Medicine and Health Sciences Commons^™

The Effect Of A Community Resiliency Model Education On Resilience, Psychological Empowerment, And Well-Being In Behavioral Health Nurses, Lorrie Smith-Esterle

DNP Projects

Background: Resilience, well-being, and psychological empowerment are associated with improvement in job satisfaction and nurse retention rates. The Community Resiliency Model (CRM) can promote emotional regulation, well-being, and create an internal state of balance in response to work-related stressors. Educating nurses on how to use CRM enables the recognition of changes in thoughts, emotions, sensations, and internal or external stimuli, which can promote resilience, well-being, and psychological empowerment.

Purpose: The purpose of this project was to evaluate evaluate the effect of a resiliency education using the Community Resiliency Model (CRM) on resilience, psychological empowerment, and well-being of behavioral health nurses. …

Improving Nutrition Screening Practice In The Hospitalized Heart Failure Patient Population, Amanda J. Bourgeois

DNP Projects

Background: Heart Failure is a disease known to affect nearly 6.5 million adults in the United States. Characterized by recurrent hospitalizations, heart failure significantly contributes to morbidity, mortality, and healthcare costs in the United States and worldwide. Because malnutrition is prevalent in the heart failure population, healthcare providers must perform nutritional assessments on admission to intervene in the case of malnutrition, prevent deterioration, and improve patient prognosis. Without intervention and early identification of malnutrition, heart failure hospitalizations will remain a significant problem.

Purpose: The purpose of this study is to evaluate the effect of an evidence-based educational program for cardiac …

Neural Hyperactivity During Value-Based Decision-Making In People With Daily/Near Daily Cannabis Use, Miranda Ramirez

Theses and Dissertations--Psychology

Value-based decision-making involves the coordinated effort of multiple brain regions to guide future choices based on past experiences. These processes are disrupted in cannabis use disorder, where individuals continue to use cannabis despite negative consequences. Reinforcement learning (RL) paradigms can be used to capture changes in the value of available options and may inform how the brain is impacted by frequent cannabis use. This study combined fMRI with behavioral modeling of probabilistic choice task data to compare value-based choices between young adults reporting daily/near daily cannabis use (CAN) and controls (CTRL). Participants selected one of two options reinforced ($0.25) at …

Humor Matters: An Adapted Multiple Case Study Exploring Music Therapists’ Perspectives Of Humor With Older Adults, Caleb M. Posey

Theses and Dissertations--Music

Humor is a ubiquitous human experience and a skill retained in older adulthood. It is also an integral but elusive therapeutic tool with numerous benefits and risks to well-being. Therapeutic humor – the application of humor to client well-being – is an emerging area of study. However, scant music therapy literature on humor is available. The purpose of this qualitative thesis was to explore the use and function of humor in music therapy with older adults from the perspectives of experienced music therapists. There were three research questions: (1) how do music therapists describe their use of humor with older …

Cbt And Me: A Beginning Therapist's Journey Utilizing Client Feedback, Haley Scruggs

Theses and Dissertations--Family Sciences

Cognitive behavioral couple therapy (CBCT) is a model of therapy targeting cognitions, emotional responses, and behavioral interactions between couples experiencing relationship distress. Routine outcome monitoring (ROM) is a tool that clinicians can use to track the progress of their clients in therapy from the perspective of the client. This study aimed to use MFT-PRN, a type of ROM, to gather client progress throughout CBCT treatment. Prototypical change trajectories were created in Microsoft Excel for examination of presenting problem progress, couple satisfaction, and overall relationship functioning. It was found that small data sensitivity affected the trajectories immensely, though ROM outcomes revealed …

Effects Of Social Isolation And Adolescent Ethanol Exposure On Adult Drinking And Nicotine Co-Use, Jakob Shaykin

Theses and Dissertations--Psychology

Alcohol use often begins in adolescence and can lead to increased susceptibility to AUD in adulthood. Stress in the form of social isolation during adolescence can also prompt substance use disorders later in adulthood. This thesis determined if exposure to ethanol (EtOH) during adolescence and social isolation alters the trajectory of alcohol and nicotine intake during adulthood. In Experiment 1, adolescent male and female Sprague-Dawley rats were administered intermittent injections of EtOH (2g/kg 20% EtOH, IP) or saline (PND 28-41). EtOH consumption was measured in adulthood (PND 49-55) using a 2-bottle choice procedure where one bottle contained a 0.2% saccharin/15% …

The Effects Of Extended Fructose Access On Relative Value And Demand For Fructose, Saccharin, And Ventral Tegmental Stimulation, Megan Halloran

Theses and Dissertations--Psychology

Globally, food addiction (FA) is a growing area of research and is largely attributed to the availability of foods that are both energy dense and high in fats and sugars. Further, it has been suggested, that sugar and fat, when consumed frequently, have properties similar to drugs of abuse. While the validity of FA is questioned, researchers have drawn parallels between substance use disorder (SUD) and FA. For example, sugar binge models emphasize craving, withdrawal and binging as primary components of FA, which are also hallmarks of SUD. Additionally, both natural rewards, like sugars, and drug rewards act on the …

Calcium Imaging Of Central Amygdala Activity After Fentanyl Escalation, Samantha Malone

Theses and Dissertations--Psychology

Evidence suggests that rats given long access (LgA) sessions to self-administer (SA) opioids escalate their intake, while also showing greater withdrawal severity and drug-induced reinstatement compared to rats maintained on short access (ShA) daily SA sessions. Little is known about the neural changes that occur during opioid escalation that may impact withdrawal and relapse. Past work examining opioid SA using ShA sessions in rodents has identified the central amygdala (CeA) as an area of interest that becomes hyperactive in acute withdrawal and may be involved in the incubation of craving that occurs after protracted withdrawal. However, these studies have not …

Assessing 4-H And Its Circle Of Courage In A Psychiatric Residential Treatment Facility: A Case Study, Elizabeth Steering

Theses and Dissertations--Family Sciences

This 4-H case study takes place in a psychiatric residential treatment facility (PRTF) in Kentucky. The PRTF provides clinical services to youth that are not able to be safely maintained in their homes due to having demonstrated unsafe or harmful behaviors. Youth admitted to the PRTF stay for an average of three to six months while they receive intensive therapeutic and psychiatric care as well as medical treatment and public schooling. The current case study incorporates programming from 4-H, which is the youth development program of the Cooperative Extension System (CES) and the National Institute of Food and Agriculture (NIFA), …

Prenatal Ethanol Exposure Impairs Performance On Spatial And Tactile Sequential Discrimination Task In Juvenile Rats, Caleb S. Bailey

Theses and Dissertations--Psychology

Fetal alcohol spectrum disorders (FASDs) are a set of cognitive and behavioral abnormalities that arise in ~5% of children who have been prenatally-exposed to alcohol. Prenatal alcohol exposure (PAE) can cause impairments in learning acquisition, working memory, response inhibition, and attentional-set shifting that result in exaggerated deficits in executive function and impairments in goal-seeking behavior. There are standard procedures used in rodent research to address some components of these deficits, but few procedures are sensitive enough to comprehensively assess such deficits. To address this issue in FASDs research techniques, we developed a procedure that requires prolonged executive function in a …

Promotion Of Early Recognition Of Depression To Improve Health Related Quality Of Life In Pediatric Oncology Patients, Jennifer Blankenship

DNP Projects

Background: Depression and anxiety are serious complications of cancer and deemed a challenging diagnosis due to the symptoms of depression mimicking common side effects of chemotherapy and radiation. Signs/symptoms frequently are underrecognized thus appropriate treatment is delayed, compromising the health-related quality of life (HRQOL) for pediatric oncology patients.

Purpose: Analyze existing physician and Advanced Practice Provider (APP) clinical practice regarding depression, via a pre- and post-survey and educational PowerPoint on the use of the Center for Epidemiological Studies Depression Scale for Children (CES-DC) to promote early recognition of depression.

Methods: A prospective, single-arm, study was completed in the Kentucky Children’s …

A Pathway For Inclusive Innovation In Pediatric Mental Health: Prevention And Intervention Using Technology, Kate Corinne Bennett

DSW Capstone Projects

It is no secret that access to quality healthcare is difficult for citizens to achieve in the United States. Racism, discrimination, and oppression further exist at the root of compounding social problems, including limits in minority access to mental health services. The COVID-19 pandemic has also exacerbated mental health problems for young children, especially those who are already underserved and at risk. For these reasons, it is imperative that the social work profession emphasizes innovative approaches to equitable treatment access, including a focus on early intervention and the use of technology. Product one of this capstone engages a systematic review …

A Content Analysis Of Reddit Comments Discussing Fibroadenoma Appraisal And Decision Making, Hayley Marie Kay Stahl

Theses and Dissertations--Communication

Though fibroadenomas are clinically benign in most cases, clinical research suggests that these lesions can cause diagnosis-related physical health complications and psychological distress. However, this research is limited and should be investigated further. Thus, this study aimed to explore how patients appraise their fibroadenoma diagnosis uncertainty. Additionally, this study sought to determine if a correlation existed between appraisal and decision making as well as identify the factors that influence the most common treatment decision: removal. Data was retrieved from Reddit discussions for a content analysis. These discussions were then qualitatively analyzed using codebooks associated with this study’s research questions. Findings …

The Interactive Effects Of Brain-Derived Neurotrophic Factor (Bdnf) Polymorphisms And Posttraumatic Stress Disorder On Neurocognitive Functioning In U.S. Military Veterans, Colton Shafer Rippey

Theses and Dissertations--Psychology

Posttraumatic Stress Disorder (PTSD) is associated with mild-to-moderate deficits in neurocognitive functioning. Single nucleotide polymorphisms (SNPs) in the brain-derived neurotrophic factor (BDNF) gene, namely, the Met allele, may also be associated with mild deficits in neurocognitive functioning. However, findings are inconsistent and may be sensitive to environmental epigenetic moderators such as psychopathology.

The current study analyzed data from European-American U.S. military veterans (n = 1,244) who participated in the 2011 National Health and Resilience in Veterans Study (NHRVS). Multivariate analyses of covariances were conducted to evaluate the unique and interactive effects of the Met allele and probable PTSD on …

Religious Beliefs And Behaviors As Predictors Of Substance Use In First-Year College Students: A Longitudinal Study, Hannah B. Mcgee

Theses and Dissertations--Psychology

Substance use is prevalent on college campuses (e.g., Douglas et al., 1997) and can create significant negative consequences (Kodjo & Klein, 2002; NIAAA, 2006). Research suggests that religious beliefs and religious behaviors interact to predict risky substance use in first-year undergraduate students, such that students with religious beliefs but no corresponding behaviors are at risk for significant alcohol use and related problems (Brechting et al., 2010; Cole et al., 2020). However, these studies have only been cross-sectional in nature.

The current study assessed longitudinally if the interaction of religious beliefs/behaviors influenced first-year undergraduate student substance use across the early adjustment …

Psychological Distress And Relationship Satisfaction Among Survivors Of Sexual Violence, Alyssa Campbell

Theses and Dissertations--Family Sciences

The World Health Organization (WHO; 2002) has indicated that sexual violence is a serious public health concern, and both the WHO and the United Nations (UN) have declared that violence against women, in particular, is a profound violation of human rights (UN General Assembly, 1993; WHO, 2017). Although the systemic and negative impact of trauma on family and intimate relationships have been well documented, the empirical literature regarding the effects of adult sexual trauma on relationship satisfaction is less robust. These studies are designed to address this gap and will do so with analyses centered on an understudied population: the …

Measuring The Effects Of Lobinaline-N-Bioxide (419) On Alcohol Consumption, Nicotine Locomotor Sensitization, And Conditioned Place Preference In Mice And Rats, Cocanut M. Suhail

Theses and Dissertations--Medical Sciences

Objective: Novel drug 419 was examined to see the effect it has in vivo mice and rats on alcohol consumption, nicotine locomotor sensitization, and conditioned place preference (CPP) models regarding behavioral tests on dopamine transporter activity.

Methods: Mice and rats were used to see how they react to the drug 419 and control vehicle, in each of the models. The animals were assessed to pre- and post- drug administration of novel drug 419. We examined each model to see the association between how drug 419 will help with treating drug abuse.

Results: We found that in alcohol consumption model the …

Ethanol Sustains Phosphorylated Tau Protein Immunofluorescence In The Cultured Neonatal Rat Hippocampus: Implications For Fetal Alcohol Spectrum Disorders, Caleb Seth Bailey

Theses and Dissertations--Psychology

Fetal Alcohol Spectrum Disorders (FASDs) are comprised of developmental, behavioral, and cognitive abnormalities caused by prenatal alcohol exposure, affecting an estimated 2%-5% of childrenand costing up to $4 billion annually in the United States alone. Although some behavioral therapies can help, the biochemical mechanisms that underpin FASDs need further elucidation for development of more efficacious therapeutics. The tau protein modulates cytoskeletal structure in neurons, and thereby plays an integral role in proper development and function of the central nervous system, but its function is altered by its phosphorylation state, such that increased phosphorylation reduces tau protein function. The tau protein …

Cancer Patients’ Tobacco Use And Tobacco Treatment Referral Response: Implementation Outcomes At A National Cancer Institute- Designated Cancer Center, Tia Borger

Theses and Dissertations--Psychology

Smoking after cancer diagnosis is linked to cancer-specific and all-cause mortality among other adverse outcomes. Yet, 10-20% of U.S. cancer survivors are current smokers. Implementation of evidence-based tobacco treatment in cancer care facilities is widely recommended, yet rarely accomplished. This study focuses on the early outcomes of a tobacco treatment program integrated within an NCI-designated cancer center. Participants consist of 26,365 patients seen at the cancer center during the first 18 months of implementation. The study is a retrospective chart review of patients’ tobacco use, and among current users, patients’ treatment referral response. Over 99% of patients were screened for …

A Survey Of Providers And Patients Assessing The Need For And Use Of Prevention Practitioners To Combat Obesity In The Primary Care Setting, Amanda R. Lyons

DNP Projects

Purpose: The overall aim of this project was to gather information from two groups of stakeholders, providers and patients, on the feasibility of implementing prevention practitioners in the primary care system to address overweight and obesity.

Methods: This study utilized a quantitative descriptive design through the use of electronic surveys. Provider surveys were explained and presented during a monthly provider meeting. Patient flyers were posted in exam rooms and surveys were accessible through a provided link and QR code.

Results: Providers (N=10) agreed that they saw a need for the use of a prevention practitioner (Mean=4.44, SD=.88) as well as …

Screen Time And The Effects On Attention Deficit Hyperactivity Disorder, Cassandra Starks

DNP Projects

PURPOSE: The purpose of this project is to determine if an educational intervention with families decreased overall screen time use in school-aged children with attention-deficit/hyperactivity disorder (ADHD).

METHODS: This study was a single group pre-test, post-test interventional study design. The sample population consisted of the parents/guardians of 30 school-aged children diagnosed with ADHD (5-12 years) recruited from the University of Kentucky Developmental and Behavioral Pediatrics Clinic between November 2019 and February 2020. Parents completed a survey about their child’s daily screen time exposure (tablets/cell phones, laptops/computers, video games, and television) and were educated how screen time can exacerbate ADHD symptoms, …

Nurse-Led Positive Psychology Intervention Is Feasible In Patients With Heart Failure, Erin Taylor

DNP Projects

Introduction:  Prevalence of heart failure (HF) in the US is projected to rise 46% by 2030, resulting in more than 8 million people with HF.  Negative psychologic states including depression and pessimism (negative future expectations) have been linked with poor cardiovascular outcomes, including HF.  Despite the fact that optimism (positive future expectations) and other positive affective states have been associated with superior outcomes, there has been little focus on interventions designed to increase positive psychological states in patients with HF.

Objective: To test the acceptability and feasibility of a nurse-led positive psychology intervention, Best Possible Self (BPS).

Methods: A convenience …

Measuring Glutamate And Oxygen In Brain Reward Circuits In Animal Models Of Cocaine Abuse And Decision-Making, Seth Richard Batten

Theses and Dissertations--Psychology

Drug-specific reward and associated effects on neural signaling are often studied between subjects, where one group self-administers drug and a separate group self-administers a natural reinforcer. However, exposure to drugs of abuse can cause long-term neural adaptations that can affect how an organism responds to drug reward, natural reward, and their reward-associated stimuli. Thus, to isolate drug-specific effects it is important to use models that expose the same organism to all of the aforementioned. Multiple schedules provide a means of dissociating the rewarding effects of a drug from the rewarding effects of food within a single animal. Further, drug users …

Effects Of Multisensory Stop Signals On Sensitivity To Alcohol-Induced Disinhibition In Drinkers With Adhd, Alexandra R. D'Agostino

Theses and Dissertations--Psychology

Multisensory environments facilitate behavioral functioning in humans. The redundant signal effect (RSE) refers to the observation that individuals respond more quickly to stimuli when information is presented as multisensory, redundant stimuli rather than as a single stimulus presented to either modality alone. Our studies show that the disinhibiting effects of alcohol are attenuated when stop signals are multisensory versus unisensory. The present study expanded on this research to test the degree to which multisensory stop signals could also attenuate the disinhibiting effects of alcohol in those with attention-deficit hyperactivity disorder (ADHD), a clinical population characterized by poor impulse control. The …

Neurobehavioral Measurements Of Natural And Opioid Reward Value, Aaron Paul Smith

Theses and Dissertations--Psychology

In the last decade, (non)prescription opioid abuse, opioid use disorder (OUD) diagnoses, and opioid-related overdoses have risen and represent a significant public health concern. One method of understanding OUD is as a disorder of choice that requires choosing opioid rewards at the expense of other nondrug rewards. The characterization of OUD as a disorder of choice is important as it implicates decision- making processes as therapeutic targets, such as the valuation of opioid rewards. However, reward-value measurement and interpretation are traditionally different in substance abuse research compared to related fields such as economics, animal behavior, and neuroeconomics and may be …

Examining The Utility Of Behavioral Economic Demand In Addiction Science, Justin Charles Strickland

Theses and Dissertations--Psychology

The marriage of perspectives from behavioral economic theory and learning theory has the potential to advance an understanding of substance use and substance use disorder. Behavioral economic demand is a central concept to this interdisciplinary approach. Evaluating demand in the laboratory and clinic can improve previous research on the relative reinforcing effects of drugs by accounting for the multi-dimensional nature of reinforcement rather than viewing reinforcement as a unitary construct. Recent advances in the commodity purchase task methodology have further simplified the measurement of demand values in human participants. This dissertation project presents a programmatic series of studies designed to …

When Brain Stimulation Backfires, Sarah Beth Bell

Theses and Dissertations--Psychology

tDCS brain stimulation does not always work in the intended direction. It has been found to sometimes worsen behavior rather than improve it. A preliminary study shows that people high on sensation-seeking and lack of premeditation were prone to reverse effects of tDCS on performance on a Stop Signal Task. Both of these constructs are related to dopamine levels. Study 2 seeks to intentionally cause a reverse effect of tDCS by increasing participants’ dopamine levels via caffeine. There was not a significant interaction between tDCS and caffeine on errors on the Stop Signal Task in this study. However, other factors …

Beyond Telling: A Phenomenology Of Adoptive Parents' Adoption Communication Openness With Early Adolescents, Jane D. Samuel

Theses and Dissertations--Family Sciences

Despite calls for increased Adoption Communication Openness (ACO) within the adoptive family, research indicates that families still struggle to accomplish the recommended elements and levels of openness. What could be holding families back from this key process? Three focus groups comprised of 17 adoptive parents of early adolescents (aged 10-14) who were age 0-2 at the time of placement were thematically coded. This inductive analysis revealed the complexity rooted in being —sometimes successfully and sometimes not—communicatively open. Four key themes emerged painting a vivid and rich picture of: a) the breadth and depth of this experience; b) the work entailed; …

Evaluating The Relationship Between Phq9 And Global Pain Scale (Gps) Scores In Opioid Dependent Adults: A Retrospective Correlational Study, Lori Nolan

DNP Projects

Background: Depression, chronic pain and opioid dependence are conditions commonly encountered in primary care settings. These comorbidities create treatment challenges while negatively influencing outcomes of care. The Patient Health Questionnaire (PHQ9) and Global Pain Scale (GPS) are valid screening tools used to score depression and pain symptoms. The purpose of this study was to determine the relationship between the PHQ9 and Global Pain Scale (GPS) scores in opioid dependent adults with chronic pain to determine whether both tools are necessary.

Methods: This was a descriptive study using a retrospective correlational research design. Data was obtained from the electronic medical records …

Diabetes-Related Distress Screening: A Survey Of Primary Care Providers' Knowledge, Attitudes, And Practices In Treating Patients With Difficulty Meeting Glycemic Goals., Michele Patrice Paxton

DNP Projects

A patient with diabetes is two to three times more likely to be depressed than the general population. Furthermore, the combination of diabetes and depression is associated with increased morbidity and mortality. However, research has shown that treatment for depression does not correlate with lower HbA1c levels or a decrease in morbidity and mortality. Recently, a body of evidence has shown that increased HbA1c levels and depression are associated with the emotional burden of managing diabetes. The emotional burden is caused by the constant behavioral and mental demands of managing the disease and the worry and fear of the impending …