Medicine and Health Sciences Commons^™

The Lived Experience Of Using Opiates Among Young Adults, Catherine Mbewe

Dissertations, Theses, and Capstone Projects

The purpose of this research study is to explore the lived experience of using opiates, as described by young adults aged 18 to 25 years. Over the last 2 decades, opioid use disorders (OUDs) and opiate overdose deaths have increased dramatically in the United States. What used to be a problem primarily contained to minority groups in poor inner-city areas is now increasingly common in all races, genders, ages, and classes. There has also been an alarming increase in opiate use—including fentanyl, both legal and illegal—among young adults. While much of the literature has been focused on the opiate use …

The Effects Of Music Therapy On Elderly Adults With Dementia, Jeante J. Jackson

Dissertations, Theses, and Capstone Projects

As people age, the brain is more susceptible to changes that diminish cognitive function. In recent years neuroscience has found convergent evidence between music therapy and brain architecture, as it has shown the generation of new connections in the brain or a reorganization and possible strengthening of existing connections already in the brain. However, the literature regarding music training’s effects on executive control, selective attention, and speech processing is lacking particularly when it comes to older populations.

This study investigated Verbal Working Memory, Visuospatial Attention and Task Initiation, and Auditory Selective Attention in a 91-year-old adult (B.P.) diagnosed with dementia. …

The Impossible Situation? Impasse As Psychotherapeutic Paralysis, Possibility, And Progress, Leo Cancelmo

Dissertations, Theses, and Capstone Projects

Psychotherapeutic impasse has long been understood in the clinical literature as treatment stagnation and even failure, both from one-person and two-person psychodynamic perspectives. However, there is a dearth of empirical research that delves deeper to understand this complex and rich phenomenon. Using semi-structured interviews with nine psychodynamic therapists speaking about individual adult patients, this study examined experiences of impasse to better understand treatments that become embroiled in a kind of paralysis. Qualitative analyses revealed dyads where patients were conceptualized as struggling chronically with negative feelings about themselves and others, and who experienced traumatic personal histories. Impasse in and of itself …

The Differential Effects Of Acoustic Discriminations On Operant Learning Performance And Neurogenesis In Male And Female Zebra Finches, Kristena L. Newman

Dissertations, Theses, and Capstone Projects

Adult neurogenesis, the creation of new neurons, occurs throughout the lifespan in most organisms. However, though neuronal proliferation occurs daily, most of these neurons do not survive to become incorporated into preexisting neural circuitry and become fully functioning neurons. In the mammalian brain, adult neurogenesis occurs within the hippocampus, a brain region known to be important in learning and memory. In rats, successful acquisition of certain learning tasks increased new neuron numbers when the learning was sufficiently challenging (Curlik and Shors, 2011). It has also been demonstrated that a spatial discrimination task requires new neurons when the discrimination is more …

A Survey Study Of Speech-Language Therapists’ Experiences With Teletherapy At The Onset Of The Covid-19 Crisis, Jason A. Rosas

Dissertations, Theses, and Capstone Projects

The present study aimed to understand how delivering pediatric treatment services via ‘teletherapy’ affected speech-language therapists (SLTs) during the initial outbreak of the COVID-19 pandemic crisis in 2020. SLTs reported on their experiences with the change from in-person to remote service delivery via two national surveys distributed at the start of the pandemic between April 2020 and July 2020. To explain SLTs’ survey responses, this dissertation introduced the Professional Adaptation Model (PA Model). The PA Model facilitated evaluation of the SLTs’ professional environment and the psychological constructs of their professional identity believed to influence the transition to speech-language teletherapy. Specifically, …

Neuroanatomy In Mild Cognitive Impairment: Relationship To Functional Skills, Treatment Expectancy, And Comorbid Depression, Sara Rushia

Dissertations, Theses, and Capstone Projects

Mild cognitive impairment (MCI) is a neurocognitive disorder defined by cognitive decline in older adults. Although MCI has been studied for decades, there remain important areas to be explored in order to adequately characterize aspects of this disorder that provide information valuable for possible interventions and disease progression to dementia, including a better understanding of the neuroanatomical variables relevant to this disorder. Such neuroanatomical variables include cortical thickness, hippocampal volume, and white matter hyperintensities (WMHs). This dissertation consists of three separate studies aimed at addressing gaps in the literature on MCI in relation to brain morphometrics and under-studied characteristics involved …

Neurocardiovascular Instability (Ncvi) Risk As A Predictor Of Cognitive Function In The Long Life Family Study, Rebecca Abraham

Dissertations, Theses, and Capstone Projects

In aging populations, the abnormal neural control of the cardiovascular system has been examined within the construct of neurocardiovascular instability (NCVI). The main research aim addressed whether baseline features of NCVI could predict cognitive function (i.e., decline) at follow-up within long-lived families. Across 941 subjects, baseline NCVI risk was indexed by two features: (1) self-reported syncopal or fall events and (2) average seated BP. The Low NCVI risk group included those who were normotensive (e.g., within normal BP range) and reported no NCVI features (n=379). The Moderate NCVI risk group included those who elicited pre-hypertensive (elevated BP) or hypertensive (high …

Exploring Social Identity Threat And Safety Cues For Lesbian, Gay, Bisexual, Pansexual, And Queer Cisgender Women In Ob/Gyn Care, Rachel Fikslin

Dissertations, Theses, and Capstone Projects

Lesbian, gay, bisexual, pansexual and queer (LGBPQ) cisgender women (CW) experience a number of health inequities compared to heterosexual cisgender women related to sexual and reproductive health. Heterosexist health care cultures may signal social identity threat for LGBPQ-CW that may undermine their health care engagement and outcomes. In three online studies, I examined the effects of two heterosexist cultures (i.e., gender essentialism and pronatalism) as well as two potentially identity-safe alternatives (i.e., gender diversity and reproductive/sexual autonomy) on the identity threat and health care engagement experiences of LGBPQ-CW in OB/GYN care.

In Study 1 (n = 213), I used …

Effects Of Chronic Stress On Safety Processing And Physiology In The Medial Prefrontal-Amygdala-Basal Forebrain Circuit, Itamar S. Grunfeld

Dissertations, Theses, and Capstone Projects

Chronic stress increases generalization of fear to non-threatening cues, a key symptom in numerous psychiatric mood disorders. However, the mechanisms through which stress impacts safety learning remain poorly understood. To probe the relationship between stress and safety learning, this dissertation employed multiple behaviors, in conjunction with in-vivo multisite physiology during explicit safety and fear discrimination learning. In Chapter 1, I outline the role of chronic stress in driving neurological adaptations that result in generalized fear and highlight how this occurs because of impaired safety cue encoding. In Chapter 2, I show that chronic stress in the form of social defeat …

Reducing Fear Overgeneralization With Safety Learning: Attention Bias As A Moderator, Boyang Fan

Dissertations, Theses, and Capstone Projects

Anxiety disorders are the most prevalent mental health condition and affect one out of nine individuals around the world. Fear generalization is a neurocognitive mechanism thought to maintain and exacerbate anxiety, and thus is an important target of therapeutic interventions. Yet, intervention research and practice place relatively little emphasis on its importance. Given that a significant proportion of individuals do not respond to extant treatments of anxiety disorders, a strengthened focus on fear generalization may inform the development and personalization of new treatment approaches. Recent notions have linked fear generalization to failures in distinguishing between signals that predict the occurrence …

Informed Consent: Foundations And Applications, Joanna Smolenski

Dissertations, Theses, and Capstone Projects

Since its advent in the 20th century, informed consent has become a cornerstone of ethical healthcare, and obtaining it a core obligation in medical contexts. In my dissertation, I aim to examine the theoretical underpinnings of informed consent and identify what values it is taken to protect. I will suggest that the fundamental motivation behind informed consent rests in something I’ll call bodily self-sovereignty, which I argue involves a coupling of two groups of values: autonomy and non-domination on the one hand, and self-ownership and personal integrity on the other. I will then go on to consider two 'case …

A Randomized Controlled Trial Of Psychological Outcomes Of Mobile Guided Resonant Frequency Breathing In Young Adults With Elevated Stress During The Covid-19 Pandemic, Al Amira Safa Shehab

Dissertations, Theses, and Capstone Projects

Deep breathing practices have shown promise in reducing stress, anxiety, and depression in different populations, including young adults. Specifically, resonant frequency breathing can exert an impact on stress response systems through the vagus nerve and the hypothalamo-pituitary-adrenal (HPA) axis. This may induce reductions in stress and improvement in emotion regulation. Young adults, including college students, tend to be at a higher risk for psychological distress, as they face several psychosocial challenges. The COVID-19 pandemic has imposed new and unique stressors that resulted in higher levels of stress and emotional symptoms and it has been shown that this may have placed …

The Effect Of Anticipatory Anxiety On Fear Extinction Learning, Daniela C. Echeverria

Dissertations, Theses, and Capstone Projects

Adaptive regulation of fear is dependent on successful fear extinction learning; therefore, investigating factors that both enhance and diminish fear extinction learning is a critical line of research. In the present study, we induce mild anticipatory anxiety during fear extinction learning in an attempt to modulate how participants extinguish fear memory. In the experiment, we apply a classic three-day fear learning protocol to both control participants (N = 20) and an experimental group (N = 20) with fear acquisition, fear extinction, and fear recovery phases; each phase is separated by a period of 24 hours and we use a skin …

Delayed Modulation Of Glutamate Receptors By Anti-Epileptic Drugs After Traumatic Brain Injury In Rats, Edgar Rodriguez

Dissertations, Theses, and Capstone Projects

Traumatic brain injury (TBI) is a significant health concern. Around 74 million people sustain a traumatic brain injury worldwide. The damage caused by TBI produces two types of injury; primary and secondary injuries. Primary injury is caused within milliseconds and is irreversible. Secondary brain injury is delayed and produced by molecular, cellular, and structural disruption after the initial injury. One of the most devastating dysfunction after TBI is glutamate neurotransmitter overactivation that could lead to neurotoxic levels of glutamate in the brain (i.e., excitotoxicity). Excitotoxicity has been linked with the development of epilepsy after TBI, also known as post-traumatic epilepsy …

Antecedents Of Borderline Personality Disorder And Antisocial Personality Disorder: An Examination Of Gene X Environment Interactions, Amy L. Medina

Dissertations, Theses, and Capstone Projects

Current thinking suggests that genotypes associated with impulse-control disorders and negative emotionality, such as monoamine oxidase-a (MAOA), interact with negative early environmental factors like childhood maltreatment and develop into the disorders know as Borderline Personality Disorder (BPD) and Antisocial Personality Disorder (ASPD). Using existing data from a prospective cohort design study of the consequences of child abuse and neglect, participants (N = 896 represent individuals with documented histories of child abuse and neglect and a matched comparison group that were followed up into adulthood and interviewed. A subsample of 631 participants gave permission for DNA extraction and analyses during …

Attachment, Exploration, And Internalized Homonegativity, Gregory J. Gagnon

Dissertations, Theses, and Capstone Projects

Background: Internalized homonegativity (IH; a.k.a. internalized homophobia), has been implicated in health disparities between lesbian, gay, and bisexual persons (LGBs) and their heterosexual peers. Yet, little available research has explored factors that may increase or decrease IH.

Objective: This dissertation investigates relations between child and adult attachment and IH. It further examines the mediating and moderating roles of exploration and mentalization, respectively, in the attachment–IH relation.

Method: One hundred fifty cisgender LGB adults participated in two waves of an online survey. The first assessed recalled child–maternal and child–paternal attachment and current attachment to the romantic partner. The second, conducted two …

Sex/Gender Differences In Serial Position Profiles In Patients With Mild Cognitive Impairment And Healthy Controls, Emnet Z. Gammada

Dissertations, Theses, and Capstone Projects

Introduction: Alzheimer’s disease disproportionately affects more women, but paradoxically, men have a higher incidence of Mild Cognitive Impairment (MCI). Researchers have suggested that women’s verbal memory advantage across the lifespan reflects better premorbid skills, which then require more neurodegeneration to manifest early clinical impairment. To date, measurement of sex differences in verbal memory have used total list scores. We proposed that a granular examination of serial position effects (SPE) in list-learning can refine the source of sex/gender differences.

Methods: A cross-sectional analysis of participants with Mild Cognitive Impairment (MCI) and Healthy Controls (HC) was examined from the Alzheimer’s Disease Neuroimaging …

Taking It To Heart: Trauma And Cardiovascular Risk In Court-Involved People Of Color, Tanya Erazo

Dissertations, Theses, and Capstone Projects

Research supports that racial disparities in health persist in the United States, with cardiovascular risk and cardiovascular disease remaining particularly high in low-income, communities of color (U.S. Department of Health and Human Services: Centers for Disease Control and Prevention, 2013; Winkleby, Jatulis, Frank, & Fortmann, 1992). Public health literature often focuses on sociodemographic variables when assessing for health disparities without considering trauma or forensic populations. This dissertation provides an overview of literature that examines cardiovascular disease and its relationship to trauma, particularly in low-income, communities of color, and forensic populations. Although the dissertation culminates in providing results for an investigation …

Rehabilitative Movement Approaches And Dance Interventions In Parkinson’S Disease, Cecilia Fontanesi

Dissertations, Theses, and Capstone Projects

The scope of this work is to address the functional deficits and symptoms experienced by those living with Parkinson’s Disease through movement interventions.

Chapter 1 offers a brief overview of current pharmacotherapy and rehabilitation approaches in Parkinson’s, focusing on dance in particular as a movement intervention that may be particularly suited to this population.

Chapter 2 focuses on brain plasticity and motor learning in PD, reporting the effects of rTMS applied after the acquisition of a motor skill. In this study, adaptation tested in patients with PD was comparable in the sham and TMS sessions, while retention indices tested on …

Object Relations, Identity Formation, And Transitional Space In Religious Conversion, Arielle Rubenstein

Dissertations, Theses, and Capstone Projects

Conversion between broad religious groups is a life transformation undertaken by 15% of Americans, yet it has seldom been studied closely from a psychodynamic perspective. The psychological study of conversion began with a Protestant paradigm of sudden and total transformation of the self, and over time came to characterize different manifestations of conversion to more diverse religious groups. Research on conversion has primarily sought to understand whether conversion is essentially a psychopathological phenomenon, and has led to a multiplicity of both positive and negative, at times contradictory, findings. Research has shown that conversion is associated with insecure attachment, neurotic personality …

Neurodevelopmental Mechanisms Of Adverse Trauma Outcomes In Emerging Adulthood, Olena Kleshchova

Dissertations, Theses, and Capstone Projects

Background: Exposure to traumatic stress and adversity during the formative years of development can have adverse effects on mental health, neuroendocrine stress system function, and the brain, that persist into adulthood. One candidate mechanism that might confer vulnerability to enduring adverse outcomes of early life trauma is disruption of normal brain maturation. As the brain matures, functional interactions among brain regions change until the functional brain architecture (i.e., the functional connectome) reaches a mature state in adulthood. Given that different neural circuits have distinct developmental trajectories and sensitive periods, traumatic stress at a given point in development might have …

Development Of An Aba Tool Kit For Audiologists To Increase Hearing Aid Wear Time In Individuals With Autism, Lindsay Brown

Dissertations, Theses, and Capstone Projects

When working with individuals with the dual-diagnosis of hearing loss and Autism Spectrum Disorder (ASD), audiologists are often faced with unique challenges and must adapt their approach in order to more effectively address the needs of these individuals. Currently, there is only a small body of research focused on the special considerations required for appropriately fitting and utilizing amplification for children with the dual-diagnosis of hearing loss and ASD. Subsequently, recommendations and strategies for clinicians to implement when faced with these common challenges, specifically of hearing aid compliance and appropriate hearing aid wear time, are lacking. It is important to …

Electroencephalographic Asymmetry, Emotion Regulation, And Their Relationships With Depression Risk, Aliza Jacob

Dissertations, Theses, and Capstone Projects

Background: Research investigating patterns of electroencephalographic (EEG) brain asymmetry aids our understanding of neural systems involved in the processing of emotion, motivation, and psychopathology. Withdrawal-motivated negative emotions characteristic of depression are associated with relative right prefrontal cortex (PFC) activity, whereas approach- motivated positive emotions are associated with relative left PFC activity. Styles of emotion regulation (ER), or modulation of the intensity and duration of emotional responses, are also associated with presence (e.g., suppression, or maladaptive ER) versus absence (e.g., cognitive reappraisal, or adaptive ER) of depression vulnerability. Most PFC asymmetry studies of emotion, depression, and/or ER rely upon EEG recorded …

The Development Of Face Morphing Task To Assess Self Other Differentiation, Esen Karan

Dissertations, Theses, and Capstone Projects

Self-Other Differentiation (SOD) refers to a developmental process of acquiring a consolidated, integrated, and individuated sense of self. SOD develops at a) perceptual (e.g., facial perception) and b) representational (e.g., traits, mental states, and beliefs) levels. Impairments in representational SOD (R-SOD) are associated with many forms of psychopathology, particularly borderline personality disorder (BPD) and narcissistic personality disorder (NPD). Few studies to date have examined the perceptual aspects of SOD (P-SOD), which are hypothesized to develop from infancy onwards in tandem and in interaction with R-SOD. Given that the human face is one of the key characteristics that humans use to …

Emotion Processing Deficits In Psychopathy: Does Cueing To Relevant Facial Features Increase Cognitive And Emotional Empathy?, Shawn E. Fagan

Dissertations, Theses, and Capstone Projects

Psychopathy is a multifaceted disorder characterized by a lack of cognitive and emotional empathy. The traditional model of psychopathy divides the disorder into two factors: Factor 1 consists of the interpersonal and affective traits of psychopathy while Factor 2 measures antisocial behaviors and lifestyle choices. The attention-to-the-eyes hypothesis argues that psychopathic individuals have impaired emotion recognition (specifically for fear) due to deficits in orienting attention to salient facial features like the eyes. Psychopathic individuals also display blunted autonomic responding to emotional stimuli, though whether this is due to attention-orienting deficits remains to be clarified. The present project investigated whether empathy-related …

Does Ethnic Identity, In-Group Preference, And Acculturation Protect Latinas With A History Of Interpersonal Trauma From Developing Symptoms Of Ptsd?, Evelyn M. Ramirez

Dissertations, Theses, and Capstone Projects

Previous research suggests ethnic identity, a sense of belonging to a particular cultural group, may be protective against symptoms of post-traumatic stress disorder (PTSD). However, the role of ethnic identity, in-group preference (i.e., an individual’s preference for interactions with members of their own ethnic group) and acculturation (i.e., the level of comfort with the mainstream culture) have not been investigated as protective factors for Latinas with a history of interpersonal and sexual trauma. In this study, ethnic identity, in-group preference and acculturation were assessed via self-report on the Scale of Ethnic Experience in two samples of undergraduate Latina and non-Latina …

Impact Of Religiosity And Level Of Acculturation On Cultural Alignment: An Exploration Of Terror Management Mechanisms Among Muslim American Women, Farah T. Goheer

Dissertations, Theses, and Capstone Projects

ABSTRACT

Impact of Religiosity and Level of Acculturation on Cultural Alignment: An Exploration of Terror Management Mechanisms among Muslim American Women

by

Farah Taha Goheer, M.A.

Advisor: Joel Sneed, Ph.D.

Background: Terror management theory (TMT) is based upon the notion that human beings require ongoing psychological protection from the unyielding, existential threat of death. A large body of evidence has shown that human beings manage death-related terror by aligning with and endorsing the dominant views of their cultural worldviews. Notably, as immigrants experience a new culture, worldviews become rearticulated to incorporate elements of host and heritage cultures. However, it is …

The Social Cost Of Pain: Rejection Sensitivity, Social Rejection, And Cannabis Use In Young Adults, Naomi Dambreville

Dissertations, Theses, and Capstone Projects

Cannabis has been implicated in relieving distress and social pain, an important area of research in young adult samples, given the saliency of peer and social networks to addiction. Cannabis, via opioid pathways, has been shown to reduce, or potentially buffer, the effects of social pain and rejection. Thus, cannabis may be protective against the painful feelings of social stress, particularly for heavier or more frequent users. However, findings are not wholly positive, as other research indicates cannabis may blunt affective responses and impair social processing. The effects of cannabis use in young adults are understudied, as well as its …

Clinical Characteristics And Neuroanatomical Predictors Of Acute Antidepressant Outcome For Patients With Comorbid Depression And Mild Cognitive Impairment, Jeffrey N. Motter

Dissertations, Theses, and Capstone Projects

Background: Older adults presenting with both a depressive disorder (DEP) and cognitive impairment (CI) represent a unique, understudied population. The classification of cognitive impairment severity continues to be debated though it has recently been subtyped into late (LMCI) versus early (EMCI) stages. Previous studies have found associations between treatment outcome and both cortical thickness and white matter hyperintensities (WMH), though report inconsistent directionality and affected regions. In this study, we examined baseline clinical characteristics and neuroanatomical features as prognostic indicators for older adults with comorbid DEP and CI participating in an open antidepressant trial. EMCI is hypothesized to have greater …

Mindfulness In Medicine: Modified Mindfulness-Based Stress Reduction (Mbsr) Program Among Future Doctors, Virtue Sankoh

Dissertations, Theses, and Capstone Projects

Medical trainees are at particular risk for stress-related illness, including mental health problems such as suicidal ideation, substance abuse, and mood disorders. A vast literature on mindfulness-based stress reduction (MBSR), consisting of mindfulness education and structured meditative practices, has consistently demonstrated that MBSR and related mindfulness-based interventions improve mental and physical health, as well as one’s overall sense of well-being. Moreover, theorists and researchers have begun to suggest further that mindfulness plays a particular role in social cognition, or social-emotional learning. Medical schools have long been interested in ways to improve the “soft skills” related to interpersonal connectedness that are …