Digital Commons Network^™

Shattered Glass: Finding Anna In The Brokenness, Tracy A. Scoville

Masters Theses

This thesis began years ago when I started a novel about a woman that suffered with a mental illness. The story grew into part of a novel. Within the artist’s statement, I present a view of mental illness that I filter through my own experiences. I examine Anna’s struggles with how she thinks, acts and processes stress through a lens of bipolar II disorder. The critical paper examines the importance of dialogue and the need for it to fit the individual characters. The story of Anna, with the use of good dialogue, comes to life in the creative manuscript Shattered …

Screening And Treatment Protocols Used In Nicus Across Minnesota For Perinatal Mood & Anxiety Disorders (Pmads), Rachael Witt

Journal of Justice-Informed Social Work Practice and Research

Parents of infants with prolonged neonatal intensive care unit (NICU) hospitalizations are a population that is overlooked in recommended routine screening for perinatal mood and anxiety disorders (PMADs), yet this population is at greater risk for developing diagnosable mental health disorders. Previous research shows that across the US, PMAD screening and treatment practices vary widely, with many NICUs not providing any routine PMAD screening, psychoeducation, or treatment options to parents. The objective of this study was to explore the current mental health screening and treatment protocols used in NICUs across the state of Minnesota to learn if there are areas …

Depression And Anxiety In Pulmonary Hypertension Associated With Congenital Heart Disease: Pathophysiology And Clinical Implications Of The Heart–Brain Axis, Nicodemus N. Triatmojo, Valerinna Y.S. Putri

Journal of the Saudi Heart Association

Pulmonary hypertension associated with congenital heart disease or PH-CHD is an increasingly prevalent disorder in modern cardiology. It is characterized by progressive pulmonary vascular remodeling, chronic right ventricular (RV) pressure overload, and abnormal cardiopulmonary hemodynamic. Due to advances in congenital cardiology and treatments for pulmonary hypertension, survival rates have increased. As a result, the focus has switched to long-term functional status and quality of life. Depression and anxiety are currently recognized as prevalent and clinically significant manifestations in PH-CHD; nonetheless, they remain underdiagnosed and undertreated within cardiovascular care frameworks.

More study shows the disease's severity or symptom count cannot explain …

Examining The Moderating Roles Of Religious Coping And Belonging In The Relationship Between Moral Injury, Depression, Anxiety, And Stress Within The Israeli Defense Forces Reservist Soldiers, Rotem Z. Moshe

Electronic Theses and Dissertations 2020 - Present

This study examined the moderating roles of religious coping and belonging in the relationship between moral injury and psychological distress, among Israeli Defense Forces (IDF) reservist soldiers. This study investigated whether religious coping predicted moral injury, depression, anxiety, and stress, and examined whether religious coping and belonging moderated the relationship between moral injury and psychological distress. Exposure to potentially morally injurious events during military service is associated with increased risk for adverse mental health effects, particularly in times of prolonged conflict. Research on protective factors that mitigate these outcomes remains limited. Pointed by religious coping and belongingness frameworks, this study …

Mindfulness To Reduce Psychotropic Prescriptions In Home-Based Elderly Patients, Mojisola Akinola Olusegun

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Home-based adults aged 65 years and older receiving care at a community behavioral health center exhibited high psychotropic polypharmacy, with over 80% prescribed two or more psychotropic medications, exceeding The Center for Medicare and Medicaid services (CMS) guidance for safe use. This pattern heightened risks for adverse drug events, functional decline, and avoidable healthcare utilization, while exposing a practice gap characterized by underuse of non-pharmacologic interventions.

Aim of the Project: The Doctor of Nursing Practice (DNP) project aimed to determine whether integrating a structured Mindful Breathing and Meditation (MBM) program into routine services could reduce psychotropic medication burden …

The Moderating Effect Of Dietary Fiber And Protein On The Relationship Between Symptoms Of Depression And Anxiety And Cognitive Decline, Samantha L. Gardener, Hilal Salim Said Al Shamsi, Stephanie R. Rainey-Smith, Hamid R. Sohrabi, Kevin Taddei, Colin L. Masters, Ralph N. Martins, W. M.A.D. Binosha Fernando

Research outputs 2022 to 2026

Introduction: Depression and anxiety often co-occur with Alzheimer's disease, exacerbating the associated cognitive impairment. This study examined moderating effects of dietary protein and fiber intake on relationships between depressive and anxiety symptoms, and cognitive decline.

Methods: Cognitively unimpaired (n = 553; 39.4% male, 70.6 ± 9.6 years) provided baseline fiber and protein intake, and had repeated cognitive testing and symptoms of depression/anxiety measured (baseline and up to eight follow-ups over 144 months). Moderation and simple slope analyses were employed in the cohort as a whole and following stratification by sex.

Results: Fiber intake moderated the relationship between change in depressive …

Prevalence Of Depression Among Patients With Epilepsy In Saudi Arabia: A Nationwide Systematic Review And Meta-Analysis, Mothana Y. Al Jabr, Aryam M. Alenizi, Faisal S. Aleisa, Mazen A. Alghamdi, Noura I. Alfehaid, Muteb M. Alqahtani, Abbas S. Almutair

Neurosciences

Objective: To assess the pooled prevalence of depression among epilepsy patients and find the associated demographics and psychosocial factors. Mood disorders are significant comorbidity between patients diagnosed with epilepsy, adversely influencing quality of life and complicating disease management. However, the incidence, prevalence, and associated risk factors of depression in patients diagnosed with epilepsy in Saudi Arabia are not well elucidated.

Methods: This review was employed used studies retrieved from medical databases and the Saudi Digital Library. Observational and cross-sectional studies assessing depression between patients diagnosed with epilepsy in Saudi Arabia were included. Data were analyzed using the Freeman–Tukey double arcsine …

Effectiveness Of Lay Workers Delivering Behavioural Activation For People With Depression: Systematic Review And Meta-Analysis, Shwikar Othman, Lauren Blekkenhorst, Asangaedem Akpan, Irene Ngune, Nilufeur Mckay, Alison Kennedy, Elizabeth Armstrong, Michael Hunter, Kevin Murray, Mathew Coleman, Richard Gray, Emma Jones, Christopher Lee, Martin Jones

Research outputs 2022 to 2026

Background Behavioural activation is effective for depression, but its effectiveness in treating adults with depression when delivered by lay workers remains unclear. Aims To examine the effectiveness of behavioural activation delivered by lay workers, compared with any control group, in reducing depressive symptoms in adults. Method This systematic review searched six databases from inception to January 2025, for randomised controlled trials (RCTs) comparing behavioural activation and any control conditions for individuals with depression when delivered by lay workers. Additional searches were conducted in the international trial registries and reference lists (PROSPERO registration CRD42024625620). Risk of bias was assessed using the …

I Cry At Night Before You: Theologies Of Depression In The Psalms, Travis Spillum Osb

Obsculta

This work looks to the Psalms to discover theologies that resonate with experiences of depression. If one struggling with depression feels as if God is angry with them, that their condition is oppressing them, that loved ones have abandoned them, or that God's love for them is wavering, they can utilize the psalmist's words to voice their feelings and express their anguish in prayer to a God who is seemingly deaf to their groaning.

The Impact Of Modern Police Equipment And Training On Reported Anxiety And Depression Of Police Officers, Matthew Roy Burford

Doctoral Dissertations and Projects

This quantitative study investigated the relationships among law enforcement officers’ access to modern equipment, their confidence in their training, and their reported levels of anxiety and depression. The study also tested whether confidence in training moderated the association between equipment and mental health outcomes. Mental health symptoms were measured using the Beck Depression Inventory (Beck et al., 1961) and the Beck Anxiety Inventory (Beck et al., 1988). Two researchers-developed instruments to assess officers’ perceived adequacy of their equipment and confidence in their training. Participants were recruited from law enforcement agencies across the Dallas–Fort Worth metroplex, and data were collected through …

The Relationship Between Estimated Vo2max And Poor Mental Health: A Study Of Brfss Data, Angelina Somadina Oputa

Doctoral Dissertations and Projects

Mental health conditions are one of the leading contributors to the global burden of disease. Despite advancements in mental health therapies and psychiatric medications, significant numbers of patients continue to struggle with mental illness. Despite these challenges, exercise can serve as a powerful tool to address mental health concerns. Current literature has referenced the value of physical fitness to support mental health, however there is limited large-scale research assessing the estimated maximal oxygen uptake (VO2Max) as a predictor of poor mental health days. In response, this quantitative secondary analysis was conducted to examine the relationship between estimated VO2Max and poor …

Understanding The Impact Of Minority Stress On Mental Health Among Racially And Ethnically Diverse Adults: Insights From A Daily Diary Study, Ruba S. Rum

USF Tampa Graduate Theses and Dissertations

Minority stressors are theorized to contribute to mental health disparities for racial and ethnic minority individuals. While prior research links distal (i.e., external) and proximal (i.e., internal) minority stressors to adverse psychological outcomes for racial and ethnic minority groups, most studies have relied on cross-sectional designs that limit understanding of the immediate and short-term effects of minority stressors and potential protective factors in daily life. To address this gap, the present study examined the within-person daily associations between distal (interpersonal and vicarious discrimination, microaggressions) and proximal (internalized stigma, anticipation of rejection, identity management) minority stressors and psychological outcomes. Racial and …

Online Harassment And Mental Health Among Collegiate Student-Athletes: Findings From An Ncaa Division I Conference Survey, M. Courtney Hughes, Michelle K. Demaray, Emily A. Skiba, Sarah E. Warriner

Journal of Issues in Intercollegiate Athletics

Social media is central to college athletics, yet public visibility can expose collegiate student-athletes to online harassment, a risk the NCAA has recently highlighted by documenting sizable volumes of abusive, discriminatory, and betting-related content directed at athletes and officials. This study surveyed 85 NCAA Division I student-athletes from ten universities across the Mid-American Conference and assessed social-media behaviors, online harassment exposure, depression, and anxiety. Most athletes used social media 1–3 hours/day, 78% enabled name-mention alerts, and platforms commonly used included Instagram (98.8%) and X (65.9%). Online harassment was reported via social posts (9.4%), direct messages (4.7%), and texts (3.5%), with …

From Combustion Emissions To Neurotoxicity: Brain Health Risks Of Military Burn Pits Exposure, Katherine M. Eggers, Zoe A. Keller, Paul Barach, Julie M. Tomáška, Joshua P. Nixon, Janeen H. Trembley, Tammy A. Butterick

College of Population Health Faculty Papers

Military burn pits used during post-9/11 U.S. military deployments functioned as uncontrolled combustion systems and were widely utilized to dispose of large volumes of outdoor waste by burning. Burn pits involved heterogeneous waste materials burned under variable temperature and oxygen conditions. These combustion environments generated complex, toxic, multipollutant airborne emission mixtures that included particulate matter (PM2.5), polycyclic aromatic hydrocarbons (PAHs), and volatile organic compounds (VOCs). This narrative review synthesizes epidemiologic, experimental, and mechanistic evidence linking burn pit emissions to disruption of the lung–brain axis and adverse neurological outcomes. We specifically aim to address a critical gap in understanding how combustion-derived …

Equine-Assisted Therapy For Dementia: A Pilot Rct On Standardizing Sessions To Improve Cognition, Mood, And Quality Of Life, Madeline Alford, Maria Dos Prazeres Da Silva Gonçalves Dr., Maria Manuela Da Silva Leite Dr.

People and Animals: The International Journal of Research and Practice

Objectives: This study aimed to evaluate the effects of incorporating equine-assisted therapy (EAT) into memory workshops for older adults with mild to moderate dementia. EAT is hypothesized to enhance cognitive function, promote physical activity, and improve mood through multisensory experiences. To ensure consistency and replicability, a standardized 8-session cognitive stimulation therapy (CST) protocol was developed, structuring interventions across cognitive, emotional, and motor domains.

Methods: A 3-arm, parallel-group, randomized controlled trial (ClinicalTrials .gov: NCT06662578) was conducted with 36 older adults diagnosed with mild to moderate dementia. Participants were randomly assigned to one of three groups: equine-assisted therapy workshop (EATW), traditional …

Polygenic Risk Scores, Sex, And Socioeconomic Factors As Predictors Of Age Of Onset For Major Depressive Disorder, Kaitlyn M. Nowak

USF Tampa Graduate Theses and Dissertations

Major Depressive Disorder (MDD) is a heterogeneous psychiatric condition influenced by genetic, sociodemographic, and environmental factors, yet the extent to which these factors jointly shape the timing of disease onset remains unclear. This study evaluated the effects of polygenic risk scores (PRS), sex, and socioeconomic status (SES) on age of onset for MDD across two independent cohorts: the Pharmacogenomics Research Network Antidepressant Medication Pharmacogenomics Study (PGRN-AMPS) (N = 486) and the All of Us Research Program (N = 8,014). Analyses were restricted to individuals of European genetic ancestry, and PRS were constructed using both European-ancestry (EA) and multi-ancestry (MA) genome-wide …

Evaluation Of Neuroplastic Changes In Psychological Intervention And Contemporary Treatments Of Depression, Taylor Severance

Dissertations

Major depressive disorder is one of the most prevalent mental health disorders worldwide. There is a vast range of treatment options for depression, with varying levels of effectiveness. Recent treatments for depression have expanded, increasing alternative treatments, and it is unknown which treatments have the largest impact on depression. This research was designed to examine the treatments of depression, with a focus on psychotherapy and contemporary treatments such as ketamine, psilocybin, and transcranial magnetic stimulation. A literature review was conducted to assess treatment outcomes and neuroplastic changes in these interventions, as well as combinations of the interventions. Data were evaluated …

Exercise Therapy For Mood Disorders In Retiring/Former Athletes, Christian Antos

Dissertations

This dissertation examined the potential integration of exercise therapy and psychotherapy as a treatment approach for mood-related difficulties experienced by former elite athletes during the transition out of competitive sport. Retirement from athletics is often associated with significant biopsychosocial challenges, including disruptions in identity, healthy routines, social support, and emotional well-being. Existing literature suggests that exercise may serve as an effective adjunctive intervention for improving mood and overall psychological functioning, though limited research has explored its application among retiring athletes within psychotherapeutic contexts. This literature review synthesized current research related to athletic retirement, neurobiological mechanisms associated with physical activity, and …

Perinatal Mental Health Screening And Care Among Those With Pregnancy Complications, Alison N Goulding, Terri L Fletcher, Emily S Miller

Faculty, Staff and Students Publications

Perinatal mental health conditions are common and, without effective treatment, can contribute to adverse maternal and child outcomes. In the United States, mental health conditions are a leading cause of maternal morbidity and mortality, contributing to over 20% of pregnancy-related deaths. This expert review aims to assess current literature and provide recommendations regarding mental health care in high-risk patients who experience pregnancy complications. Individuals experiencing pregnancy complications are at increased risk for perinatal mental health conditions, including depression, anxiety, and post-traumatic stress disorder, as compared to those with uncomplicated pregnancies. Despite this increased disease burden, there is limited research on …

Resilience And Social Support On Depression Risk For Chronic Obstructive Pulmonary Disease Patients In South Tangerang, Indonesia, Adhityawarman Menaldi, Sali Rahadi Asih, Farah Ainul Mardhiyyah

Kesmas

Chronic obstructive pulmonary disease (COPD) is a major public health concern with psychosocial impacts, such as reduced resilience and depression. This study examined the moderating role of perceived social support on the relationship between resilience and depression among individuals diagnosed with COPD in South Tangerang, Indonesia. A quantitative cross-sectional study was conducted between January and February 2024 using self-administered questionnaires. Participants were adult patients with clinically diagnosed COPD, recruited from all public health centers (PHC) in South Tangerang. A total of 125 participants met the inclusion criteria and were included in the analysis. Participants had a mean age of 41.46±15.69 …

Predictive Models Of Student Mental Health: The Correlation Between Academic Burnout And Depression In The Higher Education Environment, Hyejoon Song

Masters Theses

Importance: Over 80% of U.S. college students report significant emotional difficulties, and 58% endorse academic burnout as a persistent concern, yet institution-specific data at faith-integrated universities such as Liberty University remain scarce, limiting evidence-based programmatic response.

Objective: To examine the correlation between academic burnout and depressive symptomatology at Liberty University, identify the most predictive individual burnout item via Random Forest machine learning, and characterize distinct student risk profiles via KMeans clustering. Design, Setting, Participants: Cross-sectional survey (IRB-FY24-25-1491, Exempt) of 236 Liberty University students (mean age 36.9 ± 14.3 years; 84.0% female; 61.0% graduate-level), 2025–2026 academic year.

Main Outcome and Measures: …

The Impact Of Translated Phq-9 And Gad-7 Scales On Treatment Recommendations In An Adult Vietnamese Population: A 3-Month Primary Care Evaluation, Vivienne Bui

Doctor of Nursing Practice Final Manuscripts

Depression and anxiety are prevalent yet underdiagnosed in limited-English-proficient (LEP) populations due to language barriers, cultural stigma, and provider bias. Vietnamese-speaking patients are particularly vulnerable to under-recognition in primary care. This quality improvement project evaluated whether implementing Vietnamese-translated Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) tools would improve mental health diagnosis and referral rates. Guided by the Johns Hopkins Evidence-Based Practice Model, a pre–post design was conducted at a San Diego clinic from March 26 to June 26, 2025. Vietnamese-speaking adults (≥18 years) completed translated PHQ-9 and GAD-7 forms during intake. Providers used scores in conjunction with clinical …

Addressing Triggers Of Anxiety And Depression In A Mental Health Setting, Jacqueline Elos Wahito Kabukuru

Group: Samford University Moffett & Sanders School of Nursing

In order to improve coping capacity and clinical decision-making. This project evaluated the use of the 15-item Coping Adaptation Processing Scale (CAPS-15) alongside RAM’s four adaptive modes (physiological, self-concept, role function, interdependence) to assess coping responses to stressors and support individualized care planning in a mental health counseling setting.

The Role Of Faith In Coping With Mental Health Challenges In Late Life: A Phenomenological Study Of Religious Experience In The Aging Population, Krista Kelley

Doctoral Dissertations and Projects

Depression, anxiety, and suicidal ideation are significant concerns among older adults. These conditions are often neglected due to stigma, atypical symptom presentation, and medical comorbidities, resulting in increased healthcare utilization, heightened suicide risk, and emotional dysregulation. Psychosocially, these challenges obstruct a successful resolution of Erikson’s final stage, ego integrity versus despair, leading to dissatisfaction, regret, and reduced well-being. Although previous research has suggested a link between religious engagement and improved mental health outcomes, few studies have explored older adults’ lived experiences of faith in coping with mental health. This qualitative phenomenological study examined the experiences of 25 older adults regarding …

A Phenomenology Study: Exploring The Lived Experiences Of Latino Women In The South Of California With Symptoms Of Depression And The Influence Of Faith And Religion In Their Recovery, Ivette G. Perez-Paquien

Doctoral Dissertations and Projects

This is a qualitative study of a phenomenological nature that explores the phenomenon and experiences of Latina women with depressive symptoms residing in Southern California, as well as the influence of faith and religion on their recovery. The investigation of this phenomenon was conducted using the theoretical model of descriptive research proposed by Husserl, along with the data analysis technique for descriptive phenomenological research based on the approach designed by Richard Krueger. The research question posed to guide this study was: What are the experiences described by Latina women suffering from symptoms of depression regarding faith, religion, and their recovery …

Understanding Husbands Who Live With A Spouse Who Abuses Substances: A Phenomenological Study, Starla Rachelle Huckeba

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to describe the lived experiences of Christian non-addicted husbands who are married to a substance-abusing wife in Texas. A thorough review of existing literature indicated that previous research has focused on female non-addicted family members. From this, a gap was identified, and the central research question was developed: How did the Christian non-addicted husband describe the personal effect of living with a substance-abusing wife? Family systems theory, attachment theory, and attachment to God theory guided this study. The sample included 12 husbands whose wives abuse substances. The data collection consisted of the completion …

Psychological Impact Of Career Roles On African American Women: A Qualitative Study On The Long-Term Effects On Behavioral Health Providers' Field, Yolanda Seals-Stewart

Doctoral Dissertations and Projects

There is an untold narrative regarding the levels of stress, anxiety, and depression. This leaves a gap in researchers understanding systemic, cultural, and social factors that shape mental health outcomes in a unique way. There is also a deeper need for exploration of resiliency and coping skills strategies utilized by African American women in the behavioral health field, as well as how behaviors such as discrimination, workplace dynamics, and microaggression impact the overall psyche. By addressing these gaps, a more thorough understanding of the long-term psychological effect can be addressed, and these women can receive support mechanisms and interventions that …

Mindfulness-Based Interventions: Improving Quality Of Care In Breast Cancer, Deborah Schindele

Group: Northern Arizona University School of Nursing, DNP Doctoral Papers

Breast cancer is the second leading cause of death in women and leads to decreased quality of life owing to increased anxiety, depression, fatigue, stress, and a lack of social support. The American Society for Integrative Oncology ranks mindfulness-based interventions (MBI) as the most highly recommended integrative interventions known to decrease anxiety, depression, and fatigue, and improve the quality of life of breast cancer patients. However, they were not regularly used or recommended by support group facilitators of the project. A quality improvement project was implemented with the five support group facilitators to address this deficit. The purpose was to …

Psychosocial Predictors Of Depression And Anxiety In Thai Stroke Caregivers, Chanatip Tongyonk, Sorawit Wainipitapong, Chavit Tunvirachaisakul, Aurauma Chutinet, Michael Maes, Thitiporn Supasitthumrong

Chulalongkorn Medical Journal

Background: Caregivers of stroke survivors often face significant psychological challenges, yet limited research in Thailand has explored how patient and caregiver characteristics jointly influence caregiver mental health outcomes.

Objective: To identify characteristics of ischemic stroke patients and their caregivers that may predict distress, sadness, and anxiety symptoms in the caregivers.

Method: To measure caregivers' burden, stress, depression, and anxiety symptoms, the Hospital Anxiety and Depression Scale (HADS), Zarit Burden Interview (22-item ZBI), and Perceived Stress Scale (PSS-10) were utilized. To define a multi-step mediation model, we used partial least squares structural equation modelling (PLS-SEM).

Result: 97 stroke patients and their …

Perceived Parental Favoritism And Disfavoritism: Associations With Depression And Entitlement In College Students, Emma S. Hren

Senior Honors Projects, 2020-current

Research consistently shows that children’s perceptions of differential treatment can have negative and lasting impacts on their well-being. Suitor and colleagues (2017) examined perceptions of favoritism among adult children in the form of emotional closeness, disappointment, conflict, and pride. The current study builds upon prior research by adding fathers, entitlement, and dimensions of practical and financial help. At James Madison University, 235 undergraduate students completed an online survey, which measured depression, entitlement, and social comparison in relation to perceptions of parental treatment. Results indicated associations between perceptions of differential parenting across emotional closeness, disappointment, conflict, pride, and financial and practical …