Mental Health Comorbidities And Ibd Outcomes In Patients Treated With Anti–Il-23 Therapy, Jashanveer S. Johal, Archana Salek, Mahmoud Al-Bataineh, Bianca Patel, Om Patel, Yecheskel Schneider, Jason Hyman, Abdallah Hussein

Rowan-Virtua Research Day

Background: Depression and anxiety are prevalent in inflammatory bowel disease (IBD) and may adversely influence outcomes. We evaluated the impact of comorbid mood disorders on clinical outcomes among IBD patients treated with anti–IL-23 agents.

Methods: Using a global de-identified electronic health record network, adults with Crohn's disease or ulcerative colitis initiating an anti–IL-23 agent were identified. Cohort 1 included patients with a documented mood disorder (depression and/or anxiety) at or prior to treatment initiation; Cohort 2 included those without mood disorders. Propensity score matching (1:1) on demographics and comorbidities yielded 3,546 patients per cohort. Primary outcomes included inpatient/ED encounters, abscess/fistula, …

Refractory Catatonia In Schizoaffective Disorder (Bipolar Type) Successfully Treated With Electroconvulsive Therapy, Shreya Kadi, Victoria Coles

Rowan-Virtua Research Day

Background: Catatonia is a neuropsychiatric syndrome

associated with mood and psychotic disorders and may

become life-threatening if untreated. While benzodiazepines

are first-line therapy, some cases are refractory and require

electroconvulsive therapy (ECT).

Hypothesis: Early use of ECT in refractory catatonia leads to

improved clinical and functional outcomes.

Methods: We present a retrospective case analysis of a 62-

year-old female with schizoaffective disorder, bipolar type,

who developed severe catatonia during inpatient psychiatric

hospitalization. Clinical course, Bush–Francis Catatonia Rating

Scale scores, and response to treatment were reviewed.

Results: The patient presented with severe catatonia (Bush–

Francis score 19) and elevated creatine kinase …

Mental Health Comorbidities And Ibd Outcomes On Anti-Tnf Therapy, Jashanveer S. Johal, Mahmoud Al-Bataineh, Archana Salek, Bianca Patel, Om Patel, Jason Hyman, Yecheskel Schneider, Abdallah Hussein

Rowan-Virtua Research Day

Background: Depression and anxiety are prevalent in inflammatory bowel disease (IBD) and may adversely affect biologic therapy outcomes. We evaluated the impact of comorbid mood disorders on clinical outcomes among IBD patients treated with anti-TNF agents.

Methods: Using a global de-identified electronic health record network, adults with Crohn's disease or ulcerative colitis initiating an anti-TNF agent between 2018–2023 were identified. Cohort 1 included patients with a documented mood disorder (depression and/or anxiety) at or prior to anti-TNF initiation; Cohort 2 included those without mood disorders. Propensity score matching (1:1) on demographics and comorbidities yielded 9,605 patients per cohort. Primary outcomes …

Music And Movement For Individuals With Parkinson's Disease, Jordan Butler

The Corinthian

Parkinson’s disease, affecting approximately 10 million people worldwide, causes deficits in fine motor function, speech, and movement, as well as many other secondary symptoms, such as depression (Parkinson’s Foundation, 2020, para. 1). Past researchers have outlined many different studies and interventions regarding Parkinson’s and the effects of various types of music therapy (Andrejeva et al., 2019; Bukowska et al., 2016; Tamplin et al., 2019; Thaut, Rice, Braun Janzen, Hurt-Thaut, & McIntosh, 2019; Zhang, Liu, Ye, Li, & Chen, 2017). This review includes numerous ways that music therapy has benefited, and assisted people diagnosed with Parkinson’s. Vocal practices, auditory stimulation, and …

A Retrospective Look At Self-Reported Mental Health Prevalence In Division Iii Student-Athletes, Jacob F. Neri

Masters Theses/Capstone Projects

Mental health concerns among collegiate athletes have gained increased attention, but there has been limited research focus on Division III student-athletes. This study aimed to examine the self-reported prevalence of anxiety, depression, anger, stalking/harassment, abuse/assault, alcohol/substance abuse, self-harm, suicide ideation, and suicide attempt to identify contributing factors amongst this population. A retrospective, cross-sectional study was conducted looking at data collected from the student-athlete mental health history & well-being questionnaire that was administered as part of their pre-participation exam (PPE) prior to the beginning of each academic year. A total of 554 Division III student-athletes were included in the study. Results …

Does Self-Compassion Buffer Against The Potential Effects Of Perfectionism And Psychopathology On Non-Suicidal Self-Injury?, Natasha Bourgoin

Electronic Theses and Dissertations

University students with increased rates of reported perfectionism, anxiety, and depression, are vulnerable to non-suicidal self-injury (NSSI). However, not all students with psychological distress engage in NSSI, suggesting protective factors may help to mitigate this risk. The present study examined the relation between perfectionism and NSSI, via the mediating effects of anxiety and depression, and the moderating role of self-compassion. Participants were 338 university students (67% female; 87% White) who completed several self-report measures. Students with greater perfectionism reported higher levels of anxiety and depressive symptoms and, in turn, more NSSI engagement. Self-compassion and several self-compassionate domains attenuated connections between …

The Power Of Belief: Investigating The Intersection Of Religious Observance, Social Support, And Psychological Distress, Victoria R. Atwater

Undergraduate Honors Thesis Collection

Religion can act as a protective factor against stress and depression (Koenig et al., 2009; Krok, 2008) and can be examined through an individual’s relationship with religion or the efficacy of religious practices on mental health. In this study, 206 participants completed an online questionnaire that measured stress, depression, religious coping, religiosity (intrinsic religiosity, organized religious activities and non-organized religious activities), and social support using validated scales. The results indicate a positive correlation between stress, depression, and negative religious coping as predicted. While intrinsic religiosity and positive religious coping did not significantly influence stress or depression, organized religious activities were …

Depression Symptoms Are Associated With Less Positively Biased Self-Ratings Of Attentional Control, Anna E. Morgan

Psychological Science Undergraduate Honors Theses

Deficits in the ability to flexibly direct, sustain, and shift attention, known as attentional control, have been linked to anxiety and depression. Attentional control supports engaging with goal-relevant stimuli while effectively disengaging from irrelevant or emotionally distracting stimuli. Thus, it is crucial in cognitive processes and emotional responses. Common measures of attentional control include behavioral tasks and self-report measures. However, behavioral and self-report measures are weakly correlated, suggesting that individuals generally are not good at perceiving their attentional control abilities. This mismatch between measures could be related to anxiety and depression symptoms. The goal of my project was to examine …

“Menopause Is Universal, But No One Prepared Us”: An Inductive Thematic Analysis Of R/Menopause, Alissa Lauren Hardwick

Graduate Theses and Dissertations

Menopause is a universal biological transition, yet women’s lived experiences of its emotional, cognitive, relational, and healthcare dimensions remain comparatively underrepresented in research. Guided by critical feminist theory and feminist standpoint epistemology, this study examined how women in the r/Menopause online community described experiences of depression and anxiety during the menopausal transition, how they narrated healthcare encounters, and how they made sense of shifting identity and social value. By treating self-authored online narratives as situated forms of knowledge, the study aimed to illuminate how menopausal distress is interpreted and negotiated in everyday discourse. An inductive qualitative reflexive thematic analysis was …

Exploring Exercise Motivation And Mental Well-Being In College Students, Elaine M. Lindesmith, Anqi Deng Dr

Health, Human Performance and Recreation Undergraduate Honors Theses

This study examined the relationship between physical activity, exercise motivation, and mental well-being among 48 undergraduate students at the University of Arkansas. Guided by Self-Determination Theory, the study used survey data to measure depression, anxiety, physical activity, and open-ended exercise motivation responses. Motivation responses were coded as autonomous or controlled.

Results showed that physical activity was weakly and negatively related to depression and anxiety, but these relationships were not statistically significant. There were also no significant differences in mental health between autonomous and controlled motivation groups, and motivation did not significantly predict mental health outcomes in regression analyses. Overall, the …

Negative Core Beliefs And Cognitive Fusion As Predictors Of Depressive Symptom Severity And Course, Caila Flaemig

Honors Scholar Theses

Major depressive disorder (MDD) is one of the most prevalent mental health disorders among young adults, and its prevalence has continued to increase in recent years. Cognitive vulnerabilities are believed to play a significant role in the onset and maintenance of depressive symptoms. Thus, the present study examined the relationship between negative automatic thoughts and cognitive fusion as predictors of depressive symptom severity and course among psychologically vulnerable young adults. The study also explored how these constructs relate to the expression of negative core beliefs in participants’ open-ended written responses and whether these relationships differed by gender. Participants included 320 …

Social Media’S Impact On School-Aged Children's Mental Symptoms, Tiffany Espinoza

Electronic Theses, Projects, and Dissertations

With the increased usage of social media among individuals, this has raised concerns about its impact on the mental health symptoms of the younger population. Previous research has shown the impact of social media on adolescents' depression and anxiety; however, there is limited research showing the impact on younger school-aged children. The purpose of this study will be to examine the relationship between social media use and mental health symptoms among school-aged children from kindergarten through twelfth grade. The proposed research study will seek to address gaps in previous research by analyzing a wider age range and more diverse subgroups …

University Student Mental Health: Service Utilization, Equity Gaps, And Strategies To Improve Access, Richard Mutua Kilonzo

Electronic Theses and Dissertations

Student mental health and access to care are pressing concerns in higher education. This study assesses mental health outcomes and access to campus mental health services at East Tennessee State University. Survey data from the 2023–2024 Healthy Minds Study were analyzed to report the prevalence of depression, anxiety, and suicidal ideation across the student population. The study evaluates disparities in these outcomes and barriers to care across student groups, with particular attention to equity-impacted students, especially sexual and gender minority students.

Findings indicate widespread psychological distress alongside persistent barriers, including long wait times, limited-service availability, and stigma-related concerns. These barriers …

Psychological And Inflammatory Ties To Diet In Breast Cancer Survivors, Sonal Kaur Johal

Master's Theses

Breast cancer is among the most prevalent forms of cancer and is a primary cause of death among women (Wang et al., 2020). Cancer patients experience higher levels of anxiety symptoms, depressive symptoms, and inflammation compared to non-cancer patients, which can predict a diminished quality of life but also contribute to higher mortality rates among cancer patients (Bortolato et al., 2016; Song et al., 2022). Diet has the potential to impact the manifestation of depressive and anxiety symptoms in both healthy individuals and those battling cancer. This study explored the association between dietary habits, specifically cholesterol, fiber, saturated fat, added …

Impact Of Escitalopram On Postpartum Sleep/Wake Activity And Maternal Behaviors, Kimberly Guerrero Leon

Electronic Theses, Projects, and Dissertations

The postpartum period is characterized by profound physiological and psychological changes, including disruptions in sleep and activity patterns, which may contribute to the onset of postpartum depression. If left untreated, postpartum depression can result in long-term consequences, including cognitive impairments, emotional dysregulation, impaired maternal-infant attachment, and the onset of sleep-related disorders. Selective serotonin reuptake inhibitor (SSRI), escitalopram, is prescribed for the treatment of postpartum depression due to its efficacy, favorable safety profile, and relatively low cost. While escitalopram is considered an effective treatment for depression and anxiety, far less is known about its impact on maternal behaviors during the postpartum …

Parental Rejection, Identity Development, And Mental Health Among Lgbtqia+ Youth, Litzy Rodriguez

Electronic Theses, Projects, and Dissertations

Compared to their heterosexual and cisgender peers, LGBTQIA+ youth continue to experience increased rates of anxiety, depression, suicidality, and identity development distress. Parental rejection has been identified as the central impact of these outcomes. However, limited research has examined the influence of parental responses on identity development and the role of micro-level supports, such as counseling and support groups, and macro-level supports, such as inclusive policies and community protections. The purpose of this proposed study is to examine the relationship between early parental rejection or acceptance and LGBTQIA+ youth’s mental health outcomes, identity development, and perceived effectiveness of support systems. …

Assessing The Mental Wellness Of Professional Pilots And Their Willingness To Seek Professional Help, Bill Deng Pan, Flavio A. C. Mendonca Ph.D.

International Journal of Aviation, Aeronautics, and Aerospace

Professional pilots face distinct mental health challenges arising from irregular schedules, fatigue, high responsibility, and the need to maintain medical certification. These factors contribute to elevated stress, anxiety, and depression, while concerns about stigma, confidentiality, and potential career consequences often discourage pilots from seeking professional psychological support. As a result, barriers to early identification and intervention of mental health challenges remain a persistent concern within the aviation industry. This ongoing study utilizes a non-experimental, survey-based design to examine the mental wellness of professional pilots worldwide and their willingness to seek mental health support. The survey includes demographic items, standardized mental …

The Relationship Between Sports Related Head Injuries, Mental Health And Academic Performance In University Student-Athletes, Odyssey Keller

Electronic Theses and Dissertations

Student athletes face many challenges when it comes to participating in team sports, one of the most notable being sport-related head injuries. Concussions are a growing concern since they have the potential to impact mental health and academic performance long-term. While many athletes report recovery within weeks, some continue to struggle with impairments in their psychological functioning and overall mental well-being that interferes with academic performance over time. Many of the standardized protocols in place for concussion management vary across institutions. This study aimed to address gaps in the existing literature by assessing concussion history, mental health and academic challenges …

Antidepressant-Like Effects Of Extinction Learning As An Animal Model Of Behavioral Therapy, Jing Liu, Sarah E Bulin, David A Morilak

Faculty, Staff and Student Publications

Exposure-based behavioral therapy, the most effective treatment for posttraumatic stress disorder (PTSD), also reduces depressive symptoms. However, neurobiological mechanisms underlying the beneficial effects of exposure-based behavioral therapy on depression remain unknown. Our lab has established fear extinction as a rat model of exposure therapy to investigate the mechanisms underlying its therapeutic behavioral effects in chronically stressed rats. In this study, we demonstrated that extinction learning reduced immobility in the forced-swim test and reversed chronic stress-induced reduction in sucrose preference. Chemogenetic inactivation of pyramidal neurons in the ventral medial prefrontal cortex (vmPFC) prevented these antidepressant-like effects of extinction. Extinction learning enhanced …

The Impact Of Traditional Machismo On Mental Health Outcomes: Depression And Suicide Risk Among Latino Immigrant And Non-Immigrant Men, Yesenia A, Romero

Electronic Theses and Dissertations

Traditional masculine norms have long been recognized as influential factors in men’s psychological well-being. Within Latino cultures, the construct of machismo represents a culturally specific form of masculinity characterized by ideals of masculinity and characterized by ideals of strength, dominance, and emotional restraint. While these norms may promote resilience and family responsibilities, rigid adherence to traditional machismo has also been associated with emotional suppression, reduced help-seeking behaviors, and increased psychological distress. The present study conducted a meta-analysis to examine the relationship between traditional machismo and mental health outcomes among Latino men, with particular attention to depressive symptoms as well as …

Not Just Anyone: Living Situation Is Indirectly Associated With Cognitive Impairment Via Depressive Symptoms, Chin Hong Tan, Jacinth Jia Xin Tan

Research Collection School of Social Sciences

Objectives: Socially isolated individuals are at a greater risk of cognitive decline. We examined whether this relationship is dependent on the type of household living situation, living alone or living with others (spouse/ partner or relative/friend), and the indirect effects of depression. Methods: We evaluated 10,545 cognitively normal (CN, mean age = 71.6) and 9334 individuals with mild cognitive impairment (MCI, mean age = 72.9) cross-sectional data from the National Alzheimer's Coordinating Center. Participants' living situation was classified as living alone, living with spouse/partner, or living with a relative/friend. Cognitive function and depression were assessed by a neuropsychological battery and …

Factors Associated With Postpartum Depression Symptoms Following Antepartum Hospitalization, Alison N Goulding, Daniel Palacios, Sukru Aras, Hu Chen, Sasidhar Pasupuleti, Marika Toscano, Nicole Cirino, Israel C Christie, Zhandong Liu, Emily S Miller, Terri L Fletcher

Duncan NRI Faculty and Staff Publications

Background: Hospitalized antepartum patients are at increased risk for postpartum depression (PPD). Developing approaches to identify those at highest risk for PPD would enable timely and targeted intervention.

Objective: We aimed to identify factors associated with the development of PPD symptoms in hospitalized antepartum patients and to assess their predictive utility.

Study design: This retrospective cohort study included pregnant individuals hospitalized in a regional referral center due to medical or obstetric complications between 2012 and 2025. Data were extracted from the electronic health record, including demographics, medical and obstetric history, hospitalization characteristics, and postpartum Edinburgh Postnatal Depression Scale (EPDS) scores …

Plasma Proteins Associated With Psychosocial Factors And Heart Disease: The Jackson Heart Study, Sara N O'Brien, Madeline G Gillman, Michael D Green, Daniel E Cruz, James S Floyd, Susan Hankinson, Daniel H Katz, Xiaojuan Liu, Michelle C Odden, Bruce M Psaty, Alexander P Reiner, Jerome I Rotter, Stephen S Rich, Robert E Gerszten, Amil Shah, Mario Sims, Usman A Tahir, Lesley F Tinker, Alexis C Wood, Bing Yu, Anthony S Zannas, Laura M Raffield, Láshauntá M Glover

Faculty, Staff and Students Publications

Background: Knowledge of proteomic mechanisms explaining the link between psychosocial stress and cardiovascular disease is limited. This study aimed to (1) identify plasma proteins associated with psychosocial factors and (2) assess associational pathways between psychosocial factors, identified proteins, and incident cardiovascular disease events in a discovery cohort, JHS (Jackson Heart Study), and 2 replication cohorts, the CHS (Cardiovascular Health Study), and the MESA (Multi-Ethnic Study of Atherosclerosis).

Methods: JHS participants from exam 1 (2000-2004) with SomaScan 1.3k platform proteomics data were included (n=2143, mean age=55.3). Depressive symptoms and perceived stress scores were measured via the 20-item Center for Epidemiological Studies …

Development And Pilot Testing Of Transdiagnostic Exposure Therapy/Behavioral Activation For Autistic Adolescents With Internalizing Disorders, Andrew G Guzick, Elizabeth A Kaplan-Kahn, Jessica Szu-Chi Cheng, Callie Murphy, Ogechi C Onyeka, David Riddle, Tracy Dibbs, Leandra N Berry, Robin P Goin-Kochel, Eric A Storch

Faculty, Staff and Students Publications

Internalizing disorders disproportionately affect autistic adolescents, though limited research has focused on tailoring therapy for this population. The purposes of this paper were (1) to describe the development of a transdiagnostic exposure therapy/behavioral activation intervention for autistic adolescents with internalizing disorders, and (2) to present a pilot test of feasibility, acceptability, and efficacy of the intervention. The development of this therapy is described in detail, which prioritized the following domains: (1) building on the existing evidence base of exposure-based cognitive behavioral therapy for autistic youth with anxiety disorders, (2) involving caregivers considerably, (3) incorporating autism-specific considerations into case conceptualization and …

Cognitive Behavioral Therapy For Individuals With Low Literacy And Perinatal Depression: A Randomized Clinical Trial, Eliza Kleban, Ashleen Lee, Aminata Koroma, D Taylor Hendrixson, Joshua Duncan, Mark J Manary, Kevin B Stephenson

2020-Current year OA Pubs

IMPORTANCE: Perinatal depression is common in sub-Saharan Africa, yet treatment gaps are substantial. Cognitive behavioral therapy (CBT) is effective but relies on written materials.

OBJECTIVE: To evaluate the efficacy of a culturally adapted CBT intervention delivered by lay counselors to women with perinatal depression in rural Sierra Leone.

DESIGN, SETTING, AND PARTICIPANTS: This study was an individually randomized, outcomes assessor- and investigator-blinded, clinical trial of an adapted CBT intervention vs enhanced usual care. The trial was conducted in 6 government-run antenatal clinics in Pujehun District, Sierra Leone, which has limited infrastructure, low literacy, high maternal undernutrition, and no perinatal mental …

Genetic Variation In Slc6a4 And Cytochrome P450 Enzymes: Implications For Personalized Antidepressant Treatment In Major Depressive Disorder, Claudia Buda

Harriet L Wilkes Honors College Theses 2020 - Present

Depression is one of the most common psychiatric disorders worldwide, with a significant impact on quality of life and global health. Despite the widespread use of selective serotonin reuptake inhibitors (SSRIs) as first-line treatment, individual responses vary significantly due to genetic differences. Variations in the serotonin transporter gene (SLC6A4) and the cytochrome P450 (CYP450) enzyme family have been identified as key factors influencing the efficacy, metabolism, and tolerability of SSRIs. This thesis examines the impact of polymorphisms in SLC6A4 and CYP450 on SSRI pharmacodynamics and pharmacokinetics, explores their potential for guiding personalized antidepressant therapy, and discusses the ethical and practical …

Age Of First Smartphone Ownership With Social Media Access And Its Impact On Mental Health Outcomes, Derrick W. Swandol

Doctoral Dissertations and Projects

The purpose of this quantitative study was to examine the relationship between the age of smartphone ownership with social media access (ASO) and self-esteem and depression symptoms, as well as to determine if the results could be moderated by adverse childhood experiences (ACEs) as an individual transitions from adolescence to adulthood. The study was conducted with n=54 (72% female), of whom 83% first owned a smartphone with social media access ≥ 12 years-of-age. This study was unable to obtain the minimum sample size for a statistically significant study and is considered underpowered due to needing a minimum sample size of …

Lived Experiences Of Individuals With Adverse Childhood Experiences And Mitigating Factors Of Personal Spiritual Disciplines, Carolyn Potts Simoneaux

Doctoral Dissertations and Projects

This qualitative phenomenological study sought to understand the impacts of adverse childhood experiences (ACEs) and what mitigating factors can help alleviate the pain and suffering caused by their residual life-long impacts. A literature review was done, and a gap was found on the subjects of personal spiritual disciplines (PSDs) of prayer, Bible reading/study, public/private worship, repentance and forgiveness as mitigating factors for the impacts of ACEs. This study recruited 15 participants who identified as victims of ACEs and used PSDs as mitigating factors to overcome the lifelong impacts. Interviews were done, using an online forum, to question participants on their …

Mental Health In Relation To Parental Absence: A Systematic Review, Mohammed Barry, Abdulaziz Alyahyawi, Heba Jafar Sabbagh

Saudi Medical Journal

Objective: To evaluate the literature based on the relationship between orphaned children and mental health, compared to non-orphaned children. Mental well-being of orphaned children is a profound intricate topic that connects with broader concerns of childcare. This systematic review aims to evaluate the literature regarding the relationship between mental health and parental absence. Methods: We conducted a systematic search of PubMed, MEDLINE, and Science Direct in October 2025, with 1017 screened studies. Six studies met the inclusion criteria. Independent reviewers performed quality assessments using the Newcastle-Ottawa scale (NOS). Subsequently, a meta-analysis was performed when possible. Results: Findings indicate that orphaned …

Does Mandated Paid Maternity Leave Affect Postpartum Depression?, Amaya S. Hall, Shay Y. Bullwinkel, Loran M. Hurley, Sara Cook

Epsilon Sigma at-Large Research Conference

This project analyzes the effects that paid maternity leave has on postpartum depression. Upon reviewing multiple studies, it has been demonstrated that unpaid maternity leave is associated with postpartum depression. Throughout researching postpartum depression rates, it has been proven to be much higher in unpaid leave compared to paid maternity leave. Mothers that have the burden of staying home with their infants and having to juggle time off work, without being compensated, are at an increased risk of experiencing postpartum depression. It has been shown that when a mother is able to focus on her child and her healing after …