Digital Commons Network^™

Reverse Koebner Phenomenon In Linear Scalp Morphea Following Punch Biopsy: A Rare Therapeutic Response, Suhas C. Gowda, Akshay Samagani, Shreyas C. Gowda

Digital Journal of Clinical Medicine

Morphea is a chronic immune-mediated fibrosing disorder characterized by excessive collagen deposition in the skin. Linear morphea of the scalp (en coup de sabre) commonly demonstrates the Koebner phenomenon, wherein lesions develop at sites of trauma; however, the reverse Koebner phenomenon—trauma-induced regression—is exceptionally rare. We report an unusual case of linear scalp morphea showing early regression following a diagnostic punch biopsy. A 71-year-old male presented with an asymptomatic, indurated linear plaque on the scalp of two months’ duration. Histopathology from a 3.5-mm punch biopsy confirmed morphea, demonstrating dense collagen bundles with lymphoplasmacytic infiltrate. At follow-up eight days after …

The Effects Of Antidepressant Medications On Sleep Quality In Dominican University Of California Students, Natalie L. Davis, Kenna Wohlford, Stephanie Lee

Physician Assistant Studies | Graduate Research Papers

We spend approximately one third of our life time sleeping or attempting to sleep. The quality of our sleep is equally, if not more important than the amount of sleep we get. This study assesses the effects that medications, specifically antidepressants, can have on sleep quality in Dominican University of California students. 118 participants completed a Qualtrics survey including questions regarding stress, sleep quality, medication lists, and demographics. This study utilized the Pittsburgh Sleep Quality Index (PSQI) to quantify participants’ sleep quality as the outcome. Participant stress levels were assessed with a Likert scale question asking for stress levels on …

Genomic Determinants Of Appetite Regulation And Their Role In Obesity Risk, Timothy J. Renier

Dartmouth College Ph.D Dissertations

Over 40% of US adults and 20% of children live with obesity. It is related to increased risks of diseases including type II diabetes and cancer, is a source of harmful stigma, and impairs child development. Appetitive traits describing patterns of food approach and avoidance behaviors may serve as windows into the underlying pathophysiology of obesity. As both obesity and appetitive traits are heritable, common genetic drivers of obesity may lead to phenotypic obesity through appetitive traits as a disease mechanism. Additionally, GLP-1 receptor agonists (GLP-1RAs) have been shown to exert their profound clinical effects in part by modulating appetite. …

Improving Pediatric Emergency Department Lethal Means Safety Documentation Rates For Adolescents With Mental Health Concerns, Cassandra L. Stegall, Ana-Maria Mcgill, John Fanton, Paul C. Mullan

Department Psychiatry & Behavioral Science Faculty Publications

Introduction:

Lethal means safety counseling (LMSC) is recommended for children presenting to the emergency department (ED) for a mental health (MH) evaluation. Currently, no gold-standard guidelines exist for documenting LMSC in the ED.

Methods:

This quality improvement project was conducted in the ED of a tertiary children's hospital. Baseline data were analyzed for access to any LMSC documentation (ALD) for "firearms/guns," "sharps," or "medication," and for complete LMSC documentation (CLD) if access to all 3 types was documented. The first intervention period added open-ended screening questions about access to lethal means to the MH-licensed clinical social worker note template. Intervention …

Brief Exposure Therapy With Exercise For Ptsd: A Pilot Study Using Single Case Experimental Design, Troy J.J. Hubert

Theses and Dissertations--Psychology

Posttraumatic stress disorder (PTSD) is a common and often disabling psychiatric disorder associated with an increased risk of multiple mental and physical health conditions. Exposure therapy is a gold standard treatment for PTSD, but attrition rates and treatment response are notable limitations. Animal and human research collectively indicate that aerobic exercise can enhance preclinical and experimental models of exposure by improving consolidation of fear-extinction memories. To date, only one clinical trial has attempted to translate exercise augmented exposure therapy for PTSD. The current study is an open-label pilot clinical trial aiming at gauging the effectiveness of a brief eight-session PTSD …

Stress Dynamics Between Clinical Supervisors And Allied Health Students: A Scoping Review, Piao Wang, Laurie Peebles, Aine O'Connor, Xinrong Li, Yongsheng Wang

Funded Scholarship

Stress within clinical supervision in allied health education functions as a reciprocal and relational process that shapes both learning and professional development. This scoping review synthesizes findings from 54 studies published between 1980 and 2024 to examine how stress is experienced, transmitted, and managed between students and clinical supervisors. Four interconnected domains were identified through the synthesis: the supervisory relationship, systemic and contextual pressures, personal factors, and the placement environment. Together these domains illustrate how organizational demands and supervisory strain influence student engagement, feedback processes, and educational outcomes. The literature provides valuable descriptive insight but remains fragmented, methodologically inconsistent, and …

Felt Ambivalence Weakens The Attitude-Intention Pathway For Regular Leisure-Time Physical Activity In Chinese Adolescents: A Three-Wavee Prospective Study, Yaogang Han, Yubing Wang, Pan Li, Guohua Zheng

Human Movement Studies & Special Education Faculty Publications

Background: Favorable attitudes toward regular leisure-time physical activity may not always translate into intention if adolescents feel ambivalent about the behavior. This study tested whether felt ambivalence weakens the prospective attitude–intention association and the indirect effect of attitude on later behavior through intention. Methods: Chinese adolescents (N = 1714; Grades 7–12; mean age = 15.0 years) completed a three-wave survey at approximately two-week intervals. Wave 1 assessed attitudes toward regular leisure-time moderate-to-vigorous physical activity, felt ambivalence, and physical activity habit; Wave 2 assessed intention; and Wave 3 assessed leisure-time physical activity. Moderated mediation was tested in a structural equation model …

Reward Deficits In Co-Occurring Social Anxiety And Depression: The Roles Of Anhedonia, Boredom, Loneliness, And Covid-19 Social Restriction, Nathan M. Hager, Alicia L. Milam, Hannah C. Hamrick, Benjamin Swanson, Matt R. Judah

Psychology Faculty Publications

Prior research points toward reward deficits as crucial to the link between social anxiety disorder and major depressive disorder. However, studies have not explored specific types of reward deficits or how social-environmental factors may impact them. The current study examined whether the indirect effects of three reward deficits (anhedonia, boredom, and loneliness) accounted for the connection between social anxiety and depression. Questionnaires were collected in a sample of college students (N = 523) during the first year of the COVID-19 pandemic, allowing examination of environmental stressors (i.e., remote learning and current friend network size) on reward deficits. Indirect effect models …

Digital Cognitive Behavioral Therapy Versus Education For Chronic Pain In Adults With Sickle Cell Disease: 12-Month Randomized Trial Results, Olubusola B. Oluwole, Yi-Fan Yi-Fan Chen, Christina M. Lalama, Julia A. O’Brien, Laura M. De Castro, Charles Patrick Carroll, Darla Liles, Nirmish Shah, Santosh L. Saraf, Victor R. Gordeuk, Leshana Saint Jean, Michael Debaun, Robert M. Cronin, Tonya M. Palermo, Sherif M. Badawy, Megan E. Hamm, Jennifer N. Stinson, Chitra Lalloo, Sophie Lanzkron, Cassandra Trimnell, Lakiea Bailey, Raymona H. Lawrence, Kaleab Z. Abebe, Charles R. Jonassaint

Department of Medicine Faculty Papers

Background: Chronic pain affects up to 40% of adults with sickle cell disease (SCD), yet treatment options remain limited. While cognitive behavioral therapy (CBT) is effective in other chronic pain conditions, it is underutilized for SCD pain, and its effectiveness remains unclear. Purpose: The Cognitive Behavioral Therapy and Real-time Pain Management Intervention for Sickle Cell via Mobile Applications (CaRISMA) compared digital CBT to Education for chronic SCD pain in adults. At 6 months, the primary outcome (pain interference) showed no between-group difference but both groups improved (CBT: −2.13; Education: −2.66). This report presents 12-month outcomes. Methods: A total of 359 …

Blue Poppy Study: Frequency Of Ptsd In The West Australian Police Force, Daniel Talbot, Peter Drummond, Christopher Lee

Research outputs 2022 to 2026

Objective: As exposure of police officers to traumatic incidents has increased in recent years, the aim was to determine the prevalence of post-traumatic stress disorder (PTSD) and associated distress in the West Australian (WA) Police Force. Method: Participants were 1,278 sworn officers from the Western Australia (WA) Police Force, recruited via advertisements placed in the WA Police Union newsletter. This sample represented approximately 18.5% of the WA Police workforce. PTSD symptoms were assessed using the PTSD Checklist for DSM-5 (PCL-5), administered through an online survey platform. This study employed a cross-sectional correlational design. Factors related to PTSD were assessed using …

Is A Fear Of Death Keeping You Awake At Night? Death Anxiety Predicts Insomnia Through Nightmare Severity, Rachel E. Menzies, Jessie Brown, Mitchell Turner, David Cunnington, Malisa Burge, Ian C. Dunican, Hailey Meaklim

Research outputs 2022 to 2026

The fear of death (death anxiety) is a risk factor for various mental health conditions. Death anxiety has been theorized to elicit physiological arousal and worry and is empirically associated with attachment insecurity, each of which has been linked to disrupted sleep. However, limited research has explored the relationship between death anxiety, nightmares and insomnia. We examined the relationship between death anxiety and insomnia, as well as attachment style as a potential moderator, and nightmare severity as a possible mediator. Five hundred and fifteen adults completed an online survey; 70% were female, and 89% resided in Australia. Regression analyses revealed …

Trial Tribulations: Lessons Learned From An Unsuccessful Pilot Trial Of Behavioural Activation In Young People With Early Or Emerging Psychosis At A Regional Mental Health Service, Janina Catalao Dionisio Murta, Bróna Nic Giolla Easpaig, Mitchell K. Byrne, Richard Gray, Martin Jones, David Mitchell, Rebecca Creek, Ellie Brown, Jing Yu Tan, Shaun Dennis, Daniel Bressington

Research outputs 2022 to 2026

AimThe experience of conducting an unsuccessful pilot trial of behavioural activation (BA) to improve depressive symptoms in young clients with early or emerging psychosis is reported on. We aimed to identify barriers and enablers to inform the conduct of future trials with this client group.MethodsClinicians completed BA training with the aim of delivering this to suitable clients. Feasibility outcomes were calculated as proportions of feasibility targets. The various stages of the pilot randomised trial were examined, informed by interviews with five young people with early or emerging psychosis and four clinicians. Interviews were content analysed.ResultsClient recruitment and retention targets were …

You Can Only Take Your Clients As Far As You’Ve Been Yourself: Examining The Intersections Between Psychedelic-Assisted Therapy, Lived-Living Experience, And Clinical Practice, Jordan J. Negrine, Stephen J. Bright, Monica J. Barratt, Matthew Pennell, Anthony Barnett, James Bennett-Levy, Timothy Piatkowski

Research outputs 2022 to 2026

Background: Following Australia’s landmark 2023 decision to approve psilocybin and MDMA for clinical use, psychedelic-assisted therapy (PAT) is beginning to emerge within regulated mental health settings. This study investigates psychologists’ views on the relevance of psychedelic therapists’ lived-living experience (LLE) with psychedelics. While discussion around LLE is growing, little is known about how psychologists perceive its role in clinical preparedness for PAT. Methods: Twenty Australian psychologists were recruited through purposive and snowball sampling. Semi-structured interviews explored perceptions of LLE in therapist training and practice. Data were coded and thematically analyzed to identify patterns in how experiential knowledge is valued within …

Mental Health Professionals’ Perspectives On Essential Elements Of Telehealth Family Psychoeducation For Major Depressive Disorder: An Exploratory Study, Obumneke Obieche, Jing Yu Tan, Sita Sharma, Daniel Bressington, Tao Wang

Research outputs 2022 to 2026

Family-inclusive interventions, such as family psychoeducation (FPE), improve outcomes in major depressive disorder (MDD), particularly when tailored to the needs of individuals with MDD, their families, and carers. This study explored mental health professionals’ (MHPs) perspectives on the essential elements of telehealth FPE for MDD, including patients’ and their families’ informational and support needs. An exploratory cross-sectional study was conducted as part of the Supportive Program for Advancing Recovery, Knowledge, and Empowerment in Depression (SPARKED) research project, using an online questionnaire targeting MHPs within a regional area of Australia. Data analysis included descriptive statistics and quantitative and qualitative content analysis, …

Suicidality, Self-Neglect, And Medical Refusal In Advanced Illness: An Ethical Case Report, Austin Supak, Sarah Greene, Madeline Adelman, Whitney Snyders

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.

Efficacy Of Zuranolone In The Treatment Of Postpartum Depression: An Evidence-Based Review, Shana-Kay Lambert-Johnson, Tasaduq Mir

North Texas GME Research Forum 2026

BACKGROUND: Postpartum depression (PPD) is a common and potentially severe condition frequently managed in primary care, where delayed treatment adversely affects maternal and infant outcomes. Neuroactive steroid therapies targeting γ-aminobutyric acid type A receptors represent a novel therapeutic class. Brexanolone, the first FDA-approved treatment for PPD, required prolonged inpatient administration and was withdrawn from the U.S. market in 2025. Zuranolone is currently the only FDA-approved medication specifically indicated for PPD, offering a short-course oral treatment suitable for outpatient use. This review evaluated the efficacy of zuranolone and its applicability in primary care practice.

METHODS: This evidence-based review was conducted in …

Harmonizing Healing: Examining Music Therapy As An Adjunctive Treatment For Mental Health, Shalin Patel, Karen Foote

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Procedural Justice And Body Worn Cameras, Yael Granot

Psychology: Faculty Publications

The extensive and rapid roll out of body cameras across American police forces in the past decades was intended to improve issues of accountability and transparency in policing. Trust and perceptions of fairness of police are shaped, in large part, by how one is treated by officers and departments—the fundamental interpersonal work of procedural justice. This Article reviews findings on public and police support for body cameras, as well as research connecting body cameras to perceptions of procedural justice. It then elaborates on past research with a vignette experiment, aimed at isolating the unique and interactive effects of just policies, …

Pillpetz: A Smarter Way To Encourage Medication Adherence In Children, John H. Begley

CMC Senior Theses

Medication adherence is usually framed as a problem of patient behavior, but this thesis argues that it is equally a problem of design. Children who take daily medication face barriers that adults often do not: developing executive function, dependence on caregivers, shifting school and home routines, privacy concerns, and stigma around being perceived as different. The standard prescription bottle, by contrast, was designed primarily for dispensing efficiency, safety, and accidental ingestion prevention—not for sustained daily use by a developing child.

This thesis proposes PillPetz, a smart pill case and digital companion that uses routine, play, dose confirmation, and caregiver-connected support …

Tele-Psychiatry Adoption And Its Effect On Rural Mental Health Service Availability, Anna Heineman, Kaylee Canterbury, Taylor Carpenter

Theses, Dissertations and Capstones

Purpose of study: This study examined the association between tele-psychiatry implementation and mental health service availability in rural healthcare settings. The analysis compared tele-psychiatry to traditional in-person psychiatric care among rural populations, focusing on access and utilization outcomes, including time to first psychiatric appointment, number of completed visits, and appointment no-show rates.

Methods: A qualitative literature review following a systematic approach was conducted using peer-reviewed articles published between 2016-2026. Databases included PubMed, ProQuest Health, CINAHL, Journal of Medical Internet Research, and the National Library of Medicine, with Google Scholar used as a supplemental source. The review followed PRISMA …

Clinical And Demographic Characteristics Of Participants In A Hepatitis C Treatment Trial In Rural Kentucky: How Policies Around Treatment Access May Impact Elimination Efforts In The United States, Jennifer R. Havens, Brittney D. Williams, Takako Schaninger, Virginia A. Shepherd-Tackett, Michelle R. Lofwall, Michele Staton, Sharon L. Walsh, Hannah K. Knudsen

Behavioral Science Faculty Publications

Introduction: The advent of curative direct acting antiviral (DAA) drugs to treat those actively infected with the hepatitis C virus (HCV) has allowed for discussion around HCV elimination. Restrictive state-by-state policies for the coverage of DAAs for Medicaid recipients may hamper elimination efforts in the United States by limiting access to these curative treatments. Methods: The purpose of the current analysis was to examine the sociodemographic, drug use and clinical characteristics of participants in the Kentucky Viral Hepatitis C Treatment (KeY Treat) study in the context of Medicaid policies in the United States. The goal of KeY Treat was to …

The Interaction Of Tobacco Retailer Density And Rurality With Tobacco Use Prevalence In Kentucky, Shyanika W. Rose, W. Jay Christian, Judy Van De Venne, Delvon T. Mattingly, Bethany Shorey Fennell, Saber Feizy, Mary Kay Rayens

Behavioral Science Faculty Publications

Purpose: Tobacco retailer density is a key correlate of tobacco use prevalence in the United States, but this relationship has typically been examined in urban areas. We examined the relationship between retailer density and tobacco use across Kentucky counties, a state with high smoking rates and a substantial rural population.

Methods: We obtained a list of tobacco retailers from the 2021 Kentucky Synar program, used for minor’s access inspections. We merged these data with county-level prevalence estimates for cigarette and smokeless tobacco use for each county in Kentucky, calculated using pooled 3-year estimates (2017-2019) of Kentucky Behavioral Risk Factor Surveillance …

Acceptability And Appropriateness Of Harm Reduction Vending Machines Compared To Syringe Service Programs In Appalachian Kentucky, Hannah K. Knudsen, Jennifer R. Havens, April M. Young

Behavioral Science Faculty Publications

Objective:

Many rural people who inject drugs do not use syringe service programs (SSPs). In addition, people who use drugs but do not inject may perceive that SSPs are not intended for their use. Harm reduction vending machines (HRVMs) may be preferred by some individuals. This study examines attitudes and preferences regarding HRVMs to consider possibilities for enhancing the reach of harm reduction services. Method:

Structured surveys were conducted with 712 people who use drugs in two rural Appalachian counties in Kentucky. Participants rated the acceptability/appropriateness of SSPs and HRVMs; HRVM preference was the difference between the two scales. Linear …

Perceived Neighborhood Disadvantage And Current Nicotine Pouch Use Among U.S. Youth, Delvon T. Mattingly, Meman Diaby, Jing Zhang, Juhan Lee, Melinda J. Ickes

Behavioral Science Faculty Publications

Introduction: Nicotine pouches (NPs) are emerging nicotine products that appeal to youth due to their discreet use, tobacco-free formulation, and flavor availability. However, given their recent introduction to the market, little is known about how neighborhood environments may influence US youth NP use.

Methods: We imputed cross-sectional data from the 2023 National Youth Tobacco Survey (n = 22,069, ages 9 + years) and developed a neighborhood risk score (range: 1–4) by averaging 10 items related to neighborhood disorder, safety, and disadvantage. To estimate associations between the risk score and current (past 30-day) NP use, we fit logistic regression models adjusted …

Beyond Weak Ties In Prison: An Investigation Of Core Support Networks Of Incarcerated Persons, Siyun Peng, Martha Tillson, Maria Rockett, Marisa Booty, Carrie B. Oser

Behavioral Science Faculty Publications

Tie formation has been a core interest of network researchers. However, most existing research on tie formation in prisons has focused on weak ties, assuming that a core network approach is less applicable within total institutions such as prisons. Drawing on egocentric network data from 389 incarcerated individuals and 1352 named network members, this study demonstrates that relationships between incarcerated persons can be examined using a core support network framework. We find that about 20 % of participants include at least one incarcerated peer in their core support networks, with these ties providing both practical and emotional support comparable to …

Decreasing Prevalence In Youth Depressive Episodes: Evidence From The 2021-2024 National Survey On Drug Use And Health, R. Andrew Yockey, Aminul Apu, Timothy Grigsby, Jacob Bleasdale, Delvon T. Mattingly, Rachel Hoopsick

Behavioral Science Faculty Publications

Background: Major depressive disorder (MDD) is a leading contributor to the global burden of disease and commonly develops during adolescence. The COVID-19 pandemic was linked to significant increases in depressive symptoms among youth, but less is known about whether these increases have continued in recent years.

Objective: Using the first four consecutive years of methodologically comparable national data since the pandemic, we examined changes in past-year major depressive episode (MDE) among U.S. adolescents aged 12–17 years from 2021 to 2024 and evaluated demographic and substance use factors.

Methods: We analyzed pooled, cross-sectional data from the 2021–2024 National Survey on Drug …

Differences In The Use Of Smokeless Tobacco, Alcohol, And Co-Use Among U.S. High-School Students: Analysis Of National Youth Risk Behavior Survey Data, Ganna Kostygina, Yoonsang Kim, Alex Kresovich, Simon Page, Shyanika W. Rose, Sherry L. Emery

Behavioral Science Faculty Publications

Introduction: This study was aimed to examine the bidirectional relationships and patterns of concurrent smokeless tobacco and alcohol use among U.S. high-school students, investigating whether demographic characteristics and behavioral factors differentially predict concurrent versus single substance use of smokeless tobacco or alcohol (referred to as either-alone use in the remaining parts of this paper).

Methods: Analysis of nationally representative Youth Risk Behavior Survey data was perfomed, combining 3 cross-sectional surveys (2019, 2021, 2023) from 39,164 students in Grades 9–12. Logistic regression examined the bidirectional smokeless tobacco–alcohol associations, whereas multinomial models compared the characteristics of concurrent users, users of smokeless tobacco …

An Exploratory Study To Determine The Feasibility And Processes Needed To Implement The Immunization Neighborhood To Increase Hpv Vaccination Among African American Adolescents And Adolescents In The General Population: A Multi-Partner Perspective, Jennifer Cunningham-Erves, Freneka Minter, Pamela C. Hull, Amanda F. Dempsey, Alexandria Demons, Mariya Chalise, Consuelo H. Wilkins

Behavioral Science Faculty Publications

Limited education and healthcare access are major contributors to Human Papillomavirus (HPV) vaccination disparities among African American adolescents. The Immunization Neighborhood (IN) involves enhanced communication and collaboration among providers to address people’s needs by expanding access points and education to increase vaccination. Because needs of immunization providers and parents to effectively collaborate are unknown, this study explored the feasibility of and processes needed for IN utilization across key partners: pediatricians, pharmacists, school nurses, health department staff, and African American parent–child dyads. We conducted a semi-structured interviews in a qualitative, descriptive study with a purposive sample of 30 African American parent–child …

Extended-Release Vs Sublingual Buprenorphine In Pregnancy Through 12 Months Post Partum: A Randomized Clinical Trial, T. John Winhusen, Michelle R. Lofwall, Frankie Kropp, Daniel Lewis, Marcela C. Smid, Jessica L. Young, Candace Hodgkins, Elizabeth E. Krans, Zachary Hansen, Elisha M. Wachman, Davida M. Schiff, Constance Guille, Vania Rudolf, Tara Chowdhury, Lawrence Leeman, Mitra Lewis, Abigail G. Matthews, Gerald Cochran, Jacquie King, Christine Wilder, Carmen Rosa

Behavioral Science Faculty Publications

Importance: Treating opioid use disorder (OUD) in pregnancy with sublingual buprenorphine is an evidence-based practice, but it has disadvantages that could be addressed with an extended-release formulation.

Objective: To evaluate the effectiveness and safety of extended-release buprenorphine vs sublingual buprenorphine for OUD in pregnancy through 12 months post partum.

Design, Setting, and Participants: This 2-group, open-label, noninferiority, randomized clinical trial was conducted between July 2, 2020, and October 30, 2024, among adults with OUD and a singleton pregnancy of 6 to 30 weeks’ gestational age at 13 outpatient cross-disciplinary peripartum OUD treatment sites.

Interventions: Randomization to sublingual or extended-release buprenorphine …

Feeding The Family—A Food Is Medicine Intervention: Preliminary Baseline Results Of Clinical Data From Caregivers And Children, Gabriela Drucker, Christa Mayfield, Elizabeth T. Anderson Steeves, Sara Maksi, Tabitha Underwood, Julie Brown, Marissa Frick, Alison Gustafson

Behavioral Science Faculty Publications

Background/Objectives: Food is Medicine (FIM) programs have been shown to be effective at addressing food and nutrition insecurity among individuals. However, more evidence is needed to determine effective interventions at the household level and their impact on child health outcomes. Feeding the Family is a randomized controlled trial which aims to determine whether the amount of food provided and the ability to select foods in FIM interventions have an incremental effect on child and caregiver clinical outcomes relative to nutrition counseling alone. The objective of this paper is to describe the population at baseline among those enrolled in Feeding the …