Medicine and Health Sciences Commons^™

A Review Of The Role Of Anxiety In Diagnosis Of Children And Adolescents With Autism Spectrum Disorder: A Paradigm Shift In Conceptualization And Diagnosis, Evan Wahlquist

Dissertations

Early evidence of co-occurring anxiety symptoms in children and adolescents with autism spectrum disorder (ASD) dates back to the first descriptions of ASD by Leo Kanner (1943) and Hans Asperger (Frith & Mira, 1992). While current research has identified anxiety disorders as one of the most prevalent co-occurring disorders in children and adolescents with ASD, little is known about the nature of the relationship between these disorders. In an effort to explain these high prevalence rates, recent research has started to investigate the relationship between these two disorders. To join these efforts, this clinical research project explored the role of …

Self-Care Practices In Doctoral Nursing Students And Effects On Educational Experience, Megan Lutman

Dissertations

Problem: Doctoral nursing students are often faced with stressors on top of their schooling, one of which is continuing to work while pursuing their education. This in combination with normal life stressors can be challenging. The purpose of this project was to survey doctoral nursing students on what their current self-care practices.

Methods: An exploratory needs assessment project was created to gather data from Doctor of Nursing practice (DNP) and Doctor of Philosophy (PhD) nursing students in an urban, mid-sized, Midwestern, public university to identify current self-care practices, barriers to self-care, preference of self-care practices, and the impact these …

Acute Agitation Intervention Tool For Reduction Of Polypharmacy, Brooks J. Propst

Dissertations

Introduction: Patients with behavioral health diagnoses are among the highest risk for
aggression. For pediatric patients with behavioral health needs, urgent treatment is
needed for aggressive behavior, due to the potential unwanted outcomes. The purpose of this Quality Improvement (QI) pilot project was to implement an Acute Agitation Intervention Tool that uses the Broset Violence Checklist (BVC) to guide
pharmacological intervention for mild and moderate to severe agitation in pediatric
patients with behavioral health needs ages 8 to 18 to decrease the number of medications that patients are getting per agitation event over a 12-week period.

Methods: This QI included …

Hippocampal Volume And The Detection Of Mild Cognitive Impairment In An Older Adult Population: Assessing Performance On Cognitive Screeners Administered In-Person And Electronically, Kristen Fabrizi

Dissertations

The present study investigated how performance on in-person and electronic neuropsychological assessment measures predicted subcortical hippocampal volume and cognitive decline consistent with mild cognitive impairment. It was hypothesized that the Montreal Cognitive Assessment would display better predictive strength than the Cogstate Brief Battery when evaluating subcortical hippocampal volume measured via structural magnetic resonance imaging. It was further hypothesized that the Montreal Cognitive Assessment would be more sensitive to predicting group membership to the diagnostic classification of mild cognitive impairment compared to the Cogstate Brief Battery. The sample included 445 older adult participants selected from the Alzheimer’s Disease Neuroimaging Initiative 3. …

Evidence-Based Practices And Self-Efficacy: A Quantitative Study Of Mental Health Counselors Treating Clients With Substance Use Disorder, Carl Bastien

Dissertations

Substance use disorder affects a substantial number of individuals in the United States. The specific problem of this research is that it was not known to what extent their use of evidence-based practices is driven by their sense of self-efficacy. The purpose of this quantitative correlational research was to examine to what extent the use of evidence-based practices covary with a sense of self-efficacy for mental health counselors treating individuals diagnosed with a substance use disorder. The study population was 121 mental health counselors who specialized in substance use disorder treatment who completed a digital survey. The study findings did …

The Motherhood Crusade: Rural Low-Income Mothers, Support, And Empowerment, Christina Castellano

Dissertations

Previous research has shown that postpartum women with untreated mental health conditions are more likely to fail to manage their own health, have inadequate nutrition, abuse substances, experience abuse, be less responsive to their baby’s needs, have fewer positive interactions with their baby, experience difficulties breastfeeding, and question their abilities as a mother. Rural culture plays a complex role in the transition to motherhood, influencing whether mothers seek out and use resources. While more is known about location and access issues, less is known about how rural culture and, more specifically, how empowerment and social support impact postpartum experience. The …

Assessing And Characterizing Marijuana Use Disorders (Dsm-5) — National Survey On Drug Use And Health, United States, 2020, Alejandro Azofeifa-Ujueta

Dissertations

Despite that marijuana (cannabis) is still considered, under federal law, an illegal Schedule I drug, marijuana is the most commonly used illicit substance in the United States. National trend data has shown that the prevalence of marijuana use has increased over time, particularly among those aged 18 years and older. Some individuals can use marijuana without harm; however, long-term and heavy marijuana users may experience health consequences, including marijuana use disorders (addiction). For the last 20 years, existing national and statelevel epidemiological, surveillance, and research data have analyzed marijuana use disorders (MUD) using previous diagnostic criteria (DSM-IV). There is limited …

Single-Case Pilot Study For Longitudinal Analysis Of Referential Failures And Sentiment In Schizophrenic Speech From Client-Centered Psychotherapy Recordings, Travis A. Musich

Dissertations

Though computational linguistic analyses have revealed the presence of distinctly characteristic language features in schizophrenic disordered speech, the relative stability of these language features in longitudinal samples is still unknown. This longitudinal pilot study analyzed schizophrenic disordered speech data from the archival therapy audio recordings of one patient spanning 23 years. End-to-end Neural Coreference Resolution software was used to analyze transcribed speech data from three therapy sessions to identify ambiguous pronouns, referred to as referential failures, which were reviewed and confirmed by multiple raters. Speech samples were analyzed using Google Cloud Natural Language API software for sentiment variables (i.e., score, …

Childhood Trauma And The Faith Maturity Of Seventh-Day Adventist Pastors And Seminarians, Pete A. Palmer

Dissertations

Problem

Unfortunately, Childhood Trauma is a fact of life. For instance, children lose parents/guardians through death or divorce. Children grow up in impoverished situations. Children have parents who suffer from mental illness and/or commit suicide. In addition, more unfortunately, some children are mistreated, neglected, and/or abused. The long-lasting impact of Childhood Trauma includes increased morbidity and mortality, and decreased opportunities for prosperity. This research sought to establish a statistical relationship between Childhood Trauma and Faith Maturity. Childhood Trauma has been demonstrated to affect attachment processes in children and, since religion is an attachment process and God is an attachment figure, …

Preclinical Behavioral Assessments Of Mitraginyne, The Main Psychoactive Alkaloid In Kratom, Rachel Burroughs

Dissertations

Mitragyna speciosa (kratom) is a medicinal plant indigenous to Southeast Asia and Africa with a long history of use for a variety of ailments, including diarrhea, pain relief, cough suppression, and amelioration of opiate withdrawal symptoms. Despite its status as an herbal remedy, kratom is banned in some countries due to a myriad of negative health risks. Preclinical psychopharmacology studies of mitragynine (MG), the main alkaloid of kratom, indicate it has opioid-like effects at higher doses and psychostimulant-like effects at lower doses. The current study utilized three rodent behavioral paradigms to evaluate the putative psychostimulant effects of MG. The specific …

Lifestyle Choices Related To Food Consumption And Their Relationship To Depression, Steven L. Jennings Jr.

Dissertations

Dieting, or the act of restricting oneself to small amounts or particular kinds of foods on the basis of health, spirituality, lifestyle, and moral decisions, is a practice that dates to 1066 A.D. However, with social media being as influential as it is, one might believe dieting is a new obsession or at least an obsession to which popular culture is returning. Despite this, it is only in recent years that researchers have begun to focus on the health benefits of such behaviors. The present study was designed to take this focus a step further by exploring the potential risks …

Hiv And Early Life Stress On Neuroimaging And Risky Behavior, Paola Garcia Egan

Dissertations

This study examined the interactive effects of early life stress (ELS) and HIV on brain morphometry, diffusion-basis-spectrum-imaging (DBSI), risky decision-making, and sex-risk behavior. 122 people with HIV (PWH) and 113 people without HIV (PWoH), free of major psychiatric illness and neurological confounds, were stratified into high (≥ 3 events) vs. low (< 3 events) ELS [PWoH/low ELS (n = 57), PWoH/high ELS (n =56), PWH/low ELS (n = 43), PWH/high ELS (n = 79)] and underwent structural magnetic resonance imaging, DBSI, neuropsychological, and risky-behavior assessment; all PWH were virologically controlled. Compared to PWoH, PWH had smaller orbitofrontal cortex (OFC), parietal lobes, insula, caudate and anterior cingulate. No ELS effects were detected in volumetric measures. Significant interactions were found between HIV serostatus and ELS on the OFC and on cellularity of the inferior fronto-occipital fasciculus after multiple comparisons adjustment. Specifically, PWH/high ELS exhibited significantly smaller OFC and PWoH/high ELS show significantly larger OFC than the other groups. PWoH/high ELS exhibited higher DBSI cellularity (neuroinflammation proxy) of the inferior-occipital-fasciculus compared to PWoH/high ELS. Regardless of HIV status, executive function moderated the relationship between the OFC and sex-risk behavior such that individuals within the sample who performed above average on a measure of executive function and had a larger OFC reported fewer sex partners in past six months than individuals with smaller volumes. No interaction was found between HIV serostatus and ELS on risky behavior measures. Clustering analyses defined ELS subgroups in PWH that were determined by demographic characteristics, duration of infection, recent CD4+ T-cell count, nadir CD4+ T-cell count and high/low ELS.Even in PWH that are virologically controlled, without major current psychiatric comorbidities, there is evidence of a synergistic impact of ELS and HIV on OFC volumes. Higher volumes in the OFC were detrimental when associated with lower executive function scores or advantageous when associated with higher executive function. Findings suggest that ELS is associated with different brain signatures among PWoH and virally suppressed PWH. However, ELS was not directly associated with risky behaviors, and subgroups in PWH were characterized by demographic variables, past substance use and HIV clinical variables.

Risk Factors Of Cyberbullying Victimization: The Impact Of Developmental Trauma, Yuliya Mykytyn

Dissertations

Trauma has been considered as one of the significant causes of psychological distress, especially if the traumatic event occurred in the childhood. At the same time, due to wide popularity of social media as a source of communication, cyberbullying emerged as a new way to harass someone, with specific focus on adults and young adults. The area of focus of this research project is to investigate whether experienced trauma, specifically developmental trauma might serve as a risk factor for cyberbullying victimization. Additional focus was on the differences in traumatic experiences and their impact for people with diverse cultural and ethnic …

Determining The Effectiveness Of Virtually-Delivered Written Exposure Therapy For Treatment Of Posttraumatic Stress Symptoms, Stephanie M. Haft

Dissertations

The COVID-19 pandemic has disproportionately impacted individuals with mental health issues (Swendsen, 2020). Although the peak destruction of the COVID-19 pandemic has passed, the psychological fallout remains. Social isolation, home confinement, and travel restrictions have exacerbated mental health issues during the COVID-19 pandemic, contributing to negative psychological distress (Smith et al., 2020). Survivors of trauma have higher vulnerability to prolonged psychological distress than the general population and others with non-trauma-related mental health conditions, which has been exacerbated during and following the COVID-19 pandemic. For these reasons, survivors of trauma may particularly benefit from virtual-delivery of trauma-focused treatments. Mental health providers …

Examining P3 And N2 Amplitudes Following Social Exclusion And Provocation In College Students With High And Low Narcissistic Traits, Kathleen Ramsey

Dissertations

Adults with narcissistic traits are prone to reacting aggressively following provocation due to elevations in emotional reactivity and perceived threat to their grandiose self-views. Prior studies have examined event-related potentials (ERPs) measures in college students with narcissistic traits in the context of risky decision making and facial emotion processing; however, no known studies have examined how those with narcissistic traits react to rejection and provocation at the neurophysiological level during an externally valid social rejection task (i.e., Cyberball). For the purposes of this study, it was predicted that participants with higher levels of narcissistic traits (both total narcissism and grandiose …

Evaluating Sbirt In A Behavioral Health Urgent Care, Christina L. Williams

Dissertations

Background: Adolescent substance use (SU) is a major health concern. Most youth who engage in alcohol and other SU do not meet criteria for SU disorder (SUD). Nonetheless, evidence shows SU during adolescence impacts cognitive, social, and emotional development, increases risk of physical injury, and may progress to SUD in adulthood. Only half of clinicians properly screen adolescents for SU; those identified with SUD often receive no intervention. Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based intervention to address this problem. The purpose of this project was to evaluate implementation of SBIRT using CRAFFT 2.1+N, a SU …

Visualizing Depressive Symptom Improvement: Implementing The 17-Item Hamilton Depression Rating Scale, Briana Raterman

Dissertations

Visualizing Depressive Symptom Improvement: Implementing the 17-Item Hamilton Depression Rating Scale

Abstract

Problem

Depression, a mental health diagnosis, has affected about 18.5% of adults (Villarroel & Terlizzi, 2020). Ketamine, a medication initially used as an anesthetic, has improved depressive symptoms in individuals struggling with treatment-resistant depression.

Method

This quality improvement (QI) project used the 17-item Hamilton Depression Rating Scale questionnaire to assess depressive symptom changes in patients receiving intramuscular ketamine for treatment-resistant depression. The questionnaire was administered to patients pre-and post-intramuscular ketamine administration. The data was collected on injections one, three, and six on each participant’s set schedule of injections …

Life Matters, Marina Fischer

Dissertations

Problem: One of the challenges facing many primary care providers is managing hypertension. Hypertension contributes to cardiovascular disease events. Consequently, the high occurrence of hypertension related visits signifies a clinical practice gap in hypertension management resulting in substandard blood pressure outcomes. The purpose of this clinical scholarship project was to assess the difference of pre and post Quality of Life Scale (QOLS) scores in a hypertensive population.

Methods: This quality improvement project used a longitudinal, observational design with prospective data collection. The sample included newly diagnosed hypertensive adults ages 21 to 64 years old. The sample was administered the World …

Evaluating Patient Health Questionnaire-9 (Phq-9) Use In Burn Survivors, Chelsey Friend

Dissertations

Problem: A burn injury affects both psychological and physical health, resulting in a greater than 50% major depressive disorder morbidity. The purpose of this quality improvement (QI) project is to evaluate the use of the Patient Health Questionnaire-9 (PHQ-9) in adult burn survivors, with an aim to increase the use of the screening tool.

Methods: A mixed-methods pre/post-survey design with an educational component was utilized to assess nurse knowledge, confidence, willingness, and barriers to completion of the PHQ-9. Aggregate data were collected to determine PHQ-9 completion rates for patients admitted to and discharged from the unit during the two months …

Utility Of The Motivation To Change Lifestyle And Health Behaviors For Dementia Risk Reduction Scale (Mclhb-Drr) Based On A North American Sample, Angelina E. Witbeck

Dissertations

As the population ages, the prevalence rates of dementia continue to increase. Without a cure or promising treatment for dementia, the best course of lowering the prevalence rates of dementia is through preventative measures. Through an electronic survey, the study utilized the MCLHB-DRR scale to determine whether (1) gender, age, educational background, and socioeconomic status will impact the motivational factors to change lifestyle and health behaviors to reduce the risk of developing dementia and (2) direct experiences with individuals that have a dementia diagnosis are likely to impact one's motivational factors to change lifestyle and health behaviors to reduce the …

The Life Story Analysis Of Those Suffering From Autoimmune Thyroiditis, Azalea Di Nardi

Dissertations

The purpose of this study was to understand the pervasive impacts of autoimmune thyroiditis, specifically Hashimoto’s and Graves’ disease. To accomplish this, the life story methodology was utilized to gather individual experiences from 11 participants diagnosed with Hashimoto’s or Graves’ disease. The participants completed a background and general health questionnaire and 45- to-100-minute virtual interview disclosing their journey from the onset of symptoms, through diagnosis, to their most recent state. Themes were compiled from the interviews, which allowed identification of the largest areas of impact, needs, and future implications for practitioners and providers. Major themes identified were decreased quality of …

Preexisting Sexual Trauma And The Impacts On Psychological Well-Being Of College Students, Victoria Johnson

Dissertations

Childhood sexual abuse appears to be a taboo topic with a long history of being left out of the discussion regarding mental health in adulthood despite the varied and devastating consequences. The overall lack of research on this topic, especially regarding the college student population, can be considered a barrier to treatment for those individuals. The current literature review attempts to fill the research gap by discussing the epidemiology, prevalence, and description of preexisting sexual trauma in college students. The potential negative effects of preexisting sexual trauma and how they occur with college students were explored to highlight how pervasive …

A Description Of Impostor Phenomenon In Certified Registered Nurse Anesthesiologists, Jeffrey R. Darna

Dissertations

Background: Imposter Phenomenon (IP) is an evolving, multidimensional construct defined as self-perceived intellectual phoniness and professional ineptitude frequently experienced by individuals working in high performance or competitive environments. IP consequences include psychological distress, role under-optimization, and professional paralysis. Certified Registered Nurse Anesthesiologists (CRNAs) are at risk for impostorism; however, IP presence, intensity, and career effects are unknown.

Purpose: The study measured IP in CRNAs and determined the relationship between IP and select sociodemographic and practice variables.

Methods:

Design: A descriptive, cross-sectional correlation design measured IP using an Internet-based survey from a random sample of 170 members of the American …

The Prevalence Of Mirror Gazing Behaviors In Men, Rutuja Pramod Chinchankar

Dissertations

Muscle Dysmorphia is when the individual is preoccupied with the idea that his or her body build is too small or insufficiently muscular. This study looked at the distinct criteria of MD, which is persistently and obsessively checking one’s appearance in the mirror and being dissatisfied with it. It studied the reasons behind these repetitive mirror-gazing behaviors. This study also attempted to understand the effect of an individual’s age, educational background, religious orientation, sexual orientation, and socio-economic status on his predisposition to MD via mirror-gazing behaviors. This study used a qualitative research design. Part I of the study included participants …

Generation Status, Ethnic Identity, Colonial Mentality, And Enculturation In Filipino Americans, Kamille Patricia Urmaza La Rosa

Dissertations

Filipino Americans’ psychological experiences pertaining to their generation status, ethnic identity, enculturation, and colonial mentality are rarely studied in counseling psychology due to inconsistent disaggregation of Asian American and Pacific Islander (AA&PI) data (Agbayani-Siewert, 2004; Espiritu, 2003; Nadal et al., 2010; Okamura, 2013). Literature suggests that the study of these constructs related to their mental health can guide more culturally informed care for this historically excluded population (David & Nadal, 2013; Nadal, 2020). The current study used an exploratory design to test six research hypotheses and accomplish the following: examine relationships between the constructs, investigate intergenerational differences, validate a measure …

The Influence Of Integrated Behavioral Health Primary Care Setting On The Utilization Of Mental Health Services And Depression Treatment Response Among Men, Tendai Masiriri

Dissertations

The 2010-2013 National Health Interview Survey showed that nearly 9% of men had daily feelings of anxiety or depression, yet less than 41% sought help for their symptoms (Blumberg et al., 2016). Men are more reluctant than women to seek help (Angst et al., 2002; Brownhill et al., 2005). The failure to seek help among men is associated with multiple factors related to stigma and gender, yet male suicide rates are approximately 3-5 times higher than their female counterparts. However, they have a higher likelihood of seeking help from a medical provider rather than a mental health provider. If men …

Mental Construal And Alterations In Emotional Memory, Olivia D. Beers

Dissertations

Psychological distancing refers to a shift from a psychologically immersed perspective that involves thinking about the details of an event (concretely) or stepping back from it and watching the event from an outside point of view (abstractly)––this can help individuals change how they feel about the experience. Investigating how construal levels affect emotional memories may provide more insight into how individuals may potentially alter the recall of their memories. The current study reflects a new examination of the effect of primed high and low construal levels on the recall of positive and negative arousing stimuli. This study included a pilot …

Racial Identity, Hair Esteem, Hair Texture, And Hairstyle Choice As Correlates Of Psychological Well-Being Among Afro-Latinas In The United States, Marielsy Esther Pimentel

Dissertations

Problem

During the Colonial period, hair was one of the designated phenotypic markers of racial group membership used to assign or deny privilege. Privileges are still assigned to people based on their racial group membership and their proximity to Whiteness. As such, Hair remains a salient part of Afro-Latina women’s lives and identities, with its influences seen in the personal, social, and mental realms. How an Afro-Latina wears her hair can have legal, social, and intrapersonal consequences. The subsequent treatment of Afro-Latinas because of their hairstyle can affect how they view themselves and even how they relate to others, especially …

The Role Of Youth Characteristics, Home Ecology, And Child Maltreatment In The Severity Of Problematic Sexual Behaviors And Conduct Problems, Ariel K. Berman

Dissertations

A multitude of individual, familial, and environmental variables have previously been identified as contributing to the development of problematic sexual behaviors (PSB) and general conduct problems (CP) in youth. The majority of these studies have focused either on individual youth characteristics or parenting behaviors such as child maltreatment. Although researchers examining contributions to PSB and CP generally acknowledge the importance of the impact of the home environment on youth behavior, few researchers have included family characteristics of both parents and siblings in their analyses. Additionally, some factors that have been identified as having great importance in general juvenile delinquency, such …

Mental Health Treatment In Juvenile Correctional Facilities: Utilizing Assessment To Inform Treatment, Sarah Riccio

Dissertations

Youth in juvenile correctional facilities face a wide range of mental health difficulties. Over the years, the juvenile justice system has prioritized the need for providing appropriate and effective treatment services to youth throughout their detainment. Despite these ongoing efforts, treatment practices in juvenile correctional facilities continue to fall short. This study will first focus on assessment practices within these facilities and the impact current practices have on diagnosis and subsequent treatment. Emphasis will be placed on the importance of comprehensive evaluations for informing diagnosis and determining the individual treatment needs of detained youth. An integrated approach to assessment will …