Digital Commons Network^™

Substitution Of Cannabis For Prescribed Medications In The Management Of Anxiety And Depression Among Midlife Women: A Cross-Sectional Study, Jocelyn Mueller, Jamia Sapp, Jennifer Attonito, Aditya Chakraborty, Karina Villalba

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background and Aims

Given the rising prevalence of cannabis use as an alternative strategy for managing mental health symptoms, there is a crucial need to understand the determinants of substitution behavior, particularly among midlife women who may experience distinct psychosocial and clinical profiles. This study examined the predictors of cannabis substitution among midlife women by comparing profiles of women who substituted cannabis for antidepressant medications versus those who substituted for anxiolytic medications.

Methods

A cross-sectional survey of 172 women who reported substituting cannabis for either anxiety or depression medications was conducted. Measures included the PHQ-8, OASIS, AUDIT, and ACEs. Logistic …

Dual Language Learner Status In Relation To Cortisol For Children In Head Start Preschool, Keala Bratsch

West Chester University Graduate Theses, Dissertations, and Final Projects

Early childhood education (ECE) has well documented school readiness benefits, especially for children facing economic hardship. Yet preschool context poses challenges that are associated with elevated stress levels and potential long-term tax on physiological systems that respond to stress. The present study examined dual language learner (DLL) status in relation to levels of the stress hormone cortisol among low-income children attending Head Start Preschool programs. Participants included 207 children ages 3- 5 years who attended preschool in 2021-22 (60.9% attending a dual-language learning school, 39.1% attending an English-instruction-only preschool; all participants meeting the criteria for low-income), and their parents or …

Racial Bias In Collateral Report Of Adhd Symptom Endorsement, Teresa Mejia

Electronic Theses & Dissertations (2024 - present)

Attention-Deficit/Hyperactivity Disorder (ADHD) is the most frequently diagnosed mental health condition among children in the United States. However, prevalence rates in the diagnosis and treatment of ADHD are unequal across populations. Specifically, the literature has demonstrated consistent variability in symptom endorsements and diagnosis dependent on a child’s demographic factors (i.e., race, gender, age). A diagnosis of ADHD requires that the diagnostic criteria be met in at least two aspects of a child's life, usually the school and home environments. As such, teacher reports are commonly used in the assessment of ADHD for children and adolescents. Given the challenges in obtaining …

Mindfulness Matters: Reducing Anxiety In Prelicensure Undergraduate Nursing Students Using Virtual Reality Meditation Prior To High Fidelity Simulation., Lindsey K. Hildreth

Honors Theses and Capstones

Abstract:

The aim of this study was to evaluate the effectiveness of a 5-minute virtual reality (VR) meditation intervention in reducing self-reported anxiety among prelicensure nursing students immediately prior to their participation in a high-fidelity clinical simulation. Anxiety levels were measured using a Visual Analog Scale (VAS) and compared between students who participated in the VR meditation intervention and those in a control group receiving standard prebrief, and no VR meditation. It was hypothesized that students who engage in VR meditation would demonstrate a reduction in anxiety compared to students in the control group.

Prenatal Exposure To Nicotine And Postpartum Depression: A Systematic Review And Meta-Analysis, Reem Sharaf-Alddin, May Salama, Denise Mckinney, George Saade, Qi Zhang

Health Behavior, Policy & Management Faculty Publications

Purpose: Postpartum Depression (PPD) is the most common mental health complication of childbirth, and has short-term and long-term consequences for mother, child, and the entire family. PPD is a function of several factors. Prenatal exposure to nicotine (PEN) by Active Tobacco Smoking (ATS), Secondhand Smoking (SHS), or Electronic Nicotine Products (ENPs) is a major potential risk factor. This systematic review and meta-analysis aim to summarize and evaluate all evidence regarding the association between PEN and PPD.

Methods: We searched the following databases, PubMed, Medline, Cochrane, EMBASE, and CINHAL, for studies published between Jan.1st ,2000&Sep.19th ,2024, with the outcome PPD. Studies …

From Screens To Stress: Public Health Implications Of Cancer Worry In A Digitally Connected World, Shreya Mathur, Ethan Burns, Michael Pokojovy, Tzu-Liang Bill Tseng, Sunil Mathur

Mathematics & Statistics Faculty Publications

Aims:

This study examines how digital information environments, genetic testing experiences, health behaviors, and psychological distress influence cancer-related worry among adults in the United States. It further considers the public health implications of elevated or reduced cancer worry for prevention and risk communication.

Methods:

Data were drawn from a nationally representative survey of 6,252 U.S. adults. Measures included reliance on social media for health decision-making, smoking status, history of genetic testing, and psychological distress. Multivariable analyses assessed associations between these factors and levels of cancer worry.

Results/Findings:

Reliance on social media for health decisions was associated with greater cancer worry, …

Educational Attainment And Symptom Improvement In Treatment-Resistant Depression: A Longitudinal Cohort Analysis Across Treatment Modalities, Marjorie Harrison, Giselli Scaini Msc, Phd, Aspen Viamontes

Summer Research Program Abstracts

No abstract provided.

The Tilt Continuum: Investigating The Relationship Between Emotions And Peformance In Esports., Rowan D. Steyn

Williams Honors College, Honors Research Projects

Despite widespread agreement in esports communities that tilt leads to poorer performance, this belief remains largely anecdotal. Most existing research relies on self-reported experiences of tilt and perceived decreases in performance, with very little to no empirical evidence supporting this consensus. This project seeks to provide the first systematic, within-person investigation of how varying levels of tilt relate to performance across competitive matches over time. By using post-match surveys and tracking objective performance indicators ( Match win/loss), the study will assess whether tilt consistently predicts poorer outcomes or if the relationship is more complex and nuanced, for example, a possible …

Multimodal Machine Learning For Alzheimer's Disease Classification Using Adni Biomarker Fusion, Hesameddin Mostaghimi, Hamid R. Okhravi, Bahar Niknejad, Daniel A. Cohen, Michel A. Audette, Alzheimer's Disease Neuroimaging Initiative

Electrical & Computer Engineering Faculty Publications

Despite ongoing advances, accurate diagnosis of Alzheimer’s disease (AD) remains challenging due to its multifactorial nature, comorbidities, and clinical heterogeneity. Accordingly, approaches that combine multimodal data may improve AD classification by integrating complementary information. To investigate this, we evaluated classification performance using a preprocessed ADNI-3 dataset comprising a shared set of clinical/cognitive features along with four imaging modality-based cohorts: trimodal (MRI + amyloid PET + tau PET), MRI + amyloid PET, MRI + tau PET, and MRI-only. We trained a range of supervised machine learning (ML) and deep learning (DL) classifiers using stratified five-fold cross-validation and evaluated performance using accuracy, …

Management Of Medication Nonadherence In Adults Diagnosed With Schizophrenia, Olukemi O. Adeogun

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Individuals diagnosed with Schizophrenia have high medication nonadherence rates, which increase the risk of symptom relapse and hospitalization. This evidence-based practice (EBP) project sought to reduce antipsychotic medication nonadherence among adult patients diagnosed with schizophrenia and/or schizoaffective disorder. Methods: Twenty-six individuals aged 18 and older participated in the project over 8 weeks. A pretest-posttest design was applied to measure participants' self-reported medication adherence scores before and after implementing a medication adherence bundle. The intervention included psychoeducation, long-acting injection (LAI), and phone reminders. Paired t-tests were used to compare the pre- and post-test Medication Adherence Report Scale-5 (MARS-5) scores.  The …

Emotion Regulation Difficulties And Substance Use: The Role Of Conscientiousness, Caitlyn M. Donnelly

Theses and Dissertations

Difficulties in emotion regulation have been consistently linked to substance use among college students. However, individual differences may influence this relationship. Conscientiousness, a personality trait characterized by self-control, planning, and goal-directed behavior, has been proposed as a potential protective factor. The present study examined associations among difficulties in emotion regulation, conscientiousness, and substance use behaviors, as well as whether conscientiousness moderates the relationship between emotion regulation difficulties and substance use. Using a quantitative, cross-sectional, correlational design, data was collected from college students recruited through a university participant pool. Participants completed self-report measures of emotion regulation difficulties, conscientiousness, and substance use …

Parental Behavior, Attachment, And Sibling Outcomes In Asd Families, Bridget W. Mwaura

Theses and Dissertations

Neurotypical siblings of individuals with Autism Spectrum Disorder (ASD) often experience unique challenges, including increased familial stress and differences in parental treatment, which may affect the sibling bond. Grounded in the Attachment Theory and Siblings Embedded Systems Framework, this study examined relationships among attachment security, parenting behaviors and sibling relationship quality. It was hypothesized that secure parental attachment and helpful parenting behaviors would predict greater sibling closeness and lower conflict, and that attachment security would mediate the relationship between parenting behaviors and sibling relationship quality. Results from a sample of emerging adults (N=91) partially supported these hypotheses. Bivariate …

Predicting Tilt In Esports: A Psychophysiological Approach To Understanding Player Emotional Regulation, Nathan Rhea

University of the Pacific Theses and Dissertations

Emotional regulation and stress management are important to both casual and competitive esports players. When players become dysregulated, they experience a phenomenon known as “tilt” within the gaming community, where they often lose control of their emotions and their performance declines. This study aimed to investigate whether a psychophysiological variable in heart rate variability could predict tilt in college-age esports players. Additionally, the relationship between heart rate variability and emotions predicted by the Tiltometer system with gameplay performance and winning or losing was tested.

This study used a quantitative correlational research design. Participants for this study were college-age players (N=23) …

Perceptions, Expectations, And Attitudes About Adolescent Telepsychiatry Among Indian American Family Caregivers, Udayvir Jalf

Honors Undergraduate Theses

Adolescent mental health concerns have risen sharply in the United States. The COVID-19 pandemic marked a significant turning point in mental health care access, with telehealth having become a central mode of care delivery. With adolescent telehealth, caregiver involvement has shown to improve treatment adherence and outcomes. Little is known, however, about how Indian American caregivers experience and navigate their adolescent’s virtual mental health care. This qualitative study investigated the perceptions, expectations, and attitudes of Indian American family caregivers regarding adolescent telepsychiatry and caregivers’ involvement. In depth semi-structured interviews were conducted with Indian American caregivers of adolescents who completed at …

Improving Psychiatric Paraprofessional Preparedness Through Mental Health First Aid Training In An Outpatient Mental Health Clinic, Anisha Hampton

DNP Scholarly Projects

BACKGROUND: Paraprofessional staff in outpatient mental health clinics play a critical role in monitoring clients with serious mental illness (SMI) and supporting continuity of care in community-based settings. However, the absence of standardized training contributes to variability in staff knowledge, confidence, and ability to recognize early signs of mental health deterioration. Mental Health First Aid (MHFA) is an evidence-based training designed to improve mental health literacy and crisis response skills among frontline workers.

METHODS: This quality improvement project utilized a pre-post design within a Plan-DoStudy-Act (PDSA) framework at an outpatient mental health clinic. Paraprofessional staff completed the Mental Health Literacy …

Studying Chronotypes And Their Role In Sleep And Mental Health: A Scoping Review, Evan Nguyen

Honors Undergraduate Theses

Sleep patterns remain a significant public health concern globally, impacting several aspects of life, including mental health. This scoping review examined how chronotype and circadian typology predict mental health, with sleep quality serving as a crucial mediator. While the importance of sleep is widely acknowledged, there is a lack of studies specifically investigating chronotype-aligned interventions to reduce psychological distress. To address the shortage, a comprehensive review of the peer-reviewed literature was conducted, identifying six papers for analysis. These studies mostly utilized cross-sectional designs to assess diverse global groups, including university students, healthcare workers, and military personnel. The results indicate that …

Effect Of Antipsychotic Medication Use And Type On Mortality And Cardiovascular Risks In Nursing Home Patients With Dementia, Hamid R. Okhravi, Fang Fang, Melissa P. Hunter, Brynn E. Sheehan

Glennan Center for Geriatrics and Gerontology Faculty Publications

Introduction

Antipsychotic medication (APM) use in nursing home (NH) patients with dementia is common but carries risks. This study assessed the association between APM use and mortality, stroke, and myocardial infarction (MI) compared to non-use, as well as differences between first- and second-generation APMs.

Methods

A serial cross-sectional study using Medicare data examined outcomes from 2012 to 2015 in a national sample of 328,138 US NH residents aged 50 and older with dementia. Multivariate logistic regressions were used to analyze risk.

Results

APM use was associated with increased mortality in all years (odds ratio [OR] range: 2.39 to 1.23, all …

Modern Approaches To Mental Health: App-Based Cbt Versus Traditional Psychotherapy, Samira Shende

The PA Department Journal of Medical Science

Background: Digital mental health tools are becoming widely used as flexible alternatives to in-person therapy. A key question is how effective they are compared to traditional therapy for people with depression and anxiety.

Objective: To compare how effective digital interventions, like app-based CBT or telehealth, are compared to in-person psychotherapy in reducing symptoms of depression and anxiety in adults.

Methods: A structured PubMed search was conducted using specific search terms, limited to English-language randomized controlled trials, systematic reviews, and meta-analyses published between 2020 and 2025. After screening 116 articles, four high-quality studies were selected for review.

Results: Of the four …

The Effects Of Expectancies And Attention To Placebo Relevant Sensations On The Open-Label Placebo Response, Miranda Connelly

Cal Poly Humboldt theses and projects

Placebo analgesia has shown promise in treating pain, but practitioners are reluctant to prescribe deceptive placebos. Open-label, or honestly prescribed placebos, offer an ethical alternative. Open-label placebos seem to work largely through experimenter-manipulated expectancy, as well as social/environmental factors. Additionally, verbally guided attention to relevant placebo sensations might bolster pain relief. In the present study, expectancy and attention were experimentally manipulated within a 2 (expectancy: high/low) x 2 (attention: high/low) between-subjects design with a no-treatment comparison group. Pain was experimentally induced in all five experimental groups using the well-established cold pressor task. The primary dependent variables were pain tolerance and …

Cognitive Load Classification Using Functional Near-Infrared Spectroscopy, Pratham Shah

Theses and Dissertations (Comprehensive)

This thesis investigates the classification of cognitive load using functional near-infrared spectroscopy (fNIRS) signals recorded during an N-back working memory task. The study introduces a novel short-channel correction layer designed to suppress superficial physiological noise adaptively, addressing limitations of traditional General Linear Model (GLM) based regression. A single participant dataset comprising 69 validated sessions was analyzed using both conventional machine learning and deep learning approaches. Traditional classifiers: Linear Discriminant Analysis (LDA), Support Vector Machines (SVM), Random Forests, and Gradient Boosting were first evaluated using statistical features (mean, variance, peak, and slope). Among these, Gradient Boosting achieved the highest accuracy (55.6%), …

Npd Winner's Circle: Overcoming Imposter Syndrome In New Clinical Specialties, Leanna Ross

Publications 2026-present

No abstract provided.

Ethical Considerations For Hospice Patients In Inpatient Settings: A Systematic Review And Thematic Analysis, Matthew D. Harry

Honors Theses and Capstones

Hospice care is intended to prioritize comfort, dignity, symptom management, and quality of life for individuals with life-limiting illness. However, when hospice-eligible patients are managed within inpatient hospital settings, significant ethical challenges frequently emerge due to the tension between comfort-focused care and the curative, intervention-driven structure of acute care medicine. This paper presents a systematic literature review and thematic analysis examining the ethical considerations surrounding hospice patients in inpatient settings, with particular attention to clinical decision-making, communication, prognostic uncertainty, moral distress among nurses, and conflicts involving patient autonomy and family wishes. A structured review of peer-reviewed literature was conducted using …

Preoperative Patient Sentiment Is Associated With Postoperative Outcomes In Adult Spinal Deformity Surgery, Ross J. Gore, David Mazur-Hart, Mohan K. Sunkara, Aaqib Ali, Qizar Ali, Christopher J. Lynch

Center for Secure and Intelligent Critical Systems (CSICS) Publications

Study Design:

Prospective observational pilot study of adult spinal deformity surgery patients.

Objective:

To determine whether preoperative patient sentiment, quantified using a 21-class valence scale extending the CARP paradigm implemented through an offline Large Language Model, predicts postoperative outcomes.

Summary of Background Data:

Predicting adult spinal deformity surgery outcomes remains challenging with traditional clinical and radiographic parameters alone. Although patient psychological factors and expectations significantly influence postoperative satisfaction and quality of life, systematic approaches to capture these factors are underdeveloped. Offline Large Language Models offer scalable, privacy-preserving psychological risk stratification.

Materials and Methods:

We prospectively enrolled 18 patients undergoing adult …

Examining Links Between Somatosensation And Cognition In Children With Hemiplegic Cerebral Palsy, Kassandra M. Hewitt, Donna M. Bayliss, Belinda A. Mclean, Ashleigh L. Thornton, Jonson J. Moyle

Research outputs 2022 to 2026

Children with cerebral palsy (CP) are at increased risk of impaired somatosensation and cognition. Among children with hemiplegia, approximately three-quarters have impaired somatosensation and one-third have intellectual impairment. While somatosensation may relate to cognitive functioning in CP, this relationship has not previously been investigated. This cross-sectional study examined the relationship between somatosensation and cognition in children with hemiplegic CP, and whether the pattern of brain injury, classified using an established MRI classification system, moderates this relationship. Forty-seven children (26 females) with hemiplegic CP participated (mean age = 11.0 years; SD = 3.6; range: 6–16 years). Parent questionnaires provided demographic, educational, …

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 …

Social Threat, Negative Beliefs, And Altered Social Learning Underpin Paranoia In Adolescents, Jessica L. Kingston, Ellett, Linda Richards, Henry Burgess, Joseph M. Barnby

Research outputs 2022 to 2026

Adolescent social adversity (discrimination, bullying) enhances paranoia—the perception others want to harm or upset you. In this preregistered study (AsPredicted No. 154322), we tested the impact of prior social adversity and current social exclusion on paranoia, self/other beliefs, and latent social-learning processes in UK mid-adolescents (15-17 years, N = 502). In an experimental design, participants completed baseline social-adversity measures before random allocation to a social inclusion/exclusion manipulation (Cyberball), after which the Intentions Game assessed cognitive flexibility. We tested (a) whether adversity and exclusion interact to increase paranoia (b) via (mediated) negative self/other beliefs and (c) if this was moderated by …

Opportunities To Improve The Implementation Of Relational Health Interventions For Children And Families: A Secondary Analysis Of A Scoping Review, Natasha Pearce, Natasha Pearce, Donna Cross, Jacinta Francis, Jonathan H. Sae-Koew, Alexander M. Godley, Caitlin Attwell, Tracy Evans-Whipp, Tracy Evans-Whipp, Jacqueline Allen, Ross Homel, Craig A. Olsson, Stephen R. Zubrick, Lu Zhang, Sarah Whittle, Liz Spry, Tim Slade, Lisa Ritland, Naomi Priest, Felicity Painter, Craig Olsson

Research outputs 2022 to 2026

Despite the availability of universally delivered evidence-based relational health interventions, their wide-scale translation into practice is slow and unsustained. Measuring implementation outcomes within intervention trials is critical to understand their effectiveness and inform future scaling. This study aimed to determine the extent to which universally delivered relational health interventions measured and reported on implementation outcomes to inform their effectiveness. A secondary analysis of a scoping review examined the extent to which 123 RCT-evaluated relational health intervention studies referred to (1) implementation related theories or frameworks; (2) implementation data collection methods; (3) implementation measures, and; (4) each of twelve implementation outcomes …

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 …