Medicine and Health Sciences Commons^™

Weighted Family History Density Of Substance Use: Influence On Participant Substance Use Onset, Escalation, And Duration, Carleigh A. Litteral

Theses and Dissertations--Psychology

Substance use disorders impose a staggering toll on the United States (U.S.), straining healthcare systems, destabilizing communities, and profoundly impacting both individuals and families. Approximately one in six Americans aged 12 and older had a past-year substance use disorder in 2022 (Key Substance Use, 2022), and nearly one-third of adults experience a substance use disorder in their lifetime (Wu, 2010), contributing to an economic burden exceeding $400 billion annually (National Drug Threat Assessment, 2011). Family history of substance use disorders is a key predictor of vulnerability, with individuals who have affected relatives being 2–8 times more …

Havana Syndrome: A Scientific Review Of An Unresolved Medical Mystery, Aishik Dutta

Digital Journal of Clinical Medicine

Background

Since 2016, U.S. and Canadian officials have reported Anomalous Health Incidents (AHIs), or "Havana Syndrome," characterised by a strange sensory experience followed by chronic neurological, cognitive, and vestibular issues. The cause is intensely debated, with primary hypotheses pointing to either psychosocial factors or a directed-energy weapon, creating a significant medical and geopolitical puzzle.

Methods

This review critically assesses the current evidence by analysing peer-reviewed clinical studies and major institutional reports.

Results

The findings are deeply contradictory. A 2020 NASEM report identified directed, pulsed radiofrequency energy as the most plausible mechanism for a core set of symptoms. Conversely, comprehensive 2024 …

Self-Inflicted, Non-Sexual, Non-Masturbatory Penile Fracture Case Report - An Atypical Presentation, Sajan Sehgal, Vijayakumar R, Sachin Dharwadkar, Amruthraj G. Gowda

Digital Journal of Clinical Medicine

Background: Traumatic injuries to the genitalia are uncommon due to the mobility of the penis and scrotum. Penile fracture is a relatively rare condition arising from disruption of tunica albuginea with rupture of the corpus cavernosum. In order to ensure that such an injury is not missed, it is necessary to have a high index of suspicion to diagnose this condition.

Result: Patient underwent an emergency repair of penile fracture.

Conclusion: We hereby, report a rare case of accidental, non-masturbatory, self-inflicted penile fracture which was diagnosed promptly based on clinical assessment, confirmed radiologically and managed surgically, resulting …

Case Series On Consultation-Liaison Psychiatry In Pain Abdomen With School Refusal Among Children, Jatin Kumar, Aditya Takiar, Kishor M, Sudhamshu K.C, Anil Kumar M.G., Prashanth S.N

Digital Journal of Clinical Medicine

Chronic abdominal pain is one of the most common causes of school refusal in children often leading to multiple hospital visits and expenses. This study was done to assess the psychiatric morbidity underlying functional gastrointestinal complaints in children presenting to paediatric surgery unit. We conducted a prospective case series (N=11; ages 8–13) of children referred from Paediatric Surgery between June and December 2025. All these children presented with idiopathic abdominal pain and a significant period of absence from school. These children were evaluated for any organic causes through the use of various investigations including imaging studies and were referred to …

Evaluating The Efficacy Of Vertical Integration In Training Undergraduate Medical Students Under Competency Based Medical Education Curriculum, Pratham Mehta, Yashika Sharma, Kishor M, Arun M

Digital Journal of Clinical Medicine

Background: The National Medical Council in the Indian Medical Graduate guidelines to enhance learning, recommends Vertical and Horizontal Integration. Vertical integration may be defined as a curricular strategy that aligns para-clinical and clinical teaching across time with a view to enhancing relevance and application of knowledge. The present study is an attempt to test whether vertical integration of Forensic Medicine and Psychiatry is associated with greater short-term learning gains and improved student perceptions compared with conventional didactic lectures.

Methods: With Institutional and Ethics Committee clearance, a two-phase quasi-experimental study was performed across two consecutive academic cohorts (Phase 1, …

Screening And Addressing Food Insecurity At Free Clinics: A Scoping Review, Gautam Ramanathan, William Zak, Daiwik Munjwani, Robert Fisher, Esther May Sarino, Mary J. Scourboutakos

Department of Medicine Faculty Publications

Food insecurity (FI) is highly prevalent amongst patients seeking care at free, student-run health clinics. This study sought to examine the existing literature of food insecurity screenings and interventions at free clinics across the U.S. In this review, we provide the rate of FI screenings, the prevalence of FI, demographic information of patients screened, and interventions and barriers faced by clinics while implementing interventions to improve FI. Studies included in this review needed to implement a FI screening and intervention program in a free clinic within the United States. Additionally, eligible studies could address additional social determinants of health or …

Differentiating Opioid Use Disorder From Healthy Controls Via Ml Analysis Of Rs-Fmri Networks, Ahmed Temtam, Megan A. Witherow, Liangsuo Ma, M. Shibly Sadique, F. Gerard Moeller, C. Kenneth, Dianne Wright, Khan M. Iftekharuddin

Electrical & Computer Engineering Faculty Publications

Objectives/Goals: This work aims to identify functional brain networks that differentiate opioid use disorder (OUD) subjects from healthy controls (HC) using machine learning (ML) analysis of resting-state fMRI (rs-fMRI). We investigate the default mode network (DMN), salience network (SN), and executive control network (ECN), as well as demographic features. Methods/Study Population: This work uses high-resolution rs-fMRI data from a National Institute on Drug Abuse study (IRB #HM20023630) with 31 OUD and 45 HC subjects. We extract rs-fMRI blood oxygenation level-dependent (BOLD) features from the DMN, SN, and ECN. The Boruta ML algorithm identifies statistically significant features and brain activity mapping …

Obesity Prediction From Structural Mri Using Conformal Deep Learning With Uncertainty Quantification, W. Farzana, A. G. A. Temtam, B. Humud-Arboleda, L. Ma, M. Bean, F. Gerard Moeller, K. M. Iftekharuddin

Electrical & Computer Engineering Faculty Publications

Obesity arises from a neurobehavioral disorder in which the brain’s regulation of hunger and food intake is impaired, leading to an imbalance between energy consumption and expenditure. One key phenotype associated with obesity is body mass index (BMI). BMI is influenced by multiple causal pathways driven by behavioral, metabolic, and genetic factors. Traditional obesity prediction studies often rely on magnetic resonance imaging (MRI) voxel-based morphometry to correlate BMI with obesity-related clinical measurements and brain structure, predominantly gray matter volume (GMV). However, the altered brain regions are variable and widespread between studies, with some literature presenting contradictory results between BMI and …

Differences In Prescription Drug Misuse Among U.S. Adults With And Without Disabilities, Jeanette M. Garcia, Samantha M. Ross-Cypcar, Justin A. Haegele

Human Movement Studies & Special Education Faculty Publications

Introduction

Increasing evidence suggests that adults with disabilities have higher rates of drug misuse compared to adults without disabilities, however; there is limited information on rates of commonly misused prescription drugs (e.g., stimulants, opioids, tranquilizers) to quantify the magnitude of this disparity. Thus, the purpose of this cross-sectional study is to examine and compare prevalence rates of prescription drug misuse by disability status and age group in a national sample of U.S. adults.

Methods

Data (n=47,100 adults) from the 2021 National Survey on Drug Use and Health was stratified by age group: 1) 18-29 years; 2) 30-49 years; 3) 50 …

Suicide Phenotyping From Clinical Notes In Safety-Net Psychiatric Hospital Using Multi-Label Classification With Pre-Trained Language Models, Zehan Li, Yan Hu, Scott Lane, Salih Selek, Lokesh Shahani, Rodrigo Machado-Vieira, Jair Soares, Hua Xu, Hongfang Liu, Ming Huang

Faculty, Staff and Student Publications

Accurate identification and categorization of suicidal events can yield better suicide precautions, reducing operational burden, and improving care quality in high-acuity psychiatric settings. Pre-trained language models offer promise for identifying suicidality from unstructured clinical narratives. We evaluated the performance of four BERT-based models using two fine-tuning strategies (multiple single-label and single multi-label) for detecting coexisting suicidal events from 500 annotated psychiatric evaluation notes. The notes were labeled for suicidal ideation (SI), suicide attempts (SA), exposure to suicide (ES), and non-suicidal self-injury (NSSI). RoBERTa outperformed other models using binary relevance (acc=0.86, F1=0.78). MentalBERT (F1=0.74) also exceeded BioClinicalBERT (F1=0.72). RoBERTa fine-tuned with …

Evaluating The Emotional Accuracy Of Ai-Generated Facial Expressions In Neurotypical Individuals, Antonio Pagán, Katherine A Loveland, Ronald Acierno

Faculty, Staff and Student Publications

This study examines the ability of generative artificial intelligence to produce facial expressions representing basic emotions in a neutral context using black-and-white cartoon imagery. Mentalization, the capacity to recognize and interpret one’s own and others’ mental states, is critical for social interaction and emotional regulation. We explored the emotional validation of artificial intelligence (AI)-generated images by assessing the agreement between human interpretations of emotions and those generated by an AI model. Thirty-four participants evaluated images depicting six basic emotions: sadness, anger, happiness, surprise, fear, and disgust. Our findings revealed significant variability in human agreement, with higher concordance for sadness, anger, …

Home-Based Transcranial Direct Current Stimulation Treatment For Major Depressive Disorder: A Fully Remote Phase 2 Randomized Sham-Controlled Trial, Rachel D Woodham, Sudhakar Selvaraj, Nahed Lajmi, Harriet Hobday, Gabrielle Sheehan, Ali-Reza Ghazi-Noori, Peter J Lagerberg, Maheen Rizvi, Sarah S Kwon, Paulette Orhii, David Maislin, Lucia Hernandez, Rodrigo Machado-Vieira, Jair C Soares, Allan H Young, Cynthia H Y Fu

Faculty, Staff and Student Publications

Transcranial direct current stimulation (tDCS) has been proposed as a new treatment in major depressive disorder (MDD). This is a fully remote, multisite, double-blind, placebo-controlled, randomized superiority trial of 10-week home-based tDCS in MDD. Participants were 18 years or older, with MDD in current depressive episode of at least moderate severity as measured using the Hamilton Depression Rating Scale (mean = 19.07 ± 2.73). A total of 174 participants (120 women, 54 men) were randomized to active (n = 87, mean age = 37.09 ± 11.14 years) or sham (n = 87, mean age = 38.32 ± 10.92 …

New Insights Into The Mechanisms Of Electroconvulsive Therapy In Treatment-Resistant Depression, Ana C Ruiz, Abdul Haseeb, William Baumgartner, Edison Leung, Giselli Scaini, Joao Quevedo

Faculty, Staff and Student Publications

Electroconvulsive therapy (ECT) remains one of the most effective interventions for treatment-resistant depression (TRD), particularly in cases involving severe symptomatology, suicidality, or psychotic features. Despite advancements aimed at enhancing the safety and cognitive tolerability of ECT, concerns about cognitive side effects continue to limit its broader acceptance. A deeper understanding of the mechanisms underlying ECT is therefore critical for refining its use and maximizing clinical outcomes. Through a narrative review of recent literature, this paper synthesizes current evidence comparing the efficacy of ECT, ketamine, and repetitive transcranial magnetic stimulation (rTMS) in the treatment of TRD. Then, the review delves into …

Exploring The Lived Experience Of Grief In Adults With Attention Deficit Hyperactivity Disorder, Martina Bauer

Antioch University Dissertations & Theses

The purpose of this phenomenological descriptive-interpretive study was to understand the lived experience of maintaining attention to one’s responsibilities while grieving among adults diagnosed with ADHD who have recently experienced bereavement in the United States. The population for this study included adults aged 18 and over who had experienced the loss of a loved one in the past 5 years and had a current diagnosis of ADHD. Participants were recruited using a sample of convenience via social media, email, and flyers, employing a snowball sampling technique. There were eight participants who met the inclusion criteria and participated in a semi-structured …

An Examination Of Harm During The Real-Life Experience, Michelle E. Balch

Antioch University Dissertations & Theses

The Real-Life Experience (RLE) has been described as a coercive and arbitrary requirement without evidence of validity or reliability. This can cause more harm than it prevents for a significant subset of transition-seeking transgender clients. For these reasons the RLE was dropped from the WPATH Standards of Care after version six. However, the RLE has been adopted by a number of health insurance companies as a measure of readiness to receive transition services. An Interpretative Phenomenological Analysis (IPA) and semi-structured interviews of five individuals were conducted to evaluate their perceptions of RLE and the meaning they attach to their broader …

Frozen: A Grounded Theory Of Transgenerational Trauma Cycles In The Evangelical Slavic Diaspora Of Former Soviet Union Refugees, Yulia Shtareva

Antioch University Dissertations & Theses

This dissertation builds on historical and scientific assertions that Former Soviet Union immigrants survived distinct political traumas, resulting in unique, culturally adaptive behaviors and beliefs. Using constructivist grounded theory, it examined how these behaviors manifest in the evangelical Slavic community (ESC) of former Soviet Union Refugees (FSURs) in the U.S. The researcher asserts that (a) adaptations are generationally preserved in the ESC through a “cycle of authoritarianism,” and (b) survival strategies became maladaptive in new social environments. Narratives from eight young adults raised in the ESC were analyzed alongside a literature review and lived experience. Findings show that coping strategies …

Exploring Stress, Fatigue, Burnout, And Resilience Among Healthcare Personnel In Southeast Asia: A Scoping Review, Kelsey Trulik, Vijaya Arun Kumar, Wendy Wu, Muralidhar Varma, Mauli M. Patel, Kajol Manglani, Trini A. Mathew

Global Health Research Collaborative

This study aims to compare methods used to measure burnout, fatigue, stress, and resilience, as well as resilience-building interventions among healthcare personnel (HCP) in Southeast Asia. Even before COVID-19, HCP faced high levels of burnout and stress, exacerbated by the pandemic. Identifying effective resilience-building strategies is essential to supporting a healthier workforce. Studies published from January 2016 to December 2021 focusing on burnout, stress, fatigue, and resilience in HCP in Southeast Asia. A comprehensive literature search of seven databases (Jan 2016-Dec 2021), using terms related to resilience, HCP, and Southeastern Asian countries identified relevant English-language studies. COVIDENCE software was used …

Mitochondrial-Targeted Therapies In Traumatic Brain Injury: From Bench To Bedside, Sidra Tabassum, Silin Wu, Chang-Hun Lee, Bosco Seong Kyu Yang, Aaron M Gusdon, Huimahn A Choi, Xuefang S Ren

Faculty, Staff and Student Publications

Traumatic brain injury (TBI) is a leading cause of morbidity and mortality worldwide, with limited effective therapeutic options currently available. Recent research has highlighted the pivotal role of mitochondrial dysfunction in the pathophysiology of TBI, making mitochondria an attractive target for therapeutic intervention. This review comprehensively examines advancements in mitochondrial-targeted therapies for TBI, bridging the gap from basic research to clinical applications. We discuss the underlying mechanisms of mitochondrial damage in TBI, including oxidative stress, impaired bioenergetics, mitochondrial dynamics, and apoptotic pathways. Furthermore, we highlight the complex interplay between mitochondrial dysfunction, inflammation, and blood-brain barrier (BBB) integrity, elucidating how these …

The Importance Of Accessibility, Self-Advocacy, And Affirming Care: An Interpretive Phenomenological Analysis Of Transgender And Gender Diverse Older Adults’ Primary Care Experiences, Jason Vaught

Antioch University Dissertations & Theses

The present study explored the lived experiences of Transgender and Gender Diverse (TGD) older adults when receiving primary care. The methodology utilized for this study was Interpretive Phenomenological Analysis (IPA). Three participants completed individual, semi-structured interviews. The themes that emerged included “Lack of Accessibility to Services,” “Need for Self-Advocacy,” and “Value of Affirming Care from Providers.” These results illustrated the multifarious needs that arise for TGD older adults when accessing primary care. The findings provided recommendations for healthcare organizations, primary care physicians, and other healthcare professionals. Specifically, the recommendations emphasized two key practices for physicians treating TGD older adults: (1) …

Experiences Of Dissertating Students: What Works?, Laura Durkin

Antioch University Dissertations & Theses

This study explores the experiences of doctoral graduates from Council for Accreditation of Counseling and Related Educational Programs (CACREP)-accredited Counselor Education and Supervision (CES) programs. Guided by theoretical frameworks on student attrition and institutional racism, the research investigates three primary questions: (1) What dissertation- specific programmatic factors influence time to completion for CES doctoral students? (2) What interventions most strongly promote a sense of social integration and belonging? and (3) What interventions most strongly promote academic integration and confidence in students’ ability to succeed? Data were collected anonymously through an online survey, which included demographic and open-ended questions. Twelve participants …

Outside Of The Counseling Room: Whiteness And Antiracism, Carlee D. Smith

Antioch University Dissertations & Theses

This dissertation explores the lived experiences of white counselors as they integrate antiracism practices into their non-clinical lives. Rooted in the Multicultural and Social Justice Counseling Competencies (MSJCC) framework, this study addresses the gap in literature surrounding how white counselors embody antiracist ideologies outside of the counseling room. Through narrative qualitative methods, the research examines the challenges, strategies, and reflections of white counselors committed to antiracist practices; practical integration into personal life often encounters barriers related to internal biases, social resistance, and limited educational support. Insights from this research highlight the critical need for ongoing self-reflection, community accountability, and structural …

Childhood Aggression: A New Conceptualization, Hannah G. Harrison

Antioch University Dissertations & Theses

Childhood aggression is a frequently observed behavioral phenomenon, yet lacks a precise
definition in both the DSM-5-TR and current research literature. Definitional ambiguity and
construct enmeshment continue to create construct confusion for researchers, clinicians, and
informants. This empirical review of the current literature and diagnostic criteria examines how
childhood aggression has been historically conceptualized, defined, and described. The primary
aim was to identify and clarify inconsistencies in current definitions and to address knowledge
gaps to improve diagnostic clarity. Through a thematic synthesis of recent literature, several key
issues emerged: the absence of a precise definition of childhood aggression; reliance on …

Journey To Well-Being: An Exploration Of Thrivership Post-Domestic Violence, Kader Gumus

Antioch University Dissertations & Theses

Domestic violence profoundly affects multiple facets of a survivor’s life. While most existing literature on survivorship addresses the immediate aftermath of domestic violence, this study delves into the extended process following the trauma of abuse to attain “thrivership,” a new concept in the scholarly and practice literature that emphasizes enduring well-being and flourishing. This dissertation examines the journeys from surviving to thriving for 13 women who transformed themselves and their lives to achieve well-being after traumatic domestic violence. Bronfenbrenner’s ecological systems theory was applied to examine the multiple layers of environmental influences on an individual’s development, including the micro, meso, …

She Speaks: Amplifying Women's Voices For Wellbeing, Narelle Lemon

Reports accepted as research outputs

Executive Summary

The SheSpeaks project successfully transformed how 223 Western Australian women understand and practice self-care, demonstrating  that targeted wellbeing literacy interventions can create lasting change  in women’s relationship with their own wellbeing. Funded by the Women’s Grants for a Stronger Future program, this innovative initiative combined evidence-based workshops with authentic podcasting to challenge the pervasive cultural narrative that positions women’s self-care as selfish  or impossible.

Self-Awareness And Self-Efficacy In The Novice Professional Phase Of Marriage And Family Therapists After Person Of The Therapist Training, A Comparative Survey, Rubio Betsabé

Dissertations

The study focuses on examining the influence of person-of-the-therapist or self-of-the-therapist training on therapists’ self-reports of self-awareness (as a conscious awareness of one’s internal states and interactions with others) and self-efficacy (perceived beliefs in personal capabilities to perform in ways that give control over events that affect their lives) at the novice professional stage of their career. The study will examine the experiences reported by mental health providers actively providing clinical care by utilizing a survey design focusing on person of the therapist connecting through alumni lists and online solicitation. This research adds to the current literature by using a …

What Works In Telehealth Play Therapy? An Appreciative Heuristic Inquiry, Veronica Ann Ball

Dissertations

With the onset of coronavirus disease 2019 (COVID-19) in the United States in March 2020 (World Health Organization, 2020), professional counselors providing traditional in-person play therapy found themselves in a quandary regarding the delivery of services during a global pandemic (Evans, 2022; Mitchell, 2020; Whaibeh et al., 2020). Online counseling proffered a means to prevent the disruption of services, respond to the need for emerging counseling services, and comply with social restrictions (Evans, 2022). Prior to the pandemic, telehealth play therapy was used sparingly (Haslam & Harris, 2011; Smith et al., 2021), and many child-serving mental health professionals lacked training …

What About The Children? An Exploration Of Family Counselors' Play Therapy Training And Preparedness To Integrate Children Into Family Counseling, Patricia J. Walker Monical

Dissertations

Children are an important part of families, yet family counselor education programs often do not incorporate training for including children in family counseling. At some point in their careers, family counselors and therapists will encounter clients who have children 3–12 years old. The problem is that since these professionals often receive little to no training in play therapy and thus do not typically include young children in family therapy, these younger family members are often overlooked. Research has confirmed that, due to a lack of sufficient training and supervision in play therapy, many family therapists report feeling unprepared to work …

Neighbourhood Resilience Planning With Renters In Hamilton, Ontario, Canada, Anna Do

Theses and Dissertations (Comprehensive)

This sequential mixed-methods study demonstrates the co-production of knowledge between academic researchers and local communities. Guided by the resilience planning framework, the study engaged 48 renters from the Beasley neighbourhood of Hamilton, Ontario, Canada in identifying stressful and supportive locations using a participatory mapping tool called the “Place Report.” A total of 74 Place Reports were submitted, with most reporting supportive places in or near Beasley. Thematic analysis revealed three overarching domains, and 13 themes related to the use and function of these locations. Places pertaining to food, housing, and physical activity emerged as the most frequently discussed topics. The …

Supporting The Social Emotional Needs Of Preschoolers, Giorgi Morrone

Graduate Theses, Dissertations, and Problem Reports (ETD)

Social-emotional competence is a prerequisite to school performance and participation in daily tasks. Children in West Virginia face social and emotional barriers including the effects of the opioid epidemic leading to children placed in foster care, born with neonatal abstinence syndrome, and being exposed to toxic stress in the home environment. Additionally, the COVID-19 pandemic has impacted children's social-emotional functioning due to isolation periods. Social-emotional programming can improve children's well-being, school performance, relationships, and outcomes later in life. Occupational therapy practitioners can use data-driven decision-making and relationship-centered practice to develop group-based, health-promotion social-emotional programming in the preschool setting. The purpose …

The Development Of A Family-Led Novel Intervention For Delirium Prevention And Management In The Adult Intensive Care Unit: A Co-Design Qualitative Study, Gideon U. Johnson, Amanda Towell-Barnard, Christopher Mclean, Beverley Ewens

Research outputs 2022 to 2026

Aim: The aim of this study was to codesign a Family Members’ Voice Reorientation Intervention (FAMVR) for delirium prevention and management in critically ill adult patients through collaborative process with previous patients, families, and clinical staff. Background: Delirium is a common consequence of intensive care admission, and there is limited evidence to support family-led interventions to prevent or minimise delirium in intensive care. People with lived experience of intensive care are seldom involved in codesigning delirium prevention and management interventions despite the identified benefits of their involvement in delirium care. Design: Codesign qualitative study. Methods: The process of co-designing was …