Digital Commons Network^™

Frequent Police Contact And Nonfatal Overdose Among People Who Use Drugs In Rural Appalachia, Javier A. Cepeda, Talia Loeb, Zach R. Salazar, Brittney D. Williams, Brooke Hiltz, Brandon Del Pozo, Eileen V. Pitpitan, Leo Beletsky, April M. Young, Jennifer R. Havens

Behavioral Science Faculty Publications

Introduction: Police contact shapes subsequent health practices and outcomes among people who use drugs (PWUD). However, the relationship between police encounters with overdose remains under-researched. We evaluated how police stop-and-search was associated with nonfatal overdose and identified correlates of frequent police contact among PWUD in rural Kentucky.

Methods: From May 2023– April 2024, 774 PWUD were enrolled in the Social Networks of Appalachian People and KyOSK studies. The exposure of interest was self-reported police stop-and-search in the past 6 months (0, 1–3, ≥4 times). The primary outcome was self-reported nonfatal overdose in the past 6 months. We evaluated the association …

Social Engagement Moderates The Relationship Between Cognitive Functioning, Depressive Symptoms, And Restless Sleep In Older Black Adults, Sunkanmi Folorunsho, Olufunmilola Abraham, Darlingtina K. Esiaka

Pharmacy Practice and Science Faculty Publications

INTRODUCTION: Older Black adults face higher dementia risk, but it is unclear whether social engagement offsets the effects of depression and restless sleep.

METHODS: We analyzed 1,905 Black adults aged 50+ from the 2016-2020 Health and Retirement Study (HRS). Linear mixed-effects models tested how depressive symptoms, restless sleep, and social engagement predicted baseline cognition and cognitive decline.

RESULTS: Higher depressive symptoms and restless sleep were associated with lower baseline cognition (about 0.2 and 0.5 points lower) and faster decline (β×time ≈ −0.07 and −0.05). Greater social engagement predicted higher baseline cognition (about 0.6 points higher) and slower decline (β×time ≈ …

The Effects Of Childhood Maltreatment On Executive Functioning: The Difference Between Cumulative Trauma, Abuse Severity, And Neglect, Kelly Krehbiel

Master's Theses or Doctor of Nursing Practice

Childhood maltreatment is prevalent in the United States with around 558,899 children being victims of abuse in 2022 (U.S Department of Health & Human Services, 2024). Neglect is the most common form of abuse with around 74 percent of abused children being neglected; however, neglect tends to be the least researched form of abuse. Childhood maltreatment has long-term effects on a person’s mental, physical, and cognitive health. Previous research suggests that childhood maltreatment leads to severe deficits in executive functioning skills such as working memory and cognitive flexibility. Executive functioning skills are important for almost every aspect of life including …

The Use Of Virtual Reality In Ptsd Research And Practice, Kenneth B. Abrams, Lindsay Okindo, Marta E. Bacon, Yiking Skylar Yu, Sofia Santamaria Germani, Malvika Malhotra, Nancy A. Cullen

Psychology Faculty Work

In the aftermath of traumatic events such as combat, sexual violence, or a natural disaster, individuals may develop posttraumatic stress disorder (PTSD). Technological advancements in virtual reality (VR) over the past few decades have opened new avenues for improving the assessment, treatment, and understanding of PTSD. VR allows users to be immersed in interactive, computer-generated environments that simulate real-world scenarios, such as a warzone or assault location, that would be difficult or unsafe to reproduce using traditional methods. The present paper offers an overview of how VR technology has been employed in both clinical and research settings related to PTSD. …

The Restorative Effects Of Virtual Reality Nature Simulations: An Empirical Investigation, Isabel T. Folger, Yichen Zhang, Kenneth B. Abrams

Psychology Faculty Work

Although extensive research demonstrates that nature films can facilitate recovery from stress and cognitive overload, it remains unclear whether more immersive media, such as virtual reality (VR), are more effective than similar two-dimensional films. The present study examined the effects of immersiveness on affective, cognitive, and physiological restoration. Three levels of immersiveness for film viewing were employed: 2D (computer monitor), standard VR (visual and auditory input), and enhanced VR (standard VR plus olfactory and haptic input). All participants were exposed to parallel versions of a six-minute nature film. We hypothesized that greater immersiveness would produce stronger restorative effects. All versions …

Contemporary Approaches To Group Psychotherapy Supervision, Michelle A. Collins-Greene (Ed.), Molyn Leszcz, Nina W. Brown, Ellen Wright, Scott Giacomucci, Les R. Greene, Susan P. Gantt, Leah M. Niehaus, Francis Kaklauskas, Tony L. Sheppard

Counseling & Human Services Faculty Publications

This chapter captures the work of contemporary supervisors of group psychotherapy, all of whom have practiced many years and have trained and supervised innumerable group leaders. They demonstrate the diversity of settings and theoretical orientations that are prominent in the current era. Their essays speak for themselves and provide wonderful illustrations and models for supervisors-in-training and consultation to emulate. They also talk about who influenced, mentored, and supervised them.

Socio-Spatial Patterns Of Suicide Mortality In The United States, Kushagra Tiwari, M. Amin Rahimian, Marie-Laure Charpignon, Philippe J. Giabbanelli, Praveen Kumar

VMASC Publications

Suicides cause more than 49,000 deaths per year in the United States, including 55% associated with the use of a firearm. Across states and counties in the US, suicide mortality exhibits substantial geographical and sociodemographic heterogeneity. However, the role of large-scale social networks in shaping this variation remains underexplored. To assess how both the risk of suicide mortality and the effect of firearm restriction policies propagate through inter-county social ties, we integrate data on county-level suicide mortality (2010–2022) and the Facebook Social Connectedness Index (SCI), a continuous measure of the strength of social ties between counties used to derive weighted …

“Medical Cannabis”: Advising Patients While Navigating Medical Ethics And Limited Evidence, Anna-Maria South, Shanna L. Babalonis, Laura C. Fanucchi, Michelle R. Lofwall

Internal Medicine Faculty Publications

Cannabis is increasingly legalized in more areas of the USA and marketed under the misnomer “medical cannabis.” Yet, there are no official dosing guidelines or approved medical uses for plant cannabis by the Food and Drug Administration. Due to significant federal barriers, research on efficacy, safety, and adverse effects of cannabis is limited. Patients are interested in cannabis as potential treatment of medical issues and/or symptoms and clinicians should include a discussion of the risks of cannabis consumption. However, many risks are not yet known, and clinicians might be unaware of the emerging literature. This perspective summarizes the potential harms …

Discrimination Distress And Current Combustible And Non-Combustible Tobacco Product Use Among Us Youth, 2023, Meman Diaby, Osayande Agbonlahor, Maggie K. Richardson, Joy L. Hart, Shyanika W. Rose, Delvon T. Mattingly

Markey Cancer Center Faculty Publications

Introduction: Discrimination is the unfair treatment of people based on their identity. Youth who experience discrimination may cope with associated distress by using tobacco products, with amplified health consequences depending on the type of product.

Methods: We used data from the 2023 National Youth Tobacco Survey (n = 22 069) and derived an overall continuous measure from the 15-item Adolescent Discrimination Distress Index, as well as three continuous discrimination distress sub-indices: educational, institutional, and peer (range for each: 0–5). We defined current tobacco use as two outcomes: any past 30-day use of combustible (cigarettes, cigars, hookah, roll- your-own, pipe, bidis) …

Effectiveness Of Post-Discharge Interventions Following Psychiatric Hospitalization On Readmissions And Suicide Prevention Among Adolescents, Maria Paz Eladia Posadas

Nursing | Senior Theses

Background: Suicide is a pervasive and far-reaching issue. Psychiatric hospitalization is often used as an intervention for individuals, including adolescents, experiencing suicidal ideation and/or behavior. However, post-discharge care may lack structure or clearly defined follow-up services, which can result in rehospitalizations and increased suicidality. Objective: The goal of the proposed research study is to investigate how implementation of peer support groups for adolescents following psychiatric hospitalization can assist in reducing readmissions and mitigating suicide risk. This can also help shape strategies for managing care after discharge. Method: The proposed research study utilizes a quantitative quasi-experimental design to determine the efficacy …

Chatbot Therapy - Help Or Hindrance, Kadi Rae Smith

Anthós

Introduction

Generative artificial intelligence (Gen-AI) chatbots are complex computer programs designed to mimic human conversations using programming that incorporates large language models (LLM) and natural language models (NLM) to simulate human interactions that are being rapidly integrated into everyday life across an increasing amount of online platforms. This article explores the applications and efficacy of chatbots for mental healthcare, from self-directed chatbot interactions to clinician-supervised implementation of chatbot-based therapeutic tools, weighing the benefits and limitations of this ever-expanding technology.

Methodology/Taxonomy

A literature review was conducted primarily using Web of Science, accessed through Portland State University, and Google Scholar, with specifications …

Examining The Effects Of Virtual Nature Exposure And Video Immersion On State Hope With Nature Relatedness As A Covariate, Zachary Arneson

All Master's Theses

Previous work in the field of environmental psychology has shown that virtual nature exposure can produce many psychological benefits for the viewer. Within this literature, however, there has been no examination of the effects of virtual nature exposure on levels of state hope, a goal-directed positive psychological construct made up of two types of thought: agency and pathways. Additionally, there has been no direct examination of the effect of immersion level of the virtual nature exposure on psychological measures. To fill this gap in the literature, the current study examined the effects of virtual nature exposure and video immersion on …

Low Energy Availability And Dietary Factors In High School Runners, Natalie E. Allik

All Master's Theses

Context: Low energy availability (LEA) is associated with adverse health and performance outcomes in athletes and may be particularly concerning during adolescence when growth and bone development are ongoing. Although inadequate carbohydrate (CHO) intake has been proposed as a contributor to LEA, limited research has examined this relationship in adolescent endurance athletes. Objective: To examine dietary intake, bone mineral density (BMD), and eating disorder (ED) risk in adolescent distance runners with and without LEA. Methods: Eighteen adolescent distance runners (15.7 ± 1.2 years; 7 males, 11 females) completed baseline assessments including anthropometrics, dual-energy X-ray absorptiometry (DXA), a 24-hour dietary recall, …

The Effects Of Stress-Related Hormones On Excitatory Synapse Formation, Autumn C. Garvey

Honors Undergraduate Theses

Stress profoundly influences brain function through neuromodulatory hormones that regulate synaptic plasticity, yet how temporal patterns of hormone exposure shape excitatory synapse formation remains poorly understood. This study investigates how exposure to stress hormones, norepinephrine and cortisol, affects excitatory synapse development. While existing research primarily compares concentration models, real-world stress occurs in variable patterns that may produce distinct neural outcomes. To address this gap, differentiated Neuro2A neuronal cells are exposed to norepinephrine or cortisol under a continuous treatment paradigm designed to model chronic stress conditions. Following treatment, immunofluorescence imaging is utilized to quantify excitatory synapse formation through analysis of presynaptic …

Resilience Shields And Grit Intensifies Subjective Cognitive Decline In Middle‐To‐Older Aged Black Americans, Sunkanmi Folorunsho, Maria Clark, Obinna Odo, Yolanda L. Jackson, Candidus C. Nwakasi, Darlingtina K. Esiaka

Behavioral Science Faculty Publications

Background: There is growing interest on the relationship between psychosocial factors and cognitive health trajectories in adulthood. While grit and resilience have been shown to influence health outcomes, their differential effects on subjective cognitive decline (SCD) in Black American adults remain understudied. The purpose of this study is to help fill this gap.

Methods: The study utilized a cross-sectional research design. Black American participants (N = 242; Mean age = 44.32) responded to a survey assessing SCD, grit, resilience, and sociodemographic factors. Linear regression analysis was performed to test the associations between grit and resilience and SCD, and to …

Evidence Of Heterogeneity In The Opioid Withdrawal Syndrome: Spontaneous And Precipitated Withdrawal, Suky Martinez, Jermaine D. Jones, Kelly E. Dunn, Andrew Huhn, Joshua A. Lile, Thomas P. Shellenberg, Laura Brandt

Behavioral Science Faculty Publications

Aims: This study characterized the heterogeneity of opioid withdrawal by comparing naturally occurring withdrawal during opioid abstinence (spontaneous withdrawal) with abrupt, pharmacologically induced naloxone-precipitated withdrawal in adults with Opioid Use Disorder (OUD).   Methods: A secondary analysis was conducted on de-identified data from 86 adults meeting DSM-5 criteria for moderate-to-severe OUD. Participants either presented in spontaneous withdrawal (n = 28) or underwent naloxone challenge to precipitate withdrawal (n = 58). Withdrawal symptoms were rated using the Wang procedure. Principal Component Analysis (PCA) of binary symptom data was performed to identify dominant patterns of symptom co-occurrence. Separate PCAs were then …

Facebook As A Strategy To Deliver A Peer Navigation Intervention For Recently Incarcerated Women With Opioid Use Disorder: A Mixed Methods Descriptive Profile, Martha Tillson, Jaxin Annett, Marguerite A. Webster, Amanda Fallin-Bennett, Mandi Webster, Amber Clemons, Cynthia Robinson, Kevin Crabtree, Casey Baker-Romans, Michele Staton

Center on Drug and Alcohol Research Faculty Publications

Recovery support and treatment linkages are critical during transitions from incarceration to community but can be challenging to deliver to hard-to-reach populations. This paper will examine Facebook contacts between peer navigators (PNs) and women with opioid use disorder (OUD) following jail release to explore women’s use of PN services, including purpose and content of Facebook messages. As part of a larger clinical trial under the Justice Community Opioid Innovation Network (JCOIN), PNs provided OUD treatment navigation and recovery support for 12 weeks following women’s release from jail, using remote options such as Facebook. Facebook Messenger transcripts between PNs and participants …

Evolution Of A Client‐Level Dataset: 20 Years Of National Child Traumatic Stress Network Data Collection, C. A. Purbeck, A. N. Cooke, L. J. Liang, C. Smith, J. Staten, J. Epstein, H. B. Hodgdon, Jessica Eslinger, A. Wells, J. Goodrich, T. H. Bethel, K. Willett, Y. C. Fu, J. A. Fairbank, E. C. Briggs

Center on Trauma and Children Faculty Publications

Objectives: For 20 years, the National Child Traumatic Stress Network's (NCTSN) data collection efforts have been a central mechanism for Clinical Quality Improvement (ClQI). The NCTSN is a federally funded initiative in the United States composed of programs dedicated to raising the standard of care and increasing access to services for children and families who have experienced traumatic events.

Methods: These efforts span three initiatives: the Core Data Set (CDS), the Clinical Improvement through Measurement Initiative (CIMI) Measurement Based Care (MBC), and CIMI Data Sharing (CIMI-DS) that collected and analyzed client-level data to improve care for children and families served …

Feasibility Of Telehealth-Delivered Gut-Directed Hypnotherapy For Managing Gastrointestinal Health: Exploring Specific Vs. Nonspecific Effects, Sabrina Romero

Honors Undergraduate Theses

This randomized controlled trial evaluated the feasibility and efficacy of telehealth-delivered Gut-Directed Hypnotherapy (GDH) compared to General Hypnotherapy (GH) for managing gastrointestinal symptoms associated with disorders of gut–brain interaction (DGBI). Eleven adults were randomized to receive four 1-hour hypnotherapy sessions over a 14-day period via Zoom (GH n = 5; GDH n = 6). Primary outcomes included PROMIS GI Belly Pain T-scores and Abdominal Pain Ratings assessed at baseline and post-treatment. Follow-up assessments were conducted at three months (n = 8). At post-treatment, participants receiving GDH demonstrated significantly lower PROMIS GI Belly Pain T-scores compared to GH, F(1, …

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

2026 Research Poster Competition

Social media is a worldwide phenomenon that has taken the world by storm; individuals, multimillion dollar companies, hospitals and universities alike are all similar in that there is a good chance they have a social media presence. Needless to say, there are many benefits of social media including connection and networking, however there are also consequences. My study focuses on one of the consequences, social media addiction, in hopes of enlightening individuals to the risks of social media and hopefully inspiring systematic change to make the future of social media a little less risky. I am using a scale from …

Building Mental Health Literacy: The Impact Of Youth Mental Health First Aid On Emerging Youth Professionals, Burgin Rome

2026 Research Poster Competition

Nearly half of individuals in the United States will experience a mental health disorder during their lifetime, with many symptoms first emerging in childhood or adolescence. Adolescence is a critical developmental period characterized by emotional, social, and psychological changes that increase vulnerability to mental health challenges. Although public awareness of mental health has grown, stigma and societal taboos continue to limit open dialogue and delay intervention. As a result, many young people experience a significant gap between the onset of symptoms and receipt of professional support, which can worsen mental health concerns and contribute to long-term consequences that persist into …

Resilience And Reactivity: The Relation Between John Henryism And Cardiovascular Responses To Laboratory Stressors In An Appalachian Sample, Emma Raycher Thompson

Graduate Theses, Dissertations, and Problem Reports (ETD)

John Henryism active coping (JHAC), named for folk hero John Henry, is defined as the perception that one can overcome stressors through hard work (James et al., 1983). This construct has been tied to numerous health outcomes, showing a negative influence on cardiovascular health (Bennett et al., 2004). Many researchers have examined the relation between JHAC and cardiovascular reactivity to stress, though findings are mixed. Further, despite the legend of John Henry occurring in Appalachia, and traits associated with John Henryism, such as resilience, being prominent within this region, no study has examined the relation between JHAC and reactivity in …

A Mixed Methods Study Of The Transition To Adult Health Care For Sexual Minority Young Adults With Chronic Pain: Understanding The Impact Of Stigma, Cecily Newel Conour

Graduate Theses, Dissertations, and Problem Reports (ETD)

Sexual minorities with chronic pain are likely to experience stigma stemming from their sexual identity and chronic pain. Pain stigma and sexual minority stigma are associated with increased health disparities and differences in health care utilization, particularly for adults. The transition to the adult health care system appears to be a critical point to understand the impact of stigma on health care utilization to then improve outcomes. With a sample of 48 sexual minority young adults with chronic pain, the current study investigated transition experiences using an explanatory, sequential mixed-methods design that was both observational and cross-sectional. Participants completed quantitative …

Utilizing Youth Mental Health First Aid: A Community-Based Prevention Strategy To Increase Teh Confidence Levels Of Seventh-Day Adventist Adults In Assisting Youth With Mental Health Distress, Sarah Hillebert

DNP Research Projects

Abstract 

Objective: Youth Mental Health First Aid (YMHFA) is an initiative from the National Council for Mental Wellness that trains adults in identifying and responding to adolescents exhibiting mental health distress. This DNP project evaluated the effectiveness of YMHFA in increasing the mental health literacy and confidence scores of Seventh-day Adventist (SDA) adults. Method: quality improvement, pretest-posttest quasi-experimental design was used. Participants were SDA adults aged 22 to 74 who work with youth in school, church, or camp settings (n=19; Mean age = 48.5 years, SD = 10.5). The quantitative MHFA 2.1 measured mental health literacy and confidence to intervene, …

Cb1 Allosteric Modulation: Preclinical Insights Into Therapeutic Potential And Misuse Liability, Mohammed A. Mustafa

Theses and Dissertations

Cannabinoid type-1 (CB1) allosteric modulators represent a promising approach to modulate CB1 receptor signaling by binding to distinct receptor sites, without producing adverse cannabimimetic and dependence-related effects associated with Δ9-tetrahydrocannabinol (THC) and other CB1 agonists. This dissertation investigates the pharmacological, behavioral, and dependence-related profiles of CB1 allosteric modulators for their therapeutic potential and misuse liability. Presented here, the chiral CB1 positive allosteric modulator (PAM) ZCZ011 was resolved into its R- and S-enantiomers and characterized across in vitro and in vivo assays. Both enantiomers enhance CB1 agonist activity and produce intrinsic effects in vitro. Behaviorally, they produce antinociceptive effects in the …

What’S Sleep Got To Do With It? A Mixed Methods Exploration Of The Feasibility, Acceptability, And Initial Outcomes Of Group Cbt For Insomnia In Parkinson’S Disease, Claire M. Williams

Theses and Dissertations

Parkinson’s disease is a progressive neurodegenerative disease that is commonly associated with sleep disturbances, affecting up to 80 percent of individuals with Parkinson’s. Effective and accessible treatments for sleep problems in Parkinson’s disease remain limited. Cognitive Behavioral Therapy for Insomnia (CBTi) is a well-established, non-pharmacological treatment for insomnia but has been minimally studied in Parkinson’s populations. This study evaluated the feasibility, acceptability, and preliminary outcomes of a group-based CBTi intervention adapted for individuals with Parkinson’s disease. Participants engaged in a six-week group intervention that incorporated Parkinson’s-specific adaptations. Preliminary findings indicated that the adapted group CBTi intervention was generally feasible and …

Exploring Associations Between Mental Disorder And Creativity, David A. Romero Mora

Honors Undergraduate Theses

Mental disorder has been misunderstood and misrepresented throughout history, leading mental health research to be severely behind where it needs to be. Years of misinformation, over-medicalization, negative rhetoric, and stigmatization at the hands of the very same institutions that were believed to care for mental disorder have kept this misunderstanding alive. Further, studies throughout history have failed to look at the nuances of mental health, prioritizing generalizability. This thesis explores the relationship between mental disorder and creative expression, how other factors like cultural discourse and cognitive processes inform this relationship, as well as how analyzing this relationship can provide a …

Navigating Mental Wellness: A Peer-Led Journey Into Adult Services, Kristin G. Haberek

DSW Capstone Projects

Students with severe emotional disturbances (SED) occupy one of the most underserved intersections in American education and mental health care. As they age out of children’s services, they face abrupt service discontinuation, disrupted therapeutic relationships, and adult systems ill-equipped to meet their needs. These vulnerabilities, including heightened risks of crisis, hospitalization, homelessness, and justice involvement, constitute a central practice problem. This capstone addresses these transitions across three scholarly products: a systematic literature review, a theoretical concept paper, and a practical application paper, tracing a unified arc from diagnosing structural failures to proposing an evidence-informed, equity-oriented clinical response. Synthesizing key findings …

Dengue Fever With Normal Platelet Count In A Patient With Β-Thalassemia Trait: A Case Report., Pankaj Kumar Jain, Manoj Seval, Vikas Meena, Rajesh Kumar Yadav

Digital Journal of Clinical Medicine

Dengue fever is an arboviral infection caused by different serotypes of the dengue virus. Generally, it presents with a wide variety of symptoms ranging from undifferentiated fever to dengue shock syndrome associated with thrombocytopenia and hemoconcentration. But in patients with thalassemia, it presents with anemia due to hemolysis, rather than hemoconcentration. Here we present a case of an 18-year-old female diagnosed with Dengue fever with thalassemia trait, who presented with a normal platelet count and moderate microcytic anemia.

Understanding The Progression Of Borderline Personality Disorder During Adolescence: A Clinical Case Study, Anjali Chandak, Megha Sadashiv, Bhawna Sharma, Bhargav Mulpuru

Digital Journal of Clinical Medicine

Borderline Personality Disorder (BPD) often emerges during adolescence, but remains relatively understudied in this population. This case report explores the sociobiological factors shaping symptom expression in an adolescent girl. Longitudinal clinical evaluation revealed hallmark features, including affective instability, identity disturbance, interpersonal relations, and self-harming behaviour. Early attachment disruptions, emotional regulation difficulties, and heightened sensitivity to relational stressors were identified as key developmental risk factors. Diagnostic and therapeutic considerations are presented, highlighting the need for prompt, developmentally informed, and evidence-based interventions. The case further emphasises how prognosis and chronicity may be significantly influenced by an adopting developmental approach, providing insight into …