Digital Commons Network^™

Behavioral Health Integration In Primary Care, Casey Zapata, Demetrius Carter, Marykate Crawford, Samantha Mladen, Emily Donovan, Amber Fox, Kristen O'Loughlin

UROP Posters

Behavioral Health Integration in Primary Care

Casey Zapata, Depts. of Psychology and English, Demetrius Carter, & MaryKate Crawford, and Samantha Mladen, Emily Donovan, Amber Fox, & Kristen O’Loughlin, Dept. of Psychology Graduate Students, with Dr. Bruce Rybarczyk, Dept. of Psychology

Background/Aims: Due to limited access to mental health care, many patients present to primary care with mental health concerns, such as depression and anxiety. Integrated primary care (IPC), an emerging practice model that integrates behavioral health providers with medical providers in primary care, has been demonstrated to improve patient outcomes. This project aims to characterize patients being seen in safety-net …

Vicarious Trauma Exposure And Its Effects On Mental Health Among Adolescents And Adults: A Narrative Research Review, Harrison Davis, Angel Whitfield, Sydney Judge, Bailee Beverly, Jenna Minter, Eryn Delaney, Chloe Walker

UROP Posters

Vicarious Trauma Exposure and Its Effects on Mental Health among Adolescents and Adults: A Narrative Research Review

Harris Davis, Dept. of Psychology, Angel Whitfield, Sydney Judge, Bailee Beverly, Jenna Minter, Harrison Davis, and Eryn DeLaney and Chloe Walker, Dept. of Psychology Graduate Students, with Dr. Chelsea Williams, Dept. of Psychology

A narrative research review was conducted to examine studies that have tested the relation between vicarious trauma (i.e., witnessing abuse of others; Trautmann, S., Reineboth, M., Trikojat, K., Richter, J., Hagenaars, M. A., Kanske, P., & Schäfer, J. (2018). and mental health in adolescents and young adults. Using psycinfo to …

Against Our Will: Sexual Trauma In American Art Since 1970, Andrew D. Hottle

Art Inquiries

Book review of Against Our Will: Sexual Trauma in American Art Since 1970, by Vivien Green Fryd.

Epigenetic Alterations At Synaptic Plasticity Genes In A Genetically Heterogeneous Rat Model Of Neuropsychiatric Disorders, Doan M. On

Theses and Dissertations

Sensorimotor gating impairments are observed across a range of neuropsychiatric conditions. The prepulse inhibition of the acoustic startle response (PPI) is a validated measure of sensorimotor gating. Genetic and pharmacological manipulations in rodents have shown PPI is regulated by specific brain monoaminergic systems. Using genetically heterogeneous NIH-HS rats, we stratified individuals by %PPI. In low PPI animals, we observed elevated mRNA levels of certain neurotransmitter receptors, including metabotropic glutamate receptor Grm2, dopamine receptors Drd1 and Drd2, serotonin receptors Htr1a and Htr2a, and scaffolding protein Homer1, in the frontal cortex (FC) and striatum (STR). We found Drd2 …

From Bedside To Bench: Use Of Patient-Derived Xenograft Models To Develop Novel Therapeutic Strategies For Triple-Negative Breast Cancer, Tia H. Turner

Theses and Dissertations

Triple-negative breast cancer (TNBC) is a clinically aggressive disease that is associated with bleak outcomes due to its metastatic propensity, frequent failure to respond to chemotherapy, and lack of alternative treatment options. Despite decades of major translational research efforts, there has been very little success thus far in the development of effective targeted therapies for this disease. It is imperative to develop novel therapeutic strategies to improve patient outcomes, as well as minimize the toxicity associated with standard-of-care chemotherapeutics. Given that metastatic disease accounts for the vast majority of TNBC-related deaths, a better understanding of therapeutic responses within common sites …

The Role Of Patient Room-Type, Interruptions, And Intrapersonal Resources In Nurse Performance And Well-Being, Jennifer Early

Theses and Dissertations

Interruptions create a complex challenge in health care. Because some interruptions are necessary in health care, they cannot be completely eliminated. Thus, their effects must be appropriately mitigated. To better understand predictors and consequences of interruptions, as well as factors that may mitigate their negative effects, I employed Job Demands-Resources (JD-R) theory, supplemented by additional constructs from organizational behavior and psychology to develop a model of predictors and mitigators of interruptions. Twenty registered nurses providing care on a progressive acute care unit with single- and double-occupancy patient rooms volunteered to participate in this study. The study incorporated nurse-level questionnaires, event-level …

Understanding The Contributions Of Discrepant Parent-Adolescent Views Of Parenting Practices And Peer Deviance To Adolescent Problem Behavior: A Cross-Lagged Polynomial Regression Approach, Mallory Stephenson

Theses and Dissertations

The present study used autoregressive cross-lagged models to examine the processes through which peer deviance and discrepant parent-adolescent views of monitoring-related communication, involvement, and positive parenting influence one another and contribute to physical and relational aggression, substance use, and delinquency. Participants included 535 adolescents (64% male) who were identified as prone to aggression and socially influential by their sixth-grade teachers during the 2001-2002 and 2002-2003 school years; participants self-identified as African American (69%), Hispanic (14%), White (9%), Multiracial (5%), or another race (3%). Contrary to expectations, parent-adolescent reporting discrepancies were not related to peer deviance, physical aggression, substance use, and …

An Intersectional Analysis Of Disproportionality Of Dual Language Learners In Special Education In Virginia: A Mixed Methods Study, Melissa J. Cuba

Theses and Dissertations

The disproportionality of dual language learners (DLLs) in special education has been a persistent and complex issue for decades. These students have multidimensional identities that require a look at how they are positioned in school systems and the broader social landscape. Using a multilevel model of intersectionality and an explanatory mixed methods design, this study examines how social categories, practice, and policies influence the representation of DLLs in special education in Virginia, a state where DLLs represented 13 percent of the total student population in 2018-19. Findings from this study reveal overrepresentation and underrepresentation of 63 DLL subgroups using nuanced …

“Is Therapy For Me?” Perceptions Of Therapy Inclusivity And Willingness To Seek Help Among Black Emerging Adults, Randl B. Dent

Theses and Dissertations

Mental health issues are prevalent among Black emerging adults; however, they tend to underutilize mental healthcare services. The goals of the current study were to examine whether: (1) perceived therapy inclusivity would predict willingness to utilize mental healthcare services and (2) the relationship between perceived therapy inclusivity and willingness would be moderated by two indices of racial identity (i.e., centrality and private regard). Results provide evidence that greater perceptions of therapy inclusivity are associated with greater willingness to seek mental health services even after controlling for factors, such as gender, self-stigma, and previous mental healthcare utilization. Additionally, there was no …

A Randomized Trial Of Cbt4cbt For Women In Residential Treatment For Substance Use Disorders, Sydney S. Kelpin

Theses and Dissertations

Women with substance use disorders (SUD) face unique barriers to substance use treatment, and as a result, are less likely than their male counterparts to seek treatment for the disorder. Cognitive behavioral therapy (CBT) is an evidence-based treatment known to reduce relapse rates by teaching clients to recognize and respond to their cues for substance use. Recent research suggests CBT may be particularly of benefit to women. Despite the effectiveness of CBT, its dissemination in clinical practice is limited due to a range of barriers (e.g., time, cost). Computer-based training for cognitive behavioral therapy (CBT4CBT) offers an opportunity to improve …

Disentangling Student Engagement In Afterschool Programs, Ashlee M. Lester

Theses and Dissertations

This dissertation presents a line of research exploring the characteristics and role of student engagement in afterschool programs, specifically during early adolescence. The dissertation takes a two-study format, building off of my comprehensive exam Measuring engagement in out-of-school time programs. This first chapter is an introduction in which I will detail the underlying problem that is investigated in the following two manuscripts. Following this introduction, the two separate studies are presented.

Phenotype Extraction: Estimation And Biometrical Genetic Analysis Of Individual Dynamics, Kevin L. Mckee

Theses and Dissertations

Within-person data can exhibit a virtually limitless variety of statistical patterns, but it can be difficult to distinguish meaningful features from statistical artifacts. Studies of complex traits have previously used genetic signals like twin-based heritability to distinguish between the two. This dissertation is a collection of studies applying state-space modeling to conceptualize and estimate novel phenotypic constructs for use in psychiatric research and further biometrical genetic analysis. The aims are to: (1) relate control theoretic concepts to health-related phenotypes; (2) design statistical models that formally define those phenotypes; (3) estimate individual phenotypic values from time series data; (4) consider hierarchical …

A Meisner Warm-Up: Advancing The Technique, Andrew Bryce

Theses and Dissertations

Why is there no warm-up for the Meisner technique? Why do standard vocal warm-ups not actually prepare the actor for performance? This thesis seeks to remedy both of these issues in 21st century actor training. It does so by creating a warm-up for the Meisner technique that will also prepare actors’ voice, body, and presence. This warm-up was formed by combining Meisner repetition exercises and the Miller Voice Method. The final warm-up was presented as a workshop for actors at the 2020 Southeastern Theatre Conference.

Predictors Of Mental Health Need And Treatment In Safety Net Primary Care, Kristen O'Loughlin

Theses and Dissertations

Many mental health (MH) needs go unidentified in primary care, and certain patients appear to be at higher risk of needs going unidentified and subsequently untreated. Little is known about patterns of detection and treatment in clinics with integrated mental health services. The purpose of this study was to characterize the prevalence of MH needs and evaluate patient characteristics as predictors of both the presence of a MH need and type of MH services received. Subjects were patients receiving care at two safety net primary care clinics with integrated mental health services (N=816; 52.7% Latinx, 15.9% African American), …

Associations Between Stress, Racial Discrimination, And Cytokine Levels In Black Americans, Takia Williams

Theses and Dissertations

Inflammation is a common pathophysiological pathway for a number of chronic diseases and is influenced by exposure to stress. Although there are racial disparities in health outcomes, relatively little is known about factors that may influence the inflammatory response in Black American individuals. This study examined whether racial discrimination and other forms of stress are associated with the balance of pro- and anti- inflammatory cytokines in Black American adults. Data from 22 participants were drawn from a larger study of Black American children (ages 5-12) and their primary caregivers drawn from low income neighborhoods in Richmond, Virginia. Caregivers reported demographics, …

Teachers' Perceptions Of The Broad Validity Of A High Stakes English Language Proficiency Test, Carolyn N. Waters

Theses and Dissertations

The No Child Left Behind Act of 2001 mandated that the English acquisition of all students identified as English learners be assessed annually using high-stakes standardized English language proficiency tests, and the Every Student Succeeds Act of 2015 continues this testing mandate. The WIDA ACCESS for ELLs® has been used for this and other purposes since 2005, and has been adopted by 40 State Education Agencies, including the Virginia Department of Education. However, despite the long-standing and widespread use of this assessment, no comprehensive independent evaluations of the test have been conducted. This mixed-methods study is a conceptual replication of …

Empathic Anger And Personal Anger In Response To Fairness Violations: Relations To Self And Other-Oriented Motivation And Behavior, Athena H. Cairo

Theses and Dissertations

Prosocial behavior research has shown that empathy-elicited compassionate concern often motivates actions performed with an ultimate goal of helping others even at cost to oneself, whereas empathic distress motivates low-cost help with an ultimate goal of helping oneself. Less is known about the motivational outcomes of empathic anger felt when witnessing injustice or harm to others. Though empathic anger predicts third-party compensation and punishment, it is unclear whether this motivation is ultimately self or other-oriented. Three experimental studies examined the empathic anger-altruism hypothesis, that empathic anger evoked when witnessing another being treated unjustly would evoke altruistic motivation to help the …

A Cost-Effectiveness Analysis Of Early Literacy Growth In Public Pre-Kindergarten Programs, Bruce A. Fillman

Theses and Dissertations

Student early literacy readiness is predictive of later academic success and pre-k programs are a proven intervention to develop early literacy; however, the cost of pre-k programs differs greatly. These differences in cost are related to the opportunities and services included within each program. This study examined four pre-k programs offered within a large school system in Virginia to determine if there were differences in students’ early literacy growth by program attended and evaluated the ratio of cost to achievement of each pre-k program to determine their cost-effectiveness. To do this, two one-way analyses of variances (ANOVAs) were conducted to …

Effects Of (R,S)-Ketamine And (2r,6r)-Hydroxynorketamine: A Preclinical Study, Remington Rice

Theses and Dissertations

In 2017, 7.1% of US adults were diagnosed with depression, and 50% of patients received medication to treat their depression. Depression can cause severe interruptions in an individual's cognitive functioning and behaviors like sleeping, eating, working, and socializing. Unfortunately, approximately 40% of patients do not respond to treatment with monoaminergic medications (e.g. Prozac) and therapeutic effects may be delayed 2-8 weeks. Due to these therapeutic shortcomings, faster acting and more efficacious treatments are needed. Recent preclinical findings indicate potential for glutamatergic drugs like (R,S)-ketamine and (2R,6R) hydroxynorketamine to produce more rapid and longer-acting therapeutic effects. The antidepressant effectiveness of (R,S)-ketamine …

Molecular And Behavioral Mechanisms Mediated Paclitaxel-Induced Changes In Affect-Like Behavior In Mice, Julia Meade

Theses and Dissertations

Paclitaxel and oxaliplatin are two chemotherapeutics that cause acute neurotoxicity and chemotherapy-induce peripheral neuropathy (CIPN) in 70-90% of cancer patients. Chemotherapy-induced sensory changes are correlated with depression and anxiety. We characterized the effects of these drugs on sensation and various mood-related behaviors in mice, to determine if changes in sensation are associated with depression-like behavior, to explore putative mechanisms of chemotherapy-induced depression-like behavior (Aim 1), and to develop a mouse model of chemotherapy-induced operant responding deficit (Aim 2). In Aim 1, we observed that a cumulative dose of 32 mg/kg paclitaxel induced mechanical hypersensitivity and transiently reduced preference for sucrose …

Repeat Full Mouth Dental Rehabilitation Under General Anesthesia For Medicaid Eligible Healthy Children Who Are High Caries Risk, Lajoi E. Wiggins

Theses and Dissertations

Purpose: To evaluate the treatment of healthy children who are high caries risk and of low socioeconomic status and who require repeat full mouth dental rehabilitation (FMDR) under general anesthesia (GA).

Methods: A retrospective chart review was performed on healthy Medicaid eligible patients who were initially between 18 months - 6 years of age who underwent FMDR under GA in the OR more than once at the Virginia Commonwealth University (VCU) School of Dentistry, Department of Pediatric Dentistry from January 2008 to December 2018. Biographical information for each patient was gathered into a REDCap™ Survey. Statistical analysis, chi-squared test with …

Identifying And Addressing Barriers To Accessing Treatment For Substance Use Disorders Among Opioid-Misusing Individuals Following Implementation Of The Affordable Care Act, Mirinda A. Gormley

Theses and Dissertations

BACKGROUND: This project utilized opioid-misusing adults to investigate the association between type of opioid misuse and perceived readiness, financial, structural, and stigma-related barriers to accessing SUD treatment; identified classes of PSU and the association between patterns of PSU and perceived barriers, and evaluated effectiveness of an out-of-hospital opioid-treatment connection program.

METHODS: Respondents from 2015-2018 NSDUH included insured adults reporting past year opioid misuse. Multivariate logistic regression assessed relationship between type of opioid misuse and perceived barriers to SUD treatment. LCA identified patterns of PSU, and multivariate logistic regression assessed association between PSU classes and perceived barriers. EMS ePCRs for nonfatal …

Exploring The Heteromeric Interface Of The 5-Ht2a-Mglu2 Receptor Complex, Mohamed Aarif Abdul Kareem

Theses and Dissertations

Schizophrenia is a serious mental disorder characteristic of several neurotransmitters including dopamine, serotonin, and glutamate being in imbalance. Early therapies focused solely on dopamine antagonism and second-generation antipsychotics focused on the dopamine and serotonin systems and their respective G protein coupled receptor (GPCR) proteins. Although debate for dimerization of certain classes of GPCR exist, the establishment of an mGlu2-5-HT_2A heterocomplex, which is implicated in schizophrenia is of interest. Previous studies have used a mutation-based approach to identify transmembrane domain 4 (TM4) as the domain responsible in mGlu2 for mediating heteromerization before narrowing down the individual amino acids responsible for …

From The Margins To The Center: Legitimation Strategies From An Alt-Right Case Study, Lauren C. Garcia

Theses and Dissertations

Despite a growing interest in understanding Donald Trump’s election in 2016 as part of the historical trajectory of white racial identity politics, we do not know much about how ideas deemed “radical right” become mainstreamed. My study builds on extant research that implicates the emergence of the think tank industry by viewing one such right wing think tank as a racialized organization. My analysis focuses on the organizational strategies of the National Policy Institute (NPI). Google searches for NPI spiked in 2016 with their vocal support of Trump and visible organizing in D.C. Using Williams’ (2018) theoretical framework of organizational …

Cultural Production In Qatar: Design, Dialog And The New Authentic, Asma Derouiche

Theses and Dissertations

Qatar, as a rapidly modernizing Arab country with a highly heterogeneous emergent community, is working to achieve a balance between accelerated development and cultural identity. Qatar’s cross-cultural environment and diverse attributes offer unprecedented opportunity to produce forward-looking, “100% Qatari Products,” that express a New Authentic.

This thesis explores social dynamics governing cultural production in Qatar, and it challenges unproductive manifestations of social hierarchy—particularly related to norms surrounding the default working relationship between designers and artisans. The research highlights and celebrates the inherent diversity of the Qatari artifact, creating a platform and methods wherein designers and artisans collaborate equally and meaningfully. …

Sensory Substitution, Key To Inclusive Learning, Fathima Z. Zahir

Theses and Dissertations

Visually impaired students, in primary education, encounter unique challenges while learning creative skills, exploring artistic expression and developing problem-solving skills, because so much instructional content is delivered visually. Sensory substitution—an approach that replaces visual information with feedback from other intact senses like touch, sound, taste or smell—provides an opportunity to address those challenges.

Through the use of sensory substitution, this thesis proposes concrete ways to capitalize on the enhanced abilities of visually impaired primary school students. The research outcome of this thesis is a system of templates that puts these enhanced abilities to work for visually impaired students, to support …

Three Studies Of Research-Based Pedagogy In Physical Chemistry: Development Of A Zno Thin Film Experiment, Analysis Of Student Discourse By Graph Theory And Cognitive Engagement, Building A Physical Chemistry Faculty Network., Dilhara Liyanage

Theses and Dissertations

Three research projects, each focusing on a different aspect, development of a ZnO thin film experiment, student’s cognitive engagement behavior, and building of a faculty network, are presented in this dissertation.

In the first project, a physical chemistry laboratory experiment was developed to answer the question, “How do electrons move in a solid?”. The experiment structure follows the POGIL-PCL (Process Oriented Guided Inquiry Learning - Physical Chemistry Laboratory) model. Students begin by using the PhET “Quantum Bound States” animation to compare energy levels for single atoms to energy levels of a lattice containing many potential wells, and they incorporate that …

Internalizing Data Collection: Personal Analytics As An Investigation Of The Self, Neal R. Swisher

Theses and Dissertations

Personal analytics, aka self-tracking, is the practice of using a digital device to track aspects of behavior, such as exercise habits, heart rate, sleep patterns, location, diet, and a host of other data points. This dissertation is an exploration of “self” in self-tracking, informed by theories of subjectivity, autonomy, power and knowledge. As a technological intervention, self-tracking devices change how we experience our own body and behavior. They also serve as methods to digitize human behavior. This data is combined with other data and processed using computational methods. Self-tracking devices are both personal and bureaucratic. They are devices used for …

A Theoretically-Based Mixed Methods Approach To Examining Mental Health Disorders And Help-Seeking Behaviors Among University-Enrolled African American Men, Kofoworola D.A. Williams

Theses and Dissertations

Recent studies show that African American men in college are disproportionately experiencing high levels of psychological distress, increasing their risk of developing mental health symptoms associated with depression and anxiety. Despite being at higher risk for developing mental health symptoms, university-enrolled, African American men are not seeking help even when experiencing high levels of stress and anxiety, impacting their academic performance. The evidence base describing mental health symptom prevalence and evidence-based prevention strategies among university-enrolled, African American men is limited. To that end, this dissertation work utilized a concurrent, mixed methods approach, theoretically-based in the Social Ecological Model (SEM), to …

Examining Body Mass Index And Sepsis Mortality At One Year After Sepsis, Jamie D. Robinson

Theses and Dissertations

Introduction: Sepsis is a serious and life-threatening syndrome affecting 1.7 million Americans annually and resulting in approximately 270,000 deaths. An “obesity paradox” where obese individuals have lower sepsis mortality than their non-obese counterparts has been described. The problem is that the longevity of the effect is unknown, and few studies have examined the obesity paradox after 1-2 months post-diagnosis.

Methods: This retrospective cohort study examined clinical, demographic, and biomarker variables thought to affect sepsis mortality at three-time points: 30 days, 180 days, and at one year post-sepsis diagnosis in order to shed light on specific factors that might define …