Digital Commons Network^™

Implementing A Routine Patient Health Questionnaire-9 (Phq-9) Screening Bundle For Adults (18-65 Years) Scheduled For A Psychiatric Evaluation, Olivier Bertrand Djoumessi

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Depression affects 21 million American adults (8.4%), yet only 28% receive appropriate screening. In Texas, where 20.8% of adults experience depression, systematic screening remains inconsistent. This quality improvement project addressed a critical gap at an outpatient mental health clinic in the Dallas-Fort Worth metroplex, where Patient Health Questionnaire-9 (PHQ-9) screening occurred in only 40% of psychiatric evaluations, resulting in missed diagnoses and inconsistent treatment. Using the Plan-Do-Study-Act framework, the project implemented a comprehensive PHQ-9 screening bundle consisting of staff training, electronic health record integration, and a treatment algorithm based on severity thresholds. The intervention targeted adults, aged 18-65, scheduled for …

The Impact Of Social Participation Through Adaptive Sports On Quality Of Life In Individuals With Spinal Cord Injury, Mikayla Martin, Zeida Gutierrez

Spring 2025 OTD Capstone Symposium

This project researched and explored how socialization through adaptive sports in this case impacts the perception of quality of life among individuals who have sustained a spinal cord injury.

Differences In Long Covid Severity By Duration Of Illness, Symptom Evolution, And Vaccination: A Longitudinal Cohort Study From The Inspire Group, Michael Gottlieb, Huihui Yu, Ji Chen, Erica S. Spatz, Nicole L. Gentile, Rachel E. Geyer, Michelle Santangelo, Caitlin Malicki, Kristyn Gatling, Sharon Saydah, Kelli N. O'Laughlin, Kari A. Stephens, Joann G. Elmore, Lauren E. Wisk, Michelle L'Hommedieu, Robert M. Rodriguez, Juan Carlos C. Montoy, Ralph C. Wang, Kristin L. Rising, Efrat Kean, Jonathan W. Dyal, Mandy J. Hill, Arjun K. Venkatesh, Robert A. Weinstein

Department of Emergency Medicine Faculty Papers

Background: Although short-term outcomes of Long COVID have been described, longer-term physical and mental health outcomes of Long COVID are less well-established. This study sought to assess differences in long-term physical and mental health outcomes extending up to three years among those with current, resolved, and no Long COVID, as well as duration of Long COVID and vaccination status. Methods: This was a prospective, multisite, study of participants with SARS-CoV-2 infection from 12/7/2020-8/29/2022, with data collected through 4/2/2024. Surveys included validated tools for physical and mental health. Data were analyzed by Long COVID status (never-had, resolved, current), Long COVID duration …

Social Determinants Of Mental Health Outcomes, Ariana Fein

Honors Theses

Mental health disorders, particularly anxiety and depression, are a growing global concern with profound consequences on individuals' well-being and societal functioning. The burden of these disorders is not only psychological but also economic, affecting quality of life. Mental health outcomes are heavily influenced by a range of social determinants, such as financial status, education, and access to healthcare. While extensive research has focused on WEIRD (Western, Educated, Industrialized, Rich, Democratic) countries, there remains a significant gap in understanding how these determinants affect mental health in low-resource settings or non-WEIRD countries. This study aimed to address this gap by exploring the …

Effects Of Pubertal Stress On Later Pup-Directed Behavior In Pregnant And Non-Pregnant Adult Female Mice, Marissa Marylin Nicodemus

Graduate Theses, Dissertations, and Problem Reports (ETD)

Beginning in adolescence and throughout adulthood, women are at an increased risk for anxiety and mood disorders compared to men. Several risk factors for these disorders have been identified, but it is not clear how they interact. One such factor is pregnancy. The normative changes to the brain and behavior that occur during and after pregnancy are associated with an increased risk for anxiety and mood disorders. Exposure to adverse childhood experiences (ACEs) has also been associated with an increased risk of mood disorders, and compared to men, women appear to be particularly vulnerable to the lasting effects of stress …

Adminstrative And Programmatic Supports To Enhance Veteran-Service Dog Programming, Madison Davisson

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Service dogs have long served as a valuable resource to assist veterans in overcoming challenges such as transitioning to post-military life, re-engaging in life roles, and navigating the community. There is substantial research on the benefits and impacts that service dogs have on the lives of veterans. Because of this, the number of service dog-veteran partnerships is on the rise, and each service dog program has its individualized programmatic method to enhance its offerings. However, there is limited information on administrative and programmatic support for service dog training programs intended for veterans and staff members. The veteran perspective is …

Examining The Association Between Perceived Stigma And Mental Health Help-Seeking Behavior Among Racial/Ethnic Minority Students In Health Professions Education, Camila A. Agurto

Honors Undergraduate Theses

Racial and ethnic minority (REM) students in health professions programs in the U.S. have considerable mental health issues. Still, they are less likely to access mental health services when compared to their White peers. The stigma they face, such as —public stigma, self-stigma, or intersectional stigma, may serve as a barrier to help-seeking. Although there is increasing recognition of the barriers to mental health care experienced by these students, there is no systematic understanding of how perceived stigma associated with mental health issues affects mental health help-seeking by REM students enrolled in health professions education. This systematic literature review aims …

Assessing The Relationship Between Perceived Psychological And Physical Pain In Adults With Orthopedic Pain, Daniel C. Karimi Dehkordi

Honors Undergraduate Theses

Suicide remains a public health concern in the U.S., particularly among individuals experiencing chronic pain and psychological distress. This cross-sectional study investigated the relationship between perceived physical and psychological pain in 41 adults with chronic orthopedic conditions. The relationship between other risk and protective factors and perceived levels of pain distress was also examined. Results showed a significant positive correlation between psychological distress and physical pain (r(39) = 0.388, p < .05) and psychological distress and depressive/anxiety symptoms (r (39) = 0.477, p < .01). Psychological distress was moderately associated with feelings of hopelessness (r (39) = 0.403, p < .01), however, the relationship between physical pain and hopelessness was weak and nonsignificant (r (39) = -0.06, p = .71). Contrary to expectations, emotional support did not buffer the effects of psychological distress (r (39) = 0.07, p = 0.66). Mediational analysis confirmed that emotional support did not influence the relationship between physical pain and psychological distress (Beta (β) = -0.969, p = 0.572; Sobel Z = 0.5598, p = 0.575). Age was not correlated with psychological distress (r (39) = -0.24, p = 0.13) or mental health symptoms (r (39) = -0.05, p = .77). While there was no significant difference across sex, males reported higher mental health symptomatology and psychological distress scores than female counterparts. These findings underscore the direct impact of physical pain on psychological distress and challenge assumptions about the protective role of social support. The study highlights the need for integrated, multidisciplinary interventions targeting both physical and psychological pain to mitigate suicide risk among individuals with chronic orthopedic conditions. Future research should iii explore alternative support mechanisms and resilience-building strategies to address the complex interplay of pain, distress, and suicidality.

Evolving Perceptions Of Self And Others: The Effects Of Communing With Nature While Thru Hiking The Florida National Scenic Trail, Stella P. Arbeláez Tascón

Graduate Thesis and Dissertation post-2024

This body of artwork comprises a thesis that documents and exposes the artist’s inner workings as she regained balance after experiencing deep emotional trauma. This individual’s healing transformation was prompted by her immersion in nature while walking the Florida National Scenic Trail in its entirety, 1,130 miles (or 1,818 km), from the Everglades to the panhandle, in three and a half months. The artistic research conducted, and autobiographical body of work created from it, aims to help others reconnect with their own strengths and to seek wellness in the restorative properties of Nature, while advocating for an empathetic approach to …

Pain For Pain: The Benefits And Challenges Of Bdsm Participation For People With Chronic Pain–An Exploratory Study, Reni Forer, Bryce Westlake

Faculty Research, Scholarly, and Creative Activity

Research is beginning to find that many BDSM (bondage/discipline, domination/submission, sadism/masochism) practitioners experience benefits beyond sexual pleasure. Additionally, given the relationship between pain and pleasure common in BDSM, there may be certain unanticipated benefits for practitioners reporting chronic pain (PRCP). We conducted an online survey of an international convenience sample of BDSM practitioners (N = 525). Participants were asked about self-perceived benefits and challenges related to participating in BDSM with CP. Using chi-square, independent sample t-test, logistic regression, and linear-by-linear association, responses were combined with demographics, participation timelines, co-participants, motivations, and frequency of activities to identify differences between PRCP and …

Improving Postpartum Outcomes Through Therapeutic Individual And Group Occupational Therapy Sessions In Hospitalized Antepartum Patients, Melissa C. Learish

Graduate Theses, Dissertations, and Problem Reports (ETD)

Extended hospitalization in the postpartum period is occasionally medically indicated due to a variety of diagnoses, but can pose challenges to the psychosocial well-being of pregnant women, such as social isolation, anxiety, alteration of normal life routines, and less preparation for postpartum life. In acute care settings, however, maternal management tends to focus on physical stabilization rather than holistic maternal care, including opportunities for emotional support, occupational engagement, and postpartum planning. This doctoral capstone project was designed to assess the effect of individualized and group-based occupational therapy interventions for antepartum women who have been hospitalized for extended periods of time, …

Exploration Of Coping And Mental Health In West Virginia Farmers, Jodi Meadows Richmond

Graduate Theses, Dissertations, and Problem Reports (ETD)

Compared nationally, West Virginia currently ranks lowest for life expectancy, highest for drug related deaths and 35^th for access to adequate health (WV DHHR Organization Assessment & Strategic Plan, 2022). The state also ranks first in the nation for depression with one in four adults experiencing some form of depressive condition each year (CDC, 2020). The rurality of the state may limit social interaction and availability of medical treatment facilities (Brew et al., 2016).

The situation is even more dire for those in farming-related occupations. Farmers often struggle with management stress, utilizing appropriate coping strategies, and accessing mental health …

Examining Mental And Sexual Health Themes In Latina Youth Zines: A Multi-Modal Content Analysis, Jenn M. Lilly, D'Andrah Almanzar, Doreen Dorcely, Luisa Fernanda Sandoval Cortes, Ana Iris Murcia

Social Service Faculty Publications

Multiple, convergent risk factors place Latina youth at disproportionate risk for mental

and sexual health issues. Yet, their firsthand perspectives and experiential knowledge of

how to navigate mental and sexual health challenges is rarely the subject of scholarly

inquiry. This article presents a multi-modal content analysis of themes and messages

conveyed by two digital zines created by Latina young adults for Latina teens through an

arts-based research project. In this arts-based research, zines functioned as both data and

method, capturing Latina youth’s nuanced perspectives and lived experiences of mental

and sexual health. We identified six themes in their works—acknowledging and …

Examining Mental Health Providers’ Differential Sensitivity To Youth And Caregiver Treatment Engagement Problems By Studying Clinical Decision-Making Behaviors, Wendy Chu

Theses and Dissertations

Clinical decision-making is a systematic process of collecting and using information to guide action regarding client care. Across frameworks of clinical decision-making, there is an emphasis on the assessment of a problem – which involves considering, identifying, and selecting a problem – as it directly informs intervention. In youth mental health services, problems related to treatment engagement or the ability to meaningfully participate in services are important to assess given their association with premature termination and poor outcomes. However, research suggests that assessment of engagement problems may be challenging, and one potential reason pertains to providers’ ability to assess across …

South Asian American Experiences Of Microaggressions And Wellbeing: The Moderating Role Of Social Support, Archita Birla

College of Graduate Studies: Theses & Dissertations

Although the South Asian American community is rapidly expanding in the United States (South Asian Americans Leading Together [SAALT], 2015), there remains a dearth of psychological research regarding the impacts on mental health and wellbeing affecting this diverse community. Racial microaggressions, or verbal or behavioral actions indicating hostile or negative attitudes toward marginalized individuals (Sue et al., 2007), negatively impact People of Color (POC) mental health and wellbeing (Forrest-Bank & Jenson, 2015a; Nadal, Wong, et al., 2015). Some research exists on South Asian American communities and microaggressions (Houshmand et al., 2014; Poolokasingham et al., 2014) but there is limited research …

Caregiving Burdens Of Task Time And Task Difficulty Among Paid And Unpaid Caregivers Of Persons Living With Dementia, Matthew Lee Smith, Jodi L. Southerland, Malinee Neelamegam, Gang Han, Shinduk Lee, Chung Lin Kew, Juanita Dawne R. Bacsu, Elyse Couch, Steffi M. Kim, Monique J. Brown Ph.D., Mph, Ayse Malatyali, Lucas Wilson, Zahra Rahemi, Jeremy Holloway, Marcia G. Ory

Faculty Publications

Background: Demands of caregivers of persons living with dementia (PLWD) are often influenced by the context of their caregiving situation. This study examines common and unique factors associated with caregiving burden in terms of task time and task difficulty among paid and unpaid caregivers of PLWD. Methods: Cross-sectional baseline survey data were analyzed from 107 paid and unpaid caregivers of PLWD participating in a larger NIH-funded study assessing the feasibility of using a novel in-situ sensor system. Oberst Caregiving Burden Scale constructs of task time and task difficulty served as dependent variables. Two least squares regression models were fitted, controlling …

Beyond Basic Needs : Exploring The Antecedents And Outcomes Of Seafarers’ Well-Being, Chian Liou, Cheng Kuo Sung, Kimberly Hsiu-Chin Lee, Jiunn Liang Guo

Journal of Marine Science and Technology–Taiwan

Given the importance of seafarers’ mental health and the limited literature on this topic, this study aims to explore the causes and consequences of seafarers’ well-being. A questionnaire survey was conducted, and the data were analyzed using structural equation modeling and hierarchical regression analysis. Consistent with the predictions of the happy and productive worker thesis, this study found that the more satisfied the seafarers are with the shipping company’s seafarer policy, the higher their well-being tends to be, leading to a more positive work attitude. Interestingly, the study found that a company effect is significantly present in this correlation; that …

Investigating Post-Adoption Abandonment Of Mental Health Mobile Applications Among Young Adults, Donald Harris

Electronic Theses & Dissertations (2024 - present)

The rising prevalence of mental health issues among young adults has driven increased interest in Mental Health Mobile Applications (MHMAs), which offer accessible and cost-effective solutions to traditional barriers such as financial limitations, stigma, and restricted healthcare access. Despite their promise, MHMAs frequently experience high rates of attrition and abandonment, significantly limiting their long-term effectiveness. Employing a mixed-methods, multi-stage research design, this dissertation explores the determinants of MHMA abandonment among young adults, emphasizing the interplay between technological inhibitors and enablers, individual user characteristics, and the mediating roles of user satisfaction and perceived usefulness.

Study 1 utilized quantitative text analysis, including …

Accessible Mental Health Chicago, Guadalupe Cuevas

Selected Social Change Portfolios in Prevention, Intervention, and Consultation

Goal Statement: My prevention-focused goal statement for Accessible Mental Health Chicago is to create a program that focuses on providing mental health resources for all in all areas of Chicago. This is by having community based low-cost or no-cost mental health services throughout the city, in the local languages that are of that community.

Significant Findings: While there are some limited resources in the areas with the highest calls for mental health crisis, they are not accessible for most of the city. While there are mental health centers throughout the city there aren’t many low or no cost resources. This …

Inadequate Healthcare For Women In The United States, Grace Loveless

Ballard Brief

Barriers to adequate healthcare for women stem from a lack of research on their specific health needs, gender-based biases in healthcare, and harmful societal norms. One key aspect highlighting these disparities is the menstrual cycle—a topic unique to women. Menstrual health, defined as a state of complete physical, mental, and social well-being, illustrates the urgent need for greater focus on reproductive health. Despite its significance, the dialogue and knowledge about reproductive health remain limited, exacerbated by societal attitudes of secrecy and shame. These attitudes create barriers that hinder many women in the United States from accessing adequate healthcare. As a …

Changing Climate, Changing Health: Perspectives From General Population In Mysuru, Lekhashree A, Manirsha P V, Paranthaman Chinnasamy, Srishti Arya, Sunil Kumar D

Digital Journal of Clinical Medicine

Background: Climate change has emerged as a major public health concern, contributing to rising morbidity and mortality worldwide. In India, increasing heat waves, unpredictable rainfall, and deteriorating air quality have intensified climate-sensitive health conditions. This study aims to assess the health impacts of climate change among the general population of Mysuru.

Methodology: A community-based cross-sectional study was conducted among 400 residents of Mysuru (April–June 2024). Participants were recruited through simple random sampling. Data were collected using a pre-tested semi-structured questionnaire via Google Forms. Analysis was performed using SPSS v26, with descriptive and inferential statistics.

Results: Among 400 participants, …

A Mixed Methods Study: High School Teachers’ Perspectives On Incorporating Mindful Artmaking In Their Classroom As A Mental Health Resource, Sherry A. Bosarge

Theses and Dissertations

Mental health concerns and the need for mental health resources for high school students continue to rise in Virginia. Some of the reported benefits to the current mental health services and resources offered in Virginia schools are increased academic outcomes, attendance, and positive behaviors. The reported barriers to current mental health services and resources are lack of participation, lack of training, time constraints, funding, and resources. This explanatory sequential mixed methods study examined high school teachers’ perspectives on the benefits and barriers to incorporating mindful artmaking in their classrooms as a mental health resource at a local high school. This …

Yoga As A Self-Care Practice For Mental Health Counselors Who Treat Trauma, Kari Michelle Fitzgerald

Graduate Research Theses & Dissertations

Given the high rates of burnout and compassion fatigue among trauma-exposed counselors, understanding effective self-care practices is critical for sustaining clinical effectiveness and well-being. Utilizing Interpretative Phenomenological Analysis (IPA), exploration of the lived experiences of licensed mental health counselors who treat trauma and use yoga as a self-care practice was conducted. Eight participants who were regular yoga practitioners each participated in one semi-structured interview and submitted one pre- and one post-interview reflective journal entry. Thematic analysis was used to identify six major themes; 1) emotional impact and sacred responsibility of clinical work, 2) yoga as a regulating and restorative practice, …

Confirming The Factor Structure Of The Police Officer Stigma Scale, Daniel R. Horning

Graduate Thesis and Dissertation post-2024

First responders routinely face exposure to critical incidents within the line of duty, resulting in higher prevalence of psychopathological conditions compared to the general population. However, a growing body of research identified a severe underutilization of mental health-related services among this population, with stigma towards mental illness being the most cited barrier to seeking care. Stigma as a construct is being actively measured, but the factor structure of stigma towards mental health remains contested in literature. Optimal model fit for Stuart’s Police Officer Stigma Scale is an example of these empirical debates, as both single-factor and two-factor models are offered …

Knowledge And Education Of Minnesota High School Coaches Regarding The Signs And Symptoms Of Eating Disorders In High School Athletes, Mikaela Whiteford

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this study was to assess the level of education and knowledge among Minnesota high school coaches regarding the signs and symptoms of eating disorders in high school athletes. Data were collected through a researcher-developed survey, adapted from three existing instruments. The survey was administered through Qualtrics and distributed to participants through email. The findings indicate that while Minnesota high school coaches possess some knowledge of eating disorder signs and symptoms, their formal training and education on the topic are limited. Most of the education or training received by coaches was obtained for reasons unrelated to their responsibilities …

Studying Associations Among Mental Health And Psycap In Persons With Stuttering, Jasmine Lydia Selvaraj, James R. Spears, Priscilla Rose Prasath, Gayathri Purushothaman

Counseling Faculty Publications and Presentations

This cross-sectional, psychometric validation and comparative analysis study investigates the associations between mental health and Psychological Capital (PsyCap) in persons with stuttering (PWS; n = 60) and fluent speakers (FS; n = 60), while validating the Tamil translations of the Mental Health Continuum-Short Form (MHC-SF) and Psychological Capital Questionnaire (PCQ). Exploratory Factor Analyses, Cronbach’s alphas, and item-total correlations were used to evaluate the scales with a sample size of 120 participants. The conducted factor analyses demonstrated that the translated MHC-SF aligns structurally with prior studies, as compared to the PCQ, which diverged in factor loadings. The study also applied Independent …

To Be Soft Again: A Phenomenological Study Of Uncertainty And Resilience In Childbearing During The Covid-19 Pandemic, Marcianna Nosek

Nursing and Health Professions Faculty Research and Publications

Background:

During the COVID-19 pandemic, uncertainty was exacerbated in experiences of pregnancy and childbirth as people navigated through uncharted territory. Building resilience may be one effective way to cope. However, for those who carry a heavier burden in upholding others, a societal expectation of “toughness” and the ability to endure may lead to an appearance of resilience, while on the inside, well-being may be compromised.

Objectives:

This study is part of a larger phenomenological study that explored the broad research question: What is the lived experience of childbearing during the COVID-19 pandemic? Specific themes of uncertainty and resilience are reported …

Young Adult Chronic Disease And Midlife Subjective Well-Being And Mental Health: Does Social Milestone Achievement Mediate The Link?, Hannah M. Lindl

All ETDs from UAB

Nearly one-in-four young adults ages 18-34 have a chronic disease, which has been linked to worse midlife mental health. Prior studies have little-examined the mechanism behind this association. The life course perspective suggests that because chronic disease in young adulthood is an unexpected and “off-time” event it may disrupt the achievement and timing of key social milestones. Inability to achieve or perceived delays in achieving the social markers of adulthood (e.g., completing school, homeownership, marriage) may therefore lead to worse midlife mental health. To address this proposition, I used panel data from the Youth Development Study (YDS and multivariate regression …

Exploring The Mental Health Of Korean-American Elderly Immigrants, Iris Minkyung Kim

Antioch University Dissertations & Theses

This study sought to understand the mental health of Korean-American elderly immigrants using the theoretical frameworks Erikson’s Stages of Psychosocial Development and Interpersonal Psychotherapy Theory (IPT). To achieve this purpose, this study incorporated a qualitative thematic analysis and conducted in-depth interviews with 10 elderly Korean immigrants living in the United States. From these interviews, eight themes were identified: (a) multifaceted immigration experiences, (b) immigration challenges, (c) complex language barriers, (d) personality constructs impacting experience, (e) the importance of relationships, (f) limited information and access to support, (g) life satisfaction and dissatisfaction, and (h) advice for future immigrants. These themes indicate …

Mental Heath Experiences Of Transracial Adoptees Of The Global Majority (Black, Indigenous, And People Of Color - Bipoc)., Phebe Brako

Antioch University Dissertations & Theses

This qualitative hermeneutic phenomenological study explores the lived experiences of transracial adoptees of the global majority (BIPOC), focusing on their bicultural identity integration and its impact on mental health. During semi-structured interviews, nine participants shared their stories of navigating cultural and racial dynamics as adoptees in predominantly White adoptive families and communities. The findings revealed six core themes: (1) the Quest for Bicultural Identity Formation, (2) Cultural Integration and Adaptation, (3) Navigating Racial and Cultural Tensions, (4) the Role of Family in Cultural Integration, (5) the Importance of Community and Support Systems, and (6) Mental Health and Therapeutic Experiences, addressing …