of the Experience of Clinical Intuition; Bodily Knowing, …

Childhood Aggression: A New Conceptualization, Hannah G. Harrison

Antioch University Dissertations & Theses

Childhood aggression is a frequently observed behavioral phenomenon, yet lacks a precise
definition in both the DSM-5-TR and current research literature. Definitional ambiguity and
construct enmeshment continue to create construct confusion for researchers, clinicians, and
informants. This empirical review of the current literature and diagnostic criteria examines how
childhood aggression has been historically conceptualized, defined, and described. The primary
aim was to identify and clarify inconsistencies in current definitions and to address knowledge
gaps to improve diagnostic clarity. Through a thematic synthesis of recent literature, several key
issues emerged: the absence of a precise definition of childhood aggression; reliance on …

The Gut-Brain Axis: Investigating The Effects Of Diet, Physical Activity, And Prior Adversity On Anxiety Via Autonomic Nervous System, Jenna L. Pennella

UNF Graduate Theses and Dissertations

Previous literature has highlighted a bidirectional relationship between the gut and brain called the gut-brain axis (de Punder & Pruimboom, 2015; Hill et al., 2008; Leistner & Menke, 2020). The current study aimed to investigate directional relations between different stressors (e.g. poor diet, vigorous activity, and prior adversity) and anxiety and how interactions with gut issues and autonomic dysfunction may impact these relationships. Based on previous literature, we examined (a) physical activity and diet as moderators of stress and anxiety as well as stress and GI symptoms, (b) GI symptoms as a mediator between various predictors (i.e., diet, stress, physical …

Reduced Set-Shifting Processing Speed In Male Rats Following Low Dose (10 Cgy) Proton Exposure, Hui Ho Vanessa Chang, Gyutae Kim, Kyu-Sung Kim, Richard A. Britten

Center for Integrative Neuroscience and Inflammatory Diseases (CINID) Faculty Publications

Space radiation (SR) exposure poses significant biomedical risks, including effects on the central nervous system (CNS). These risks are particularly relevant to cognitive function during long-duration space missions. One critical cognitive skill is decision-making, which requires attentional set-shifting (ATSET)—the ability to quickly assess problems, evaluate options, and select the best actions. Previous studies have shown that exposure to However, the impact of low LET (< 1 keV/μm) protons, which significantly contribute to the total radiation flux astronauts encounter within spacecraft, on ATSET performance is unknown. To address this gap, we evaluated the effects of cranial irradiation with 10 cGy of 100 MeV/n protons (LET = 0.732 keV/μm) on ATSET performance in male Sprague-Dawley rats. We also investigated whether concurrent exposure to variable gravity (hypergravity step-up, step down, purported to have the same effect as exposure to microgravity (another major spaceflight stressor) exacerbated SR-induced cognitive deficits. Our findings indicate that proton exposure alone significantly impaired ATSET performance, as evidenced by decreased processing speed while performing compound discrimination reversal and extra-dimensional shifting. Notably, no additive or synergistic effects were observed when hypergravity was combined with proton exposure. The impact that low-dose proton exposure has on CNS functionality, particularly in reducing processing speed during complex tasks, warrant further investigation. If similar cognitive deficits were to occur in astronauts exposed to galactic cosmic rays, mission success and safety could be significantly compromised.

Mobile Health Intervention Tools Promoting Hiv Pre-Exposure Prophylaxis Among Adolescent Girls And Young Women In Sub-Saharan Africa: Scoping Review, Alex Emilio Fischer, Homaira Hanif, Jacob B. Stocks, Aimee E. Rochelle, Karen Dominguez, Eliana Gabriela Armora Langoni, H. Luz Mcnaughton Reyes, Gustavo F. Doncel, Kathryn E. Muessig

Department of Obstetrics & Gynecology Faculty Publications

Background:

In 2022, 3100 adolescent girls and young women in sub-Saharan Africa experienced new HIV infections each week. HIV pre-exposure prophylaxis (PrEP) is effective at preventing HIV but has limited uptake and persistence. Mobile health (mHealth) interventions can improve medication adherence; however, their utility to improve PrEP adherence among adolescent girls and young women is not well established.

Objective:

This scoping review synthesizes evidence supporting mHealth for PrEP among adolescent girls and young women in sub-Saharan Africa and identifies strategies for further evaluation.

Methods:

We searched PubMed and Google Scholar databases, expert referrals, and reference lists using the following eligibility …

Psychedelic Minimalism: The Case Against Music In Psychedelic Therapy Settings, Samir A. Nader

Department of Medicine Faculty Publications

[Introduction: reframing the role of setting] In recent years, renewed attention has been given to the centrality of set and setting in psychedelic-assisted therapy. The Reporting of Setting in Psychedelic Clinical Trials (ReSPCT) guidelines reflect an evolving consensus: therapeutic outcomes are not solely pharmacologically determined but are heavily shaped by both the environment and the psychological state of the participant (2). Within this evolving paradigm, music has assumed a privileged role, framed as a therapeutic constant, typically curated to be emotionally supportive or evocative, and especially emphasized during peak psychedelic states (3). The prevailing assumption is that music facilitates safety, …

A Critical Examination Of Scent Avoidance And Olfactory Development After Neonatal Predator Scent Exposure, Cynthia Ware

College of Graduate Studies: Theses & Dissertations

The long-standing assumption that predator odor avoidance in rodents is an innate survival mechanism has shaped decades of behavioral neuroscience research and underpins translational models of post-traumatic stress disorder (PTSD). However, developmental systems theory (DST) posits that behaviors emerge from dynamic interactions across physiological and environmental systems over time, rather than from fixed genetic programs. This study critically evaluates the developmental plasticity of predator scent aversion by examining whether early-life exposure to red fox urine (a natural predator odor) can attenuate avoidance behaviors in Long–Evans rats. Seventy-one rats were bred into three conditions: Control (no exposure), Partial (exposure from birth), …

The Multifaceted Interplay Between Covid-19-Induced Psychological Stress, Cognitive Flexibility, Emotional Overeating, And Physical Activity Patterns In Adult Women: A Mediated Path Analysis, Siavash Naddafha, Mandana Sangari, Zohreh Eskandari, Robabeh Shahnahadd, Christopher B. Taber

Research outputs 2022 to 2026

Objective: To determine how COVID-19-related stress influences food consumption and emotional overeating in adult women, and whether cognitive flexibility and physical activity mediate these relationships. Methods: In this cross-sectional study, 303 women (20–50 y) completed validated Persian versions of the COVID Stress Scale-18, Adult Eating Behaviour Questionnaire, Self-Regulation of Eating Behaviour Questionnaire, Cognitive Flexibility Scale, and Rapid Assessment of Physical Activity. Data were collected online via the ISO-27001-certified “Press Line” platform (end-to-end encryption). Chi-square tests and Spearman’s rank correlations were performed in SPSS 19 (α = 0.05). Results: COVID-19 stress was strongly inversely associated with cognitive flexibility (rₛ = – …

Drinking Motives And Alcohol Sensitivity Mediate Multidimensional Genetic Influences On Alcohol Use Behaviors, Jeanne E. Savage, Spit For Science Working Group, Danielle M. Dick

Psychology Faculty Publications

Background

Genetic influences account for a substantial proportion of individual differences in alcohol use behaviors (AUBs). However, multiple distinct sets of genes are linked to different AUBs via uncertain causal links. Here, we explore whether intermediate neurobiological traits mediate the relationship between polygenic scores (PGSs) and multiple AUBs, with the aim to better understand processes captured by different genetic profiles.

Methods

We derived four alcohol-related PGSs in participants from Spit for Science, a longitudinal study of college students in the United States (n=4549). Using linear regression, we tested the relationship between PGSs and 22 potential mediators, including personality, …

The Physiological Consequences Of And Recovery Following The Australian Special Forces Selection Course, Angela C. Uphill, Kristina L. Kendall, Bradley A. Baker, Stuart N. Guppy, Hannah M. Brown, Michael Vacher, Bradley C. Nindl, G. Gregory Haff

Research outputs 2022 to 2026

This study aimed to determine the energy requirements, physiological consequences, and recovery rate from the Australian Special Forces Selection Course. Ninety-three male soldiers (mean ± SD, 28.1 ± 3.6 years, 1.81 ± 0.1 m, 85.1 ± 8.1 kg) vol-unteered for this study. Body composition via dual-energy X-ray absorptiometry, hormones and resting metabolic rate were assessed before, immediately after, and at 1, 3, 5, and 8 weeks post-course. Energy expenditure, assessed via doubly-labelled water during the first 10 days of the course significantly exceeded energy intake (expenditure: 7680 ± 1095 kcal. day–1, in-take: 3859 ± 704 kcal. day– 1). Body mass …

Integrated Multi-Omics Analyses Of Synaptosomes Revealed Synapse-Associated Novel Targets In Alzheimer’S Disease, Subodh Kumar, Enrique Ramos, Axel Hidalgo, Daniela Rodarte, Bhupender Sharma, Melissa M. Torres, Davin Devara, Shrikanth Gadad

School of Medicine Publications

Synapse dysfunction is an early event in Alzheimer’s disease (AD) caused by various factors, including amyloid beta, p-tau, inflammation, and aging. However, the precise molecular mechanism underlying synapse dysfunction in AD remains largely unknown. To understand this, we comprehensively analyzed the synaptosomes fraction in post-mortem brain samples from AD patients and cognitively normal individuals. We conducted high-throughput transcriptomic analyses to identify changes in microRNA (miRNA) and mRNA levels in synaptosomes extracted from the brains of unaffected individuals and those with AD. Additionally, we performed mass spectrometry analysis of synaptosomal proteins in the same sample group. These analyses revealed significant differences …

Critiques Of The Cass Review: Fact-Checking The Peer-Reviewed And Grey Literature, Kathleen Mcdeavitt, J Cohn, Stephen B Levine

Faculty, Staff and Students Publications

The Cass Review's final report, published in April 2024, made recommendations to the UK's National Health Service regarding structuring of services for minors with gender-related distress. It recommended cautious use of hormonal interventions in this population and use of research protocols. Some clinician-researchers disagree with the Cass Review's recommendations and have written critiques. A critique of the Cass Review posted on Yale Law School's website in July 2024 has received extensive media coverage. Its references identified three other critiques. In these papers, there were multiple claims that were incorrect or that lacked essential clarification/contextualization. These claims involved (1) the Cass …

Correction: Health-Related Quality Of Life After Neonatal Treatment Of Symptomatic Tetralogy Of Fallot: Insights From The Congenital Cardiac Research Collaborative, George T Nicholson, Jeffrey D Zampi, Andrew C Glatz, Bryan H Goldstein, Christopher J Petit, Yun Zhang, Courtney E Mccracken, Athar M Qureshi, Caren S Goldberg, Jennifer C Romano, Mark A Law, Jeffery J Meadows, Shabana Shahanavaz, Sarosh P Batlivala, Shiraz A Maskatia, Asaad Beshish, Michael L O'Byrne, R Allen Ligon, Kathryn O Stack, Hala Q Khan, Shalin Parekh, Dawn L Ilardi

Faculty, Staff and Students Publications

No abstract provided.

Aerodigestive Sequelae And Triple Endoscopy After Congenital Tracheoesophageal Fistula Repair In Children, Whitney Jin, Eric H Chiou, Shailendra Das, Kathleen E Hosek, Elton M Lambert

Faculty, Staff and Students Publications

Children post-tracheoesophageal fistula (TEF) repair may present with chronic respiratory and gastrointestinal symptoms that can affect quality of life.

OBJECTIVE: To identify factors associated with positive findings on triple endoscopy following neonatal TEF repair.

STUDY DESIGN: Case series with retrospective review of patients.

SETTING: Tertiary care center aerodigestive program.

METHODS: Children with neonatally repaired congenital TEF who had a triple endoscopy between 2011 and 2022 were reviewed. The presence of chronic cough, recurrent pulmonary infections, lipid-laden macrophages (LLM), and airway and esophageal anomalies were among the variables analyzed. Chi-square and Kruskal-Wallis univariate analysis was performed.

RESULTS: The mean age was …

Representative National Survey On Drug Use During The Covid-19 Stay-At-Home Order In The Usa, Soo-Hoon Lee, Bernadette Cullen, Alidon Athey, Calliope Holingue, Michelle R. Kaufman, Paul Nestadt, Jack Samuels, Tracy Vannorsdall, Phillip Phan

Management Faculty Publications

Objectives This study explores the drug use behaviour in the US general population in the early days of the COVID-19 pandemic with a focus on the relationship between sociopsychological factors, mobility restrictions from March to June 2020 and mental health conditions.

Design A retrospective anonymous online survey representing a cross-section of the US population in 2020.

Setting A qualified panel of 500 000 Qualtrics participants stratified by gender, race, age and geographical region to represent the US population.

Participants 3340 participants voluntarily consented to respond.

Measures Outcome measure for illicit and non-medical use of prescription drugs based on the National …

Psychological Impacts In Exercise Riders And Professional Jockeys Following Injury, Kelley M. Renner

Theses and Dissertations--Kinesiology and Health Promotion

One of the most well-known equestrian sports, horse racing, is not only a cornerstone of Kentucky’s economy, but also a vital part of its culture, with professional jockeys playing an essential role in the local communities and traditions that define the state. Despite its popularity and financial impact, mental health challenges within the sport have continually been shrouded in silence and ignored in research (Ball et al., 2007). Equally concerning is the high injury prevalence, and psychological impact of these injuries (e.g., psychological distress, depression, anxiety, loss of identity, and self-esteem (King et al., 2022; Losty et al., 2019; McConn-Palfreyman …

Reply [To Burnout Reflections: Musings On Bianchi And Schonfeld’S Five Focal Areas], Renzo Bianchi, Irvin Sam Schonfeld

Publications and Research

Contrary to what one might assume, the burnout construct did not emerge from systematic research. The definition of burnout was formulated in the 1970s based on prenotions and anecdotal evidence. No sound empirical studies, no in-depth theoretical reflections, not even a review of the stress literature underpinned the introduction of the construct. It is thus unsurprising that some observers regard the edifice of burnout research with scepticism. The pioneers of burnout research neglected basic scientific standards and, by overlooking the abundant work of contemporary stress researchers, deprived themselves of important safeguards against illusions of novelty making big claims based on …

Psychophysiological Tools & Techniques To Predict Perceptual Motor Task Outcomes, Bobby Gerald Rawls Iii

Graduate Theses, Dissertations, and Problem Reports (ETD)

The process of perceiving environmental information, analyzing it, formulating a plan of action, and carrying out said plan is vital to our day to day lives. This loop occurs for every motor task we perform, from actions as simple as elbow flexion to as complex as performing surgery. As such, it is imperative to understand what physiological, psychological, and neurocognitive factors most dictate success or failure in the motor performance loop.

Prior research has shown that measures from each of these facets have strong relationships with motor performance outcomes, though these findings tended to rely on artificially produced stress in …

Effects Of High-Frequency Repetitive Transcranial Magnetic Stimulation On Impulse Control Disorders In Patients With Parkinson’S Disease On Dopamine Replacement Therapy, Katherine Muksuris

Graduate Theses, Dissertations, and Problem Reports (ETD)

Parkinson’s Disease (PD) is a debilitating neurodegenerative disorder that causes motor deficits, cognitive impairment, and depression. The mainstay treatment for motor symptoms is dopamine replacement therapy (DRT). DRT takes the form of levodopa or dopamine receptor agonists (DAs) and can be associated with impulse control disorders (ICDs). Currently, the approach to mitigating these side effects is to decrease or stop DRT, which may cause motor symptoms to return, making the management of the disorder more difficult. Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive neuromodulation treatment for multiple disorders, including its approved use for smoking cessation. It has also shown …

Exploration Of Coping And Mental Health In West Virginia Farmers, Jodi Meadows Richmond

Graduate Theses, Dissertations, and Problem Reports (ETD)

Compared nationally, West Virginia currently ranks lowest for life expectancy, highest for drug related deaths and 35^th for access to adequate health (WV DHHR Organization Assessment & Strategic Plan, 2022). The state also ranks first in the nation for depression with one in four adults experiencing some form of depressive condition each year (CDC, 2020). The rurality of the state may limit social interaction and availability of medical treatment facilities (Brew et al., 2016).

The situation is even more dire for those in farming-related occupations. Farmers often struggle with management stress, utilizing appropriate coping strategies, and accessing mental health …