The Effectiveness Of Weighted Blankets As A Sleep Promoting Behavior: A Quasi -Experimental Study, Irish Amalia, Sali R. Asih, Inge U. Wiswanti, Ina Saraswati

Psychological Research on Urban Society

Sleep is crucial to the overall well-being of individuals. Sleep deficiency can lead to various physical and mental health issues, including more severe insomnia, anxiety, and depressive symptoms. Improving sleep quality is often emphasized through sleep hygiene. An emerging nonpharmacological intervention is the use of weighted blankets, which apply deep-pressure stimulation to promote feelings of relaxation, comfort, and security similar to a gentle hug. This study explored the effects of weighted blankets on sleep quality and symptoms of insomnia, anxiety, and depression. Thirty participants (M = 33 years, SD = 9.13) used weighted blankets for 14 nights. They completed the …

Nurse Suicide: Examining Depression And Anxiety In Critical Care Settings, Arianna Bernardine Barata

Nursing | Student Research Posters

Nurses play a critical role in healthcare, yet the demanding work environment often exposes them to stressors, leading to the development of depression and anxiety. According to the National Library of Medicine (NLM) (2021), 50.8% of nurses have stress, 74% have anxiety, 70.8% have depression, and 79.1% have at least one of them. Burnout, understaffing, COVID fatigue, alarm fatigue, patient ratios, and disrupted sleep patterns are some of the stressors nurses contend with in every shift. While some nurses may cope and overcome these challenges, many face more severe issues, such as suicide. Nurse suicide is an issue that has …

Examining The Effect Of Genes On Depression As Mediated By Smoking And Modified By Sex, Kirsten Voorhies, Julian Hecker, Sanghun Lee, Georg Hahn, Dmitry Prokopenko, Merry-Lynn Mcdonald, Alexander C Wu, Ann Wu, John E Hokanson, Michael H Cho, Christoph Lange, Karin F Hoth, Sharon M Lutz

Faculty, Staff and Student Publications

Depression is heritable, differs by sex, and has environmental risk factors such as cigarette smoking. However, the effect of single nucleotide polymorphisms (SNPs) on depression through cigarette smoking and the role of sex is unclear. In order to examine the association of SNPs with depression and smoking in the UK Biobank with replication in the COPDGene study, we used counterfactual-based mediation analysis to test the indirect or mediated effect of SNPs on broad depression through the log of pack-years of cigarette smoking, adjusting for age, sex, current smoking status, and genetic ancestry (via principal components). In secondary analyses, we adjusted …

Educational Campaign: Using Exercise To Prevent Postpartum Depression, Ruth Platt

MSN Capstone Projects

Postpartum depression is one of the most common medical ailments surrounding childbirth. It affects up to 20% of postpartum women and has detrimental effects not only on the mother but her infant and family as well (Navas et al., 2021). Currently, the medical community takes a reactive approach to postpartum depression by screening and treating cases of postpartum depression as they occur. An evidence-based search of peer-reviewed articles found that exercise in the perinatal period had a positive effect on maternal mental health and decreased postpartum depression scores. This is especially true for women who have a history of depression …

Exploring How Pentecostals Preach About Depression, Robert D. Mcbain

Salubritas: International Journal of Spirit-Empowered Counseling

A qualitative analysis was completed on twelve sermons into how Pentecostal preachers talk about depression from the pulpit using the Assemblies of God (AG) as a purposive sample. Findings illustrate that preachers talked about faulty thinking as the source of depression and interpreted depression as a transformative journey occurring within the context of a God encounter where the believer fixed their faulty thinking. While the way the preachers interpreted depression is not without critique, the article suggests that preaching about depression as a journey of encounter may help listeners frame their depression experiences within a narrative framework that helps them …

Impact Of Parental Spirituality On Child Depression, Anxiety, And Ptsd After A Surgical Procedure, Ashlee M. Schendel

Honors Thesis

Higher levels of religiosity and spirituality (R/S) have been associated with lower levels of depressive symptoms (Lucchetti, Koenig, & Lucchetti, 2021; Braam & Koenig, 2019). While it is unknown why the relationship exists, it may be a result of the social support obtained from attending a place of worship (Gwin et al., 2020). The relationship between anxiety and R/S is far more mixed, with studies having found both positive and negative correlations (Lucchetti, Koenig, & Lucchetti, 2021). It is theorized spirituality may be used to cope with anxiety both negatively (e.g., God hates me) and positively (e.g., God wants to …

Evaluating The Efficacy Of Universal Depression Screenings In The High School Setting, Telisha Anthony Msn, Fnp-Bc, Jennifer Thorsen Bsn, Rn, Jackie Sharp Dnp, Pmhnp-Bc, Sharon Little Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Depression in adolescents is rising each year. Early detection of depression has been shown to result in better health outcomes and success in school. This scoping review aims to evaluate the implementation of universal depression screenings in the high school setting and how this detection of depression and initiation of treatment.

Methods

From August 2022 to November 2023, we used the Medline, PubMed, Elsevier, Google Scholar, and PsycINFO databases, using specific keywords related to depression in adolescents. Of the 38 articles found, 10 were chosen after extensive article critique. The publication dates ranged from 2014-2023, were full-text, and from …

Implementing Universal Adult Depression Screening In A Rural Maine Free Medical Clinic, Karen Hussion

Doctor of Nursing Practice Scholarly Projects

Abstract

BACKGROUND: Depression in adults is a leading cause of disability, morbidity and mortality worldwide with an estimated prevalence of 20% in the US population. Despite estimates that one out of every five Americans suffers from depression, less than 50% of adult primary care patients with depression are identified, and less than 5% of all adult primary care patients are screened. To increase early detection and management of depression, the United States Protective Service Task Force (USPSTF) recommends routine depression screening for adults older than 18 years in primary care settings.

LOCAL PROBLEM: This project site was a rural, free, …

When They Just Don’T Sleep: Differential Impacts Of Reduced Child Sleep On Depression, Anxiety, And Stress Among Caregivers Of Children With And Without Neurogenetic Syndromes, Kimberly Galvez-Ortega, Kristine Marceau, Dan Foti, Bridgette Kelleher

Purdue University Libraries Open Access Publishing Fund

Introduction: Children with neurogenetic syndromes commonly experience significant and pervasive sleep disturbances, however, associations with caregiver mental health remains unclear. Previous studies have linked sleep disturbances with increased caregiver depression in typically developing populations, and heightened caregiver stress among neurogenetic populations. The present study expands on findings by exploring the longitudinal association between child sleep duration and caregiver mental health (depression, anxiety, stress) throughout development (infancy to school-aged children) in dyads with and without a child affected by a neurogenetic syndrome.

Methods: Participants were drawn from the Purdue Early Phenotype Study, including 193 caregivers (Age: M = 34.40 years, SD …

Depression And Other Risk Factors Of Suicide, Mckenna Newnam, Jaeyong Choi

Criminal Justice Student Work

Substance abuse, other mental disorders, and individual characteristics all play a role in the risk of suicide when concurrent with depression. Far more research exists on depression as it effects suicide alone. Future research needs to focus on depression as it effects suicide and explore the other possible factors that can impact the outcome. Understanding the different aspects of depression as it effects suicide will provide a template for scholars and individuals involved in the mental health system to enhance treatment.

Stroke-Related Mental Health Challenges And Interventions: Strategies For Holistic Recovery, Christopher Walsh, Sam Lee

MOT Student Capstones

This capstone project examines the relationship between post-stroke and mental health. It presents the necessity for a holistic and client-centered approach in the recovery process. Through a mixed-methods approach combining a literature review and empirical research, including surveys of stroke survivors, caregivers, and practitioners, the study shows the prevalence of depression and anxiety post-stroke and the potential benefit of comprehensive mental health support. The findings emphasize the importance of community, spirituality, and proactive education in enhancing mental well-being. The effectiveness of specific interventions for this population was found to be variable, which warrants the use of personalized assessments and intervention …

My Journey In Researching Depression Among Black People: Experiences Of A Researcher In A Sensitive Study, Brightness L. Kgatla

The Qualitative Report

The interest in qualitative research on mental health within Black communities is rapidly growing. However, there are still debates on the conceptualization of depression among the Black community. This paper focuses on the researcher’s experiences as a young Black South African experiencing depression, and their reflections on interpretivist qualitative research focused on the realities of Black South African youth experiencing depression. The paper highlights the importance of reflexivity in a qualitative study and how the topics researched by a Black South African experiencing depression which is still considered a taboo within some parts of the Black community. If a researcher …

Effects Of Electrical Exercise On Self-Reported Depression And Quality Of Life In Those With Spinal Cord Injury, Aj Barber, Eric Heidorn, John Mcdaniel, Cody S. Dulaney

International Journal of Exercise Science: Conference Proceedings

One of the most common psychological disorders that occur as a result of spinal cord injury (SCI) is depression along with reductions in quality of life. Moreover, depression is correlated with quality of life. It is increasingly apparent that exercise offers an accessible and non-pharmacological intervention to ease depressive symptoms and improve quality of life. Unfortunately, access to meaningful exercise options remains challenging to those with mobility impairments such as those seen with SCI. PURPOSE: The purpose of this study was to assess the chronic engagement of home-based electrical stimulation exercise (ESE) on self-reported depression and quality of life …

Individual Differences In Cannabis Use Disorder With Implications For Endocannabinoid Modulation In Therapeutics Development, Erin L. Martin

MUSC Theses and Dissertations

Cannabis use disorder (CUD) is increasingly prevalent in the United States, but there is no effective pharmacological means to treat it. The endocannabinoid (eCB) system has emerged as a candidate therapeutic target demonstrating some evidence of efficacy in treating CUD. However, clinical trials evaluating eCB-modulating therapeutics have historically undervalued individual differences that could contribute to variation in treatment outcome (e.g. sex, comorbid psychiatric illness). To address this gap in the literature, the present set of studies (a) compared plasma eCB tone in groups underrepresented in treatment trials for CUD (females, individuals with comorbid major depressive disorder; MDD/CUD) with males or …

Abnormal Neural Sensitivity To Rewards As A Candidate Process Of High Depression Risk In The Fmr1 Premutation: A Pilot Study, Roslyn Harold, Bridgette Kelleher, Keisha Novak, Wei Siong Neo, Teagan Stump, Taylor Lee, Tessa Garwood, Elizabeth Berry-Kravis, Dan Foti

Purdue University Libraries Open Access Publishing Fund

The etiological heterogeneity of depression poses a challenge for prevention and intervention efforts. One solution is to map unique etiological pathways for subgroups defined by a singular risk factor. A relevant population for this approach is women who carry the premutation of the fragile X messenger ribonucleoprotein 1 (FMR1) gene, who are at high risk for adult-onset depression. This study explores a candidate neurophysiological marker of depression risk: reduced reward sensitivity, indexed by the reward positivity (RewP). The RewP has been linked to depression risk in the general population, but is unexplored within FMR1 premutation carriers. 16 women with the …

Perioperative Mental Health Intervention For Depression And Anxiety Symptoms In Older Adults Study Protocol: Design And Methods For Three Linked Randomised Controlled Trials, Katherine J Holzer, Kimberly A Bartosiak, Ryan P Calfee, Chet W Hammill, Simon Haroutounian, Benjamin D Kozower, Theresa A Cordner, Emily M Lenard, Kenneth E Freedland, Bethany R Tellor Pennington, J Philip Miller, Mary C Politi, Yi Zhang, Michael D Yingling, Ana A Baumann, Thomas Kannampallil, Julia A Schweiger, Sherry L Mckinnon, Michael S Avidan, Eric J Lenze, Joanna Abraham, Et Al.

2020-Current year OA Pubs

INTRODUCTION: Preoperative anxiety and depression symptoms among older surgical patients are associated with poor postoperative outcomes, yet evidence-based interventions for anxiety and depression have not been applied within this setting. We present a protocol for randomised controlled trials (RCTs) in three surgical cohorts: cardiac, oncological and orthopaedic, investigating whether a perioperative mental health intervention, with psychological and pharmacological components, reduces perioperative symptoms of depression and anxiety in older surgical patients.

METHODS AND ANALYSIS: Adults ≥60 years undergoing cardiac, orthopaedic or oncological surgery will be enrolled in one of three-linked type 1 hybrid effectiveness/implementation RCTs that will be conducted in tandem …

Let’S Move! Benefits Of Exercise Compared To Ssris (Escitalopram) For The Management Of Depression: Research From 2020 And Beyond, Brianna Droessler-Aschliman

Physician Assistant Scholarly Project Posters

• Purpose: Determine the effectiveness of exercise as either monotherapy or in combination with SSRIs (selective serotonin reuptake inhibitors) for the management of major depressive disorder.

• Studies gathered for this review came from the following databases: PubMed, SpringerLink, Academic Search Ultimate, Academic Search Complete, and CINAHL.

• Review of current research that was completed between the years 2020-2023 that consisted of either clinical trials, RCTs, or meta-analysis. • Upon completion of the literature review: exercise is equivocal to SSRIs as a treatment option. While this is a significant finding, the benefits of exercises are more consistent in those that …

The Psychological Effects Of Solitary Confinement On Incarcerated Individuals: A Systematic Literature Review, Lara Z. Parkes, Jonathan C. Dowers

Selected Student Publications

This systematic literature review looks at previous research that explores the possibility of a correlation between solitary confinement and the presence of mental illness within those isolated inmates. Twenty percent of prison inmates experience isolation for up to twenty-two hours per day with restricted social interaction and limited amenities (Hagan et al., 2018; Ryan & DeVylder, 2020). Certain inmate demographics are more likely to be sent into isolation in an effort to protect themselves or others, including members of the LGBTQIA+ community, the developmentally impaired, and the mentally ill. However, this practice often has the opposite of its intended effect. …

Acute Post-Surgery Education And Occupational Therapy For Improved Outcomes In Rural Below Knee Amputation Patients, Spencer Mauk

MOT Student Capstones

Below knee amputation (BKA) patients who live in a rural setting see poorer functional outcomes, face systemic healthcare barriers, and have limited access to necessary healthcare resources. To improve this population's outcomes a project aimed to improve acute occupational therapy (OT) approaches for BKA patients in rural areas was developed. This project started with a literature review to identify existing best practices and gaps in post-operative care. The study also analyzed current educational materials, therapy protocols, and practices. The project's main goal was to develop educational and intervention materials catered to the health literacy levels of rural BKA patients. These …

Improving Depression Screening In Primary Care, Grace Wilson, Annmarie O'Connor

Doctor of Nursing Practice Projects

Depression remains an increasingly prevalent and underdiagnosed disorder affecting approximately 21 million adults in the United States with only 66% seeking treatment (NIMH, 2022). Untreated depression can lead to worsening mental and physical health which negatively impacts a person’s quality of life. The implementation of routine depression screening in primary care is recommended by the US Preventive Services Task Force (USPSTF) to improve early detection leading to improved outcomes (USPSTF, 2023). Despite increased depression prevalence and USPSTF recommendation, there remained an absence of routine depression screening in a primary care practice in Midwest Illinois which led to the development of …

Implementation Of Electronically Integrated Pediatric Screening Templates, Kayla Seed

Doctor of Nursing Practice Projects

Evidence-based clinic guidelines improve patient outcomes by providing clinicians with research-based recommendations, and when combined with the electronic health record (EHR), clinicians have the potential to improve their documentation and reduce the time it takes to document a patient encounter. A pediatric clinic in the metro-east area of Southern Illinois lacked EHR templates during patient encounters that focused on depression, anxiety, ADHD, and concussion screening. Templates embedded in the EHR were created in a SOAP note format to aid the clinicians during patient encounters and aid in documentation. Clinicians were asked to utilize the templates over a 6-week period. The …

Examining The Effects Of Social Group Persecution And Traumatic Humiliation In Survivors Of Torture, Tilda Cvrkel

Clinical Psychology Dissertations

Refugees and asylum seekers account for 34.4 million people worldwide (UNHCR, 2021), and up to 40% of this population are survivors of torture (UNHCR, 2017). The Istanbul Protocol (United Nations, 2022) describes one of the explicit ends of torture as the severing of a person from their community, a breaking of their dignity and humanity. This may be done explicitly, through acts of traumatic humiliation. Traumatic humiliation includes acts such as forcing victims to eat religiously forbidden food, forced posing or touching others in culturally taboo sexual ways, forced nudity or clothing that reflects misgendering (such as “emasculating” clothing), widespread …

Differential Effects Of Type 2 Diabetes Treatment Regimens On Diabetes Distress And Depressive Symptoms In The Glycemia Reduction Approaches In Diabetes: A Comparative Effectiveness Study (Grade), Jeffrey S Gonzalez, Ionut Bebu, Heidi Krause-Steinrauf, Claire J Hoogendoorn, Gladys Crespo-Ramos, Caroline Presley, Aanand D Naik, Shihchen Kuo, Mary L Johnson, Deborah Wexler, Jill P Crandall, Anne E Bantle, Valerie Arends, Andrea L Cherrington

Faculty, Staff and Student Publications

Objective: We evaluated whether adding basal insulin to metformin in adults with early type 2 diabetes mellitus (T2DM) would increase emotional distress relative to other treatments.

Research design and methods: The Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE) of adults with T2DM of < 10 years' duration, HbA1c 6.8-8.5%, and taking metformin monotherapy randomly assigned participants to add insulin glargine U-100, sulfonylurea glimepiride, the glucagon-like peptide-1 receptor agonist liraglutide, or the dipeptidyl peptidase 4 inhibitor sitagliptin. The Emotional Distress Substudy enrolled 1,739 GRADE participants (mean [SD] age 58.0 [10.2] years, 32% female, 56% non-Hispanic White, 18% non-Hispanic Black, 17% Hispanic) and assessed diabetes distress and depressive symptoms every 6 months. Analyses examined differences at 1 year and over the 3-year follow-up.

Results: Across treatments, diabetes distress (-0.24, P < 0.0001) and depressive symptoms (-0.67, P < 0.0001) decreased over 1 year. Diabetes distress was lower at 1 year for the glargine group than for the other groups combined (-0.10, P = 0.002). Diabetes distress was also lower for liraglutide than for glimepiride or sitagliptin (-0.10, P = 0.008). Over the 3-year follow-up, there were no significant group differences in total diabetes distress; interpersonal diabetes distress remained lower for those assigned to liraglutide. No significant differences were observed for depressive symptoms.

Conclusions: Contrary to expectations, this randomized trial found no evidence for a deleterious effect of basal insulin on emotional distress. Glargine lowered diabetes distress modestly at 1 year rather than increasing it. Liraglutide also reduced diabetes distress at 1 year. Results can inform treatment decisions for adults …

Cross-Cultural Equivalence Of The Kessler Psychological Distress Scale (K10) Across Four African Countries In A Multi-National Study Of Adults, Amantia Ametaj, Christy Denckla, Anne Stevenson, Rocky Stroud, Jasmine Hall, Linnet Ongeri, Barkot Milkias, Jacob Hoffman, Lukoye Atwoli, Stella Gichuru

Internal Medicine, East Africa

The Kessler Psychological Distress Scale (K10) has been widely used to screen psychological distress across many countries. However, its performance has not been extensively studied in Africa. The present study sought to evaluate and compare measurement properties of the K10 across four African countries: Ethiopia, Kenya, Uganda, and South Africa. Our hypothesis is that the measure will show equivalence across all. Data are drawn from a neuropsychiatric genetic study among adult participants (N = 9179) from general medical settings in Ethiopia (n = 1928), Kenya (n = 2556), Uganda (n = 2104), and South Africa (n = 2591). A unidimensional …

Reciprocal Relationships Between Stress And Depressive Symptoms: The Essential Role Of The Nucleus Accumbens, Yizhou Ma, Peter Kochunov, Mark D Kvarta, Tara Legates, Bhim M Adhikari, Joshua Chiappelli, Andrew Van Der Vaart, Eric L Goldwaser, Heather Bruce, Kathryn S Hatch, Si Gao, Shuo Chen, Ann Summerfelt, Thomas E Nichols, L Elliot Hong

Faculty, Staff and Student Publications

BACKGROUND: Stress and depression have a reciprocal relationship, but the neural underpinnings of this reciprocity are unclear. We investigated neuroimaging phenotypes that facilitate the reciprocity between stress and depressive symptoms.

METHODS: In total, 22 195 participants (52.0% females) from the population-based UK Biobank study completed two visits (initial visit: 2006-2010, age = 55.0 ± 7.5 [40-70] years; second visit: 2014-2019; age = 62.7 ± 7.5 [44-80] years). Structural equation modeling was used to examine the longitudinal relationship between self-report stressful life events (SLEs) and depressive symptoms. Cross-sectional data were used to examine the overlap between neuroimaging correlates of SLEs and …

Hubungan Tingkat Stres, Kecemasan, Dan Depresi Dengan Konstipasi Fungsional Pada Mahasiswa Kedokteran, Khafifah Z, Wilson Wilson, Agustina Arundina Triharja Tejoyuwono

Jurnal Penyakit Dalam Indonesia

Introduction. Stress, anxiety, and depression are factors associated with functional constipation that affect students’ quality of life. Stress, anxiety, and depression are often experienced by first-year medical students, but studies assessing these three variables with functional constipation are still limited.

Methods. This study used a cross-sectional analytical design. Study was carried out in July 2023 involving 88 first-year medical students from the Tanjungpura University Medical Study Program. Analysis of relationship tests was carried out using Kendall’s Tau-B tests.

Results. Most students were in the normal category of stress, anxiety and depression levels, however 21 students were in …

The Psychological Burden Of Nmosd - A Mixed Method Study Of Patients And Caregivers, Darcy C. Esiason, Nicole Ciesinski, Chelsi N. Nurse, Wendy Erler, Tom Hattrich, Ankita Deshpande, C. Virginia O'Hayer

Department of Psychiatry and Human Behavior Faculty Papers

Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory disorder of the central nervous system with common symptoms of rapid onset of eye pain, loss of vision, neck/back pain, paralysis, bowel and bladder dysfunction and heat sensitivity. The rare, unpredictable, and debilitating nature of NMOSD constitutes a unique psychological burden for patients and their caregivers, the specific nature and extent of which is not yet known. This mixed methods study, informed by both quantitative and qualitative data collected via self-report measures, focus groups, and in-depth interviews, aims to investigate and understand the psychological burden of patients with NMOSD and their caregiver/loved …

Profiles Of Latinx Cultural Orientation Among Adolescents: Associations With Internalizing Symptoms And Moderation By Ethnic-Racial Discrimination, Miriam Ortiz, Fantasy T. Lozada, Oswaldo Moreno, Chelsea D. Williams, Brendesha M. Tynes

Psychological Science Faculty Publications

Introduction: The objectives of the current study were the following: (1) to explore multidimensional profiles of Latinx cultural orientation using Spanish language use, familismo, and ethnic-racial identity (ERI) affirmation among Latinx adolescents, (2) to test how Latinx cultural orientation profiles were associated with adolescents' internalizing symptoms (i.e., depressive symptoms and anxiety symptoms), and (3) to test whether associations between profiles and internalizing symptoms were moderated by adolescents' ethnic-racial discrimination experiences.

Methods: The study was conducted among a sample of 204 Latinx adolescents (52.4% female; Mage = 14.35, SDage = 1.75).

Results: Latent profile analysis indicated four profiles of Latinx cultural …

The Reality Of Psychological Preparation Among Jordanian National Teams For Individual Sports During The Coronavirus Outbreak, Ayed Zureigat, Osama Abdel Fattah

Jordan Journal of Applied Science-Humanities Series

This study aimed to identify the reality of psychological preparation among players of the Jordanian national teams for individual sports during the Coronavirus outbreak. Additionally, it sought to assess the levels of depression and anxiety among these players during the same period. To achieve this, a descriptive method was employed with a sample consisting of 54 participants. To minimize face-to-face interaction, an electronic questionnaire was created using Google Forms, containing 28 items addressing depression, anxiety, and psychological methods used with players. Of these items, 12 were related to depression and anxiety, while 16 were focused on psychological methods. To analyze …

Russians Fleeing Putin’S Country: Trauma, Daily Stressors, Anxiety, Depression, Post Traumatic Stress Disorder, Maria Mccready, David Witherington, Steven Verney, Dmitry Boltyanskiy

Brain & Behavioral Health Research Day

The turmoil unleashed by the Russian invasion of Ukraine in February 2022 triggered a mass migration of individuals from Russia to nearby countries like Armenia and Georgia. Amidst this upheaval, concerns have arisen regarding the mental well-being of Russian emigrants and their experiences during this turbulent period. To bridge this gap in knowledge, our study aims to examine the mental health status of adult Russian emigrants who departed from their homeland after the beginning of the conflict.

Drawing from a sample of 67 participants, comprising 30 females and 3 non-binary individuals, our research focuses on communities in Armenia and Georgia, …