Digital Commons Network^™

Association Between Climate Change Awareness And Depression & Anxiety: Findings From A U.S. Sample, Stanley Nkemjika, Colvette Brown, Henry Onyeaka, Srikanta Banerjee, Jennifer Oliphant

Department of Psychiatry and Human Behavior Faculty Papers

BACKGROUND: Exploring the connection between climate change awareness and overall well-being is crucial, particularly in how it impacts both the environment and mental health. The mental health consequences of climate change and its awareness have not been thoroughly examined, especially in the U.S. In this study, the relationship between awareness of climate change and depression or anxiety among U.S. adults was explored. Similarly, the role of climate change awareness has not been explored in relation to mental health concerns.

METHODS: Based on the HINTS-6 dataset, a nationally representative, cross-sectional survey conducted by the National Cancer Institute, a variety of statistical …

A Qualitative Exploration Of Child, Caregiver, And Clinician Perspectives On Mental Health In Children With Osteogenesis Imperfecta, Justin H Qian, Andrew D Wiese, Clarissa Gonzalez, Whitney S Shepherd, Hannah Cho, Gianna M Colombo, Julia M Morales, Selena Guo, Kristin M Kostick-Quenet, Dianne Nguyen, Sophie C Schneider, Kara Ayers, Members Of The Bbdc, Marie-Eve Robinson, Chaya N Murali, Brendan Lee, V Reid Sutton, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Osteogenesis imperfecta (OI) is a heritable connective disorder with clinical manifestations including bone fragility and short stature. Previous research identified psychosocial themes related to mental health among children with OI and their caregivers, such as independence, social isolation, depression, and anxiety. Several studies have also examined clinicians of individuals with OI for their perspectives on mental health among their patients. However, no known studies have compared psychosocial themes among all three participant groups concurrently. This qualitative study examined mood and anxiety, along with risk and protective factors, from perspectives of youths, parents, and clinicians. Semi-structured interviews were conducted, which were …

Prevalence And Factors Associated With Depression, Anxiety And Post-Traumatic Stress Disorder Among Healthcare Workers From Sub-Saharan Africa: Systematic Review, Ezra Too, Peninah Wachira, Solomon Njenga, Sabina Odero, Eunice Ndirangu, Amina Abubakar

Institute for Human Development, East Africa

Background: Depression, anxiety and post-traumatic stress disorder (PTSD) are prevalent among healthcare workers (HCWs), including those from sub-Saharan Africa (SSA). However, there are limited summary data on the burden and factors associated with these disorders in this region. We conducted this systematic review (registration no. CRD42022349136) to fill this gap.

Aims: The aim of this review was to systematically summarise the available evidence on the prevalence and factors associated with depression, anxiety and PTSD, or their symptoms, among HCWs from SSA.

Method: We searched African Index Medicus, African Journals Online, CINAHL, PsycINFO and PubMed for articles published, from database inception …

Media And Mindfulness: Associations Between Adolescent Mindful Social Media Use, Chenae Christensen-Duerden, Sarah Coyne

Journal of Youth Development

The objective of this study is to examine social media mindfulness and other social media habits as predictors of depression in adolescents. As depression and poor mental health increase for American adolescents, so does the research surrounding the positive outcomes associated with mindfulness. It is possible that mindfulness could be an effective tool in managing individual social media habits, however, very little research exists exploring the effects of mindfulness on media use. The sample for the current study includes a national quota sample of 1,158 adolescents (between the ages of 10 and 17 years old) from the United States. Participants …

Prevalence Of Depression, Anxiety, Burden, Burnout, And Stress In Informal Caregivers: An Umbrella Review Of Meta-Analyses, Xun Ci Soh, Andree Hartanto, Naoki Ling, Mayr Reyes, Lester Sim, Nadyanna M. Majeed

Research Collection School of Social Sciences

Informal caregiving is a physically and emotionally taxing role that has a profound impact on caregivers’ emotional and mental well-being. Previous research has examined the mental health of caregivers and found elevated levels of depression, anxiety, burden, burnout, or stress. However, the global rates of the five mental health factors and/or outcomes (i.e., depression, anxiety, burden, burnout, and stress) among caregivers remain largely unclear. Therefore, this umbrella review examines the prevalence of these factors and/or outcomes, including various subgroup factors, such as gender, medical and/or psychological condition of the care recipient, region, and assessment tools. A systematic search was conducted …

Heightened Risk: Childhood Trauma And Anticipatory Grief Exacerbate The Impact Of Loneliness On Depressive Symptoms And Lps-Stimulated Cytokines In Dementia Caregivers, Kelly N Brice, Jensine Paoletti-Hatcher, E Lydia Wu-Chung, Vincent D Lai, Daniel L Argueta, Michelle A Chen, Itee Mahant, Bryan T Denny, Charles Green, Luis D Medina, Paul Schulz, Jennifer Stinson, Samantha K Henry, Cobi Heijnen, Christopher P Fagundes

Faculty, Staff and Student Publications

Dementia spousal caregivers are at a disproportionate risk for adverse mental and physical health outcomes. Loneliness is associated with depressive symptoms and proinflammatory cytokine production among caregivers. Additionally, childhood trauma, anticipatory grief, and poor sleep quality are all associated with enhanced stress reactivity. This study used a cross-sectional design to investigate whether loneliness is associated with proinflammatory cytokine production and depressive symptoms in caregivers, and whether these relationships are strongest among caregivers who report high levels of childhood trauma, high amounts of anticipatory grief, or poor sleep quality. A sample of 111 dementia spousal caregivers provided blood samples and completed …

An Epidemiological Exploration Of Binge Eating Disorder And Its Emotional Roots Among Youth In Greater Jakarta, Henny Kurniati, Yudha Asy'ari, Tri Amelia Rahmitha Helmi, Tonny Sundjaya

Jurnal Epidemiologi Kesehatan Indonesia

The rising prevalence of mental disorders among youth, including depression, anxiety, stress, and binge eating disorder (BED), has become a major concern in the context of global mental health. BED, as a form of eating disorder, often occurs with psychological conditions such as anxiety and depression, complicating diagnosis and treatment. This study aimed to investigate the prevalence and association between depression, anxiety, stress, and BED among youth in Greater Jakarta. Using a cross-sectional online design, data were collected from 231 participants aged 18-25 years through the Binge Eating Scale (BES) and Depression Anxiety Stress Scale-21 (DASS-21). Statistical analysis involved bivariate …

Does Spirituality Mediate Or Moderate The Adverse Effects Of Occupational Stressors On Mental Health In Law Enforcement Officers?, Erika D. Keplinger

Doctoral Dissertations and Projects

Law enforcement officers are often exposed to occupational stressors that can negatively affect their mental health and job performance. Spirituality has been thoroughly researched as a restorative method to improve physical and psychological health concerns. There has also been an increase in studies on workplace spirituality. The existing research on workplace spirituality suggests that incorporating spirituality into the workplace increases employee well-being and decreases stress and burnout. Unfortunately, research on police culture often neglects spirituality. There is little research to show how spirituality could mediate or moderate the adverse effects of mental health on law enforcement officers. This quasi-experimental, cross-sectional, …

Exploring The Relationship Between Depression And Implicit Bias In The Courtroom, Mary Nicole Williams

Doctoral Dissertations and Projects

This phenomenological study explored the lived experiences of people with depression as they participated in the juror experience to understand the relationship between depression, implicit biases, and the impacts on juror decision-making. Ten adults with depression participated in the experiment which consisted of being presented with a mock assault case vignette, responding to interview questions, and then being presented with new information about the defendant’s mental health condition, after which additional interview questions were asked. Three research questions guided the study, and they sought to understand if there were shared patterns in the decision-making process, in perceptions of culpability, and …

Social Media And Mental Health According To Generation Z: A Health Belief Model-Based Cross-Sectional Evaluation Of Generation Z Adults’ Attitudes And Perceptions Of Problematic Social Media Use And Its Relationship With Depression And Anxiety, Michael Chad Gann

Doctoral Dissertations and Projects

Purpose: This study aimed to examine Generation Z adults’ attitudes and perceptions of problematic social media use (PSMU) as they relate to mental health problems (depression and anxiety) through the lens of the Mental Health Belief Model.

Methods: A cross-sectional, web-based survey gathered data from a convenience sample (N = 353) of Generation Z adults (age 18-30) after receiving approval from the LU IRB. The previously validated instrument battery included the Bergen Social Media Addiction Scale (BSMAS), the Patient Health Questionaire – 9 (PHQ-9), the Generalized Anxiety Disorder – 7 (GAD-7), and the Greene (2012) MHBM subscales for perceived susceptibility …

The After Effects Of The Covid-19 Pandemic On The Mental Health Of International V/S Domestic Students - A Qualitative Study, Keerat Sidhu Bhatti

Doctoral Dissertations

The COVID-19 pandemic significantly impacted the mental health of both international and domestic graduate students, exacerbating social isolation, financial strain, and psychological distress. This qualitative study examines the long-term effects of the pandemic on these student populations, exploring shared and divergent experiences, coping strategies, and evolving priorities. While both groups faced heightened anxiety and academic disruptions, international students encountered additional stressors, including cultural displacement, visa uncertainties, and limited support networks. Domestic students, in contrast, struggled with routine disruptions but had greater access to familial and social support. Across both groups, the pandemic prompted a reassessment of personal and professional priorities, …

Risk Of Major Depression In Partners Of People With Alzheimer's Disease: A National Cohort Study, Casey Crump, Jingkai Wei, Barbara G Vickrey, Alexis C Edwards, Paul E Schulz, Weiva Sieh, Jan Sundquist, Kristina Sundquist

Faculty, Staff and Student Publications

Background: Alzheimer's disease (AD) may cause significant psychosocial distress not only in the patient but also their partner. However, long-term risks of major depression in partners of AD patients are largely unknown.

Methods: A national cohort study was conducted of all 145 289 partners of people diagnosed with all-cause dementia, including 57 113 partners of people diagnosed with AD, in Sweden during 1998-2017, and 1 300 561 population-based controls. Cox regression was used to compute hazard ratios (HRs) for subsequent risk of major depression identified from nationwide outpatient and inpatient diagnoses through 2018, adjusting for sociodemographic factors and prior mental …

Reminisce And Relive Joyful Memories Despite Dementia, Candice Cacal Nono

Creating Healthy Work Environments (CHWE)

Background: Dementia is a progressive neurological disease that affects cognition and behavioral and mood impairments, such as depression, that must be addressed. The DNP Project implemented an evidence-based intervention to improve healthcare outcomes involving depression in patients with dementia in a long-term care setting.

Problem: Dementia is a progressive neurological disease affecting mood and conditions that can lead to depression, affecting a patient’s quality of life. A quality improvement project was implemented in a long term care facility in Chicago, Illinois.

Methods: Eight residents with mild to moderate dementia participated in an eight-week Group Reminiscence Therapy program to measure the …

Confronting The Digital Epidemic: Excessive Social Media Use (Smu) In The Wellbeing Of Young Adult Populations, Joanna Abellera

McNair Research Journal SJSU

This study will investigate the relationship between social media as a

mediator and its effects on depressive symptoms, using Social Comparisons

theory (SCT; Festinger, 1954) as a framework. A series of 8-10 articles,

obtained through the San Jose State Library Database and PsycINFO, will

explore the nature of social media addiction (SMA) and problematic social

media use (PSMU) and its relation to self-esteem of young adult

populations by comparing theoretical perspectives (i.e., cross-sectional and

experimental designs) in the literature. Studies have found that [increased

SMU has been correlated with negative outcomes such as depression,

loneliness, and increased envy]. Future studies …

Personality As A Moderator Of The Relationship Between Casual Sex Behavior And Psychopathology, Dean J. Harris

Theses and Graduate Projects

Prior research has evaluated the impact of casual sex on mental health outcomes; however, there is a lack of research on the possible moderating effects of personality traits on this relationship. Thus, the purpose of this study was to clarify whether personality traits -specifically extraversion and neuroticism- are protective or risk factors for symptoms of anxiety and depression among individuals who engage in casual sexual behaviors, particularly in college-aged individuals. Using a cross-sectional design, 108 participants who met survey criteria completed self-report measures assessing casual sex behavior, the PHQ-9, the GAD-7, the International Big-Five Mini- Markers, and demographic questions. Moderation …

Understanding The Gaming Disorder–Depression Co-Occurrence: A Narrative Literature Review, An-Pyng Sun, Stephanie Diez

Social Work Faculty Research

Because gaming disorder (GD) often co-occurs with depression, understanding how both disorders work together enables clinicians to better treat individuals with GD–depression comorbidity. The extant literature on GD–depression comorbidity is unsystematic and contradictory, with some studies suggesting depression predicts GD but not vice versa, some claiming GD predicts depression but not vice versa, and some proposing a bidirectional relationship between the two. The goal of this narrative review is to explore and organize these findings to establish a holistic and coherent conceptual framework that explains how GD co-occurs with depression.

The PubMed, PsycINFO, and Web of Sciences databases were searched …

Resilience And Mental Health: Unraveling The Interplay Of Depression, Anxiety, And Stress In First-Generation College Students, Indyah Ferrouillet, Bemsimbom Nkuo, Patrick J. Cooper

Faculty and Staff Publications & Presentations

Research suggests a moderate incidence of depression, anxiety, and especially stress among college students (Ramon-Arbues et al., 2020). It is reasonable to believe that these mental health outcomes might be inversely correlated with resilience, the ability to adapt to new challenges. In this study, we hypothesize an inverse correlation between resilience stress, anxiety, and depression. In other words, college students who feel resilient will experience greater mental health and wellness. Building on previous research that suggests these effects in women only (Ahmed & Julius, 2015), gender differences will be examined. Few studies have attempted to see whether these correlations are …

Executive Functioning And Mental Health In Emerging Adults: Type 1 Diabetes Status As A Moderator, Hannah Margot Mcdaniel

Theses and Dissertations

Emerging adults (ages 18-26) with type 1 diabetes mellitus (T1DM) are especially vulnerable to diabetes management challenges when taking on increased disease responsibility during this critical period of development. They may experience higher cognitive and psychological demands compared to peers. The study examined whether having T1DM moderated the association between executive functioning (EF) and mental health symptoms (i.e., depression, anxiety, stress, and disordered eating) in emerging adults. Exploratory analyses investigated the associations between EF, disease management, and mental health symptoms. Participants were 35 emerging adults with T1DM and 35 healthy controls. Participants completed questionnaire measures of mental health and performance-based …

Defining Treatment-Resistant Bipolar Depression: Recommendations From The Isbd Task Force, Eduard Vieta, Roger S Mcintyre, Trisha Suppes, Tamsyn E Van Rheenen, Balwinder Singh, Kamilla Woznica Miskowiak, Allan H Young, Lakshmi N Yatham, Kyooseob Ha, Michael Berk, Holly A Swartz, Chantal Henry, Maja Pantovic Stefanovic, Gerard Anmella Diaz, Aysegul Ozerdem, Wiesław J Cubała, Diego Hidalgo-Mazzei, Mauricio Tohen, Isabella Pacchiarotti, Paula Villela Nunes, Carlos Lopez-Jaramillo, Ana Gonzalez-Pinto, Paolo Brambilla, Robert Post, Jair C Soares, Michael Bauer, Ana C Andreazza, Xavier Justes Fradera, Montserrat Cosials-Lopez, Giovanna Fico

Faculty, Staff and Student Publications

Objective: Despite the availability of approved treatments, a substantial proportion of patients with bipolar disorder experience treatment-resistant bipolar depression (TRBD), characterized by persistent depressive symptoms unresponsive to standard therapies. However, a universally accepted definition of TRBD is lacking. This consensus document, developed by the International Society for Bipolar Disorders (ISBD) Task Force on TRBD, aims to provide a standardized definition of TRBD to facilitate clinical trials, research, and treatment strategies.

Methods: The Task Force employed a literature review, clinical trials analysis, and expert consensus meetings to define TRBD.

Results: TRBD was defined as the failure to achieve a significant and …

Defining Treatment-Resistant Bipolar Depression: Recommendations From The Isbd Task Force, Eduard Vieta, Roger S Mcintyre, Trisha Suppes, Tamsyn E Van Rheenen, Balwinder Singh, Kamilla Woznica Miskowiak, Allan H Young, Lakshmi N Yatham, Kyooseob Ha, Michael Berk, Holly A Swartz, Chantal Henry, Maja Pantovic Stefanovic, Gerard Anmella Diaz, Aysegul Ozerdem, Wiesław J Cubała, Diego Hidalgo-Mazzei, Mauricio Tohen, Isabella Pacchiarotti, Paula Villela Nunes, Carlos Lopez-Jaramillo, Ana Gonzalez-Pinto, Paolo Brambilla, Robert Post, Jair C Soares, Michael Bauer, Ana C Andreazza, Xavier Justes Fradera, Montserrat Cosials-Lopez, Giovanna Fico

Faculty, Staff and Student Publications

Objective: Despite the availability of approved treatments, a substantial proportion of patients with bipolar disorder experience treatment-resistant bipolar depression (TRBD), characterized by persistent depressive symptoms unresponsive to standard therapies. However, a universally accepted definition of TRBD is lacking. This consensus document, developed by the International Society for Bipolar Disorders (ISBD) Task Force on TRBD, aims to provide a standardized definition of TRBD to facilitate clinical trials, research, and treatment strategies.

Methods: The Task Force employed a literature review, clinical trials analysis, and expert consensus meetings to define TRBD.

Results: TRBD was defined as the failure to achieve a significant and …

Enhancing Digital Health Development Through Speech Act Theory: Application To Peripartum Depression Management, Alexandra Zingg, Tavleen Singh, Michael Truong, Sahiti Myneni

Faculty, Staff and Student Publications

The peripartum period is a time of complex transition into motherhood when women may develop peripartum depression (PPD). Digital information sources can help prevent and monitor symptoms through social support and mental health knowledge. However, few studies have characterized the content and form of peer interactions in PPD online forums to inform interventions. In this paper, we present preliminary work using a dataset of 55,301 interactions to inform our digital health development. We combine manual coding for speech acts, behavioral theory mapping, and user engagement modeling to conceptualize dynamic digital education modules for PPD. Results reveal "Expressive" speech act, where …

A Phenomenological Study On The Experiences Of Single Mothers With Depression In Christian Counseling, Julie Adeline Bliss

Doctoral Dissertations and Projects

The population of single mothers in the United States continues to grow, whether due to widowhood, divorce, or failed relationships. It is common for single mothers to face many obstacles due to balancing life and parenthood alone. Due to these obstacles, single mothers are at a heightened risk for depression. Themes identified in current research consist of single mothers experiencing poor physical and mental health, life stressors such as financial hardships/poverty, unstable housing, inconsistent employment, behavioral and cognitive problems in their children, religious/spiritual (R/S) interventions, along with the connection of mental health and religious or spiritual beliefs. Current studies have …

Phenomenology Of Dissociation During (R/S)-Ketamine/(S)-Ketamine Therapy For Depression, Daniel William Cable

Doctoral Dissertations and Projects

The purpose of this study was to explore the dissociative experiences of patients who are receiving ketamine-assisted therapy for depression. This research was guided by the principles of phenomenological inquiry and focused on the subjective experiences of individuals and sought to explore the nuances of dissociative experiences and offer insight into its potential therapeutic implications.

The research used a qualitative methodology involving participants who have experienced ketamine-assisted therapy for depression. The setting was a controlled clinical environment where the therapy sessions were conducted. To collect data, open-ended, semi-structured interviews as well as follow-up interviews were conducted with the participants in …

The Impact Of Cell Phones And Social Media On Social And Emotional Development Of High School Students, Laura Nash

Masters Projects

Studies suggest that social media can have a negative impact on the social and emotional development of adolescents when overused or abused. This paper examines the benefits of social media and several of the adverse effects of problematic social media use. A few of the adverse effects can carry over into the school setting, resulting in students missing valuable instruction time and not being fully engaged in the learning environment. This project proposal is intended to educate parents and school employees about hazards of problematic social media use and the tools that are readily available to monitor the content that …

Factors Associated With Postpartum Depression Among Women Attending Postnatal Clinics In A Tertiary Care Hospital In Nairobi, Kenya, Cecilia Muthoni Njoga

Master of Medicine in Family Medicine

Background 

Postpartum depression (PPD) is a major mental health disorder affecting women during the postpartum period with a global prevalence of up to 17.22%. This prevalence has been shown to be higher in low and middle-income countries. In Kenya, about a fifth of women are affected. PPD can lead to poor infant growth and interference with maternal-child bonding. Additionally, women with PPD experience a lower quality of life and their children have an increased risk of developing and psychotic disorders later in life. Understanding the factors associated with PPD is crucial for early diagnosis and intervention. The study aimed to …

Delusional Parasitosis With Depression, Hypertension And Migraine, Mouli Mandal, M Kishor, Mr Murali

Digital Journal of Clinical Medicine

Delusional Parasitosis (DP) , also known as Ekbom Syndrome, is a psychiatric disorder characterised by the unshakeable belief of infestation by parasites, insects or other organisms, despite the absence of objective medical evidence.
This case report presents a 49 year old female with a history of chronic headaches, progressively worsening insect crawling sensations. She was initiated on treatment and supportive psychotherapy.
This case highlights the importance of a thorough multidisciplinary approach in managing Delusional Parasitosis, emphasising the need to differentiate between primary and secondary forms, address the potential medical and psychiatric comorbidities, and implement appropriate pharmacological and psychotherapeutic interventions.

Improving The Screening And Management Process For Mental Health Disorders And Health Risk Behaviors In College-Age Students: A Quality Improvement Project, Brooke L. Styslinger

Doctor of Nursing Practice (DNP) Manuscripts

Establishing a standardized electronic screening process for mental health disorders and health risk behaviors is crucial for early identification and intervention before poor outcomes occur. This quality improvement project addresses a gap in care relating to screening practices in a college health services office which primarily relied on a provider-based interview screening processes in students reporting for care. Pre-implementation data showed providers most often screened for Major Depressive Disorder (MDD), alcohol use, and drug use, with inconsistent screening for Generalized Anxiety Disorder (GAD) or tobacco/vaping use. Follow-up screening form administration was also inconsistent, only given 3.3% of the time for …

Hospital Experiences And Medical Traumatic Stress In Adults With Spina Bifida, Ellen Fremion, Nora Deibler, Juliana Abel, Monique Ridosh

Faculty, Staff and Students Publications

Purpose

This study examined hospital and emergency department (ED) experiences of adults with spina bifida (SB), medical traumatic stress (MTS) and participant characteristics including anxiety, depression, post-traumatic stress disorder (PTSD) symptoms, and resiliency scores.

Methods

Adults with SB who had a hospital or ED encounter within the last five years were recruited from a medical home clinic and completed a structured interview and validated questionnaires. Narrative inquiry was used and descriptive analyses were conducted. MTS scores were reported per participant characteristics and emotional health questionnaire score counts and percentages.

Results

Twenty-five adults with SB representing 37% of eligible patients were …

Addressing Anxiety And Depression In The Allergy Clinic Through Motivational Interviewing, Brief Cognitive Behavioral Therapy, And Curious Questions, Marylee Verdi, Dominic Candido, Juliette Madan, Jonathan A Bernstein, Don Bukstein, Aikaterini Anagnostou, Matthew Greenhawt, S Shahzad Mustafa, Julie Wang, Anna Nowak-Wegrzyn, Elissa M Abrams, John Oppenheimer, Alexandra E Conway, Andrew A White, Taylor A Doherty, Richard P Morse, Marcus Shaker

Faculty, Staff and Students Publications

Allergic diseases, particularly food allergy, can be associated with significant psychosocial impairment. Allergist-immunologists can provide evidence-based information to correct misperceptions and misunderstandings regarding food allergy that may perpetuate cycles of fear and anxiety. Whereas motivational interviewing can be an empathetic approach to empower patients to actualize health goals, cognitive behavioral therapy (CBT) aims to provide disease-state insight to facilitate an understanding of risk that can transform health beliefs and behaviors. Brief CBT is a clinical approach that can help address ineffective management paradigms through conversations that begin with curious questions. In this review, we discuss evidence supporting implementation of an …

Emotional Pathways To Trauma: Racialized Policing And Psychological Distress In Black Adolescent Males, Rochelle S. Parrish

All Theses

Introduction: Black American males, including adolescents, are disproportionately subjected to aggressive policing, often without criminal wrongdoing (Geller et al., 2014; Sewell et al., 2016). These encounters are frequently described as traumatic, marked by fear, loss, and emotional disruption (Smith Lee & Robinson, 2019). Whether direct or vicarious, such experiences can produce lasting psychological effects, particularly among Black boys who face compounded vulnerability from racialized surveillance and community-level trauma (DeVylder et al., 2018; Smith & Patton, 2016). Proactive policing tactics, such as investigatory stops and verbal aggression, have been linked to symptoms consistent with post-traumatic stress disorder (PTSD), including hypervigilance, avoidance, …