Medicine and Health Sciences Commons^™

A Community Re-Integration Mental Health Occupational Therapy Program For Veterans At The Sioux Falls Veterans Affairs Hospital, Holly M. Forrester

Occupational Therapy Capstone Presentations

The Veteran population continues to be disproportionately impacted by mental health disorders despite growing efforts to address this epidemic. Despite an increase in Veterans Affairs (VA) sponsored programs to mitigate the disparity, the interdisciplinary team tasked with implementing the novel programs remains undiversified. My capstone project aimed to provide a comprehensive community reintegration program to the Veterans in the inpatient behavioral health setting and advocate for the role of occupational therapy on the mental health interdisciplinary team. The literature and needs assessment indicated a need for the implementation of occupational therapy specific groups that aimed to increase functional independence and …

General Anesthesia Clinical Practice Guidelines For Patients With Posttraumatic Stress Disorder, Bradley Closson

Doctor of Nursing Practice Scholarly Projects

General anesthesia is an induced state of unconsciousness administered by anesthesia providers to obtain patient amnesia, analgesia, and akinesia. Adult patients with posttraumatic stress disorder (PTSD) are at risk for general anesthesia-related complications throughout the perioperative setting. Emergence delirium is a clinically significant postoperative complication that patients with PTSD have an increased risk of developing. Postoperative complications of emergence delirium include patient or medical staff injury, surgical site damage, prolonged postanesthesia care unit (PACU) stay, and increased medical care costs. Evidence demonstrates that implementing preventive interventions decreases the incidence of emergence delirium. There are no standardized, evidence-based general anesthesia guidelines …

The Effect Of An Intervention To Improve Screening For Opioid Use In Patients With Post Traumatic Stress Disorder, Tammy Swartz

DNP Projects

Background: Rates of post-traumatic stress disorder (PTSD) were reported to be higher during COVID-19 than during any other epidemic in history. Patients diagnosed with PTSD are at an increased risk of experiencing opioid use disorder (OUD). Early detection, prevention, and treatment are essential to prevent OUD.

Purpose: The purpose of this project was to determine if education aimed at increasing nurses’ knowledge increased patient screenings for OUD.

Methodology: A baseline chart audit was performed to determine the number of patients seen in the emergency department with PTSD who also were evaluated for OUD. Two hundred and forty emergency department registered …

Beyond The Physical Wounds: A Proactive Approach To Mental Health Recovery After A Traumatic Injury, Christine Mcgahey

Doctor of Nursing Practice (DNP) Projects

Beyond the Physical Wounds: A Proactive Approach to Mental Health Recovery After a Traumatic Injury

Background: Every year, millions of Americans incur a life-threatening traumatic event and are admitted to trauma centers to treat their acute physical injuries. While traumatic injury is closely associated with developing post-traumatic stress disorder (PTSD), patients are rarely evaluated for PTSD risk or educated about long-term psychological sequelae.

Local Problem: The predictive value of early screening to quantify PTSD risk in trauma patients is well documented in the literature. However, in a 241-bed Level II Trauma acute care hospital, there was no protocol to evaluate …

Trauma-Informed Treatment For Alcohol Use Disorder: Improving Long-Term Recovery, Aline M. Bales

Doctor of Nursing Practice (DNP) Projects

Background: This DNP project aimed to assess the feasibility of implementing trauma-informed care to Ria Health's telehealth AUD MAT recovery treatment model for patients with co-occurring PTSD, targeting high relapse rates due to cravings. Trauma-informed care addresses traumatic histories that can potentiate emotional dysregulation leading to maladaptive coping responses manifesting as cravings with addiction memory.

Methods: An integrated review assessed the prevalence of co-occurrence of AUD and PTSD, assessed interest in Ria Health patients, patients recruited from Ria Health if they mentioned cravings, offered concurrent trauma-informed care with medicated assisted treatment for 16-20 sessions, trauma-informed care used Polyvagal Theory techniques …

Second-Victimhood Among Anesthesia Providers & The Effects On Patient Outcomes, Erika Aitken

Doctor of Nursing Practice Projects

Anesthesia providers work in environments promoting productivity with tremendous pressure to begin the next case regardless of any recent adverse events that may have occurred (Wands, 2021). Certified nurse anesthesiologists (CRNAs) potentially struggle with a lack of recognition, a high number of hours, inadequate work-life balance, and limited professional advancement, which all contribute to high stress levels within the field (Andrade & Dantas, 2015). A healthcare professional involved in an unexpected adverse event, medical error, or patient-related injury is labeled as a second victim. Thirty anesthesia providers from a central Illinois hospital viewed a PowerPoint presentation, completed a survey, and …

A Holistic Approach To Post-Traumatic Stress Disorder: Alpha-2 Adrenergic Receptor-Sinophilin Cofilin Axis Biologic Antibody Treatment Proposal, Ashley S. Graham

Selected Honors Theses

PTSD affects about 5% of adults in the United States every year.1 This thesis investigates the common biologic therapies for PTSD and the specificity factor of the catecholamine binding to related norepinephrine alpha-2A adrenergic receptors. The binding of these catecholamines to adrenaline receptors in the spinophilin cofilin axis of the dorsal hippocampus causes fear-memory modulation and storage by altering dendritic morphology and thus manipulating neuronal plasticity. Targeting the inhibition of these respective receptors and increasing the activity of cofilin, a protein responsible for breaking down actin utilized for dendrite reaction to stimulus appears promising. By preventing the binding of catecholamines …

Moral Injury To Inform Analysis Of Post-Traumatic Stress Disorder, Amanda Julia Manea

Senior Theses

Post-traumatic stress disorder (PTSD) is a mental health condition that almost one out of ten veterans struggle with. Although the National Center for PTSD has made extensive progress in characterizing and developing new treatments for PTSD, most veterans still experience symptoms of PTSD following treatment. Novel avenues of investigation, such as developing algorithms to review electronic health record (EHR) data and better understanding moral injury, are being pursued to address the gap that still exists when it comes to treating veterans. Moral injury is the individual evaluation of exposure to a potentially morally injurious event (PMIE) and can lead to …

Associations Between Mindfulness Meditation, Health Status, And Activity Limitation Among United States Armed Forces, Bettie J. Dubose

Walden Dissertations and Doctoral Studies

A ready military force is essential for the safekeeping of the United States and the well-being of United States Armed Forces personnel. Today, healthcare professionals report disproportionately high rates of chronic disease and substance abuse among United States Armed Forces personnel and disabling mental health disorders that often go untreated. This quantitative research aimed to determine if there was a relationship between United States Armed Forces personnel using mindfulness meditation and their health status. The study used Bandura's social cognitive theory as its framework and theoretical foundation. Also, a quantitative experimental research design examined the causal relationships between the predictor, …

The Perceived Impact Of Childbirth Related Ptsd And Maternal Bonding, Sheila Baez

Walden Dissertations and Doctoral Studies

AbstractChildbirth has been increasingly viewed as a potentially traumatic event and process impacting both mother and infant. Previous research on childbirth has concentrated on the development of postpartum depression and its impact; research on posttraumatic stress disorder (PTSD) after childbirth has been limited. However, the results of this research study suggested that the development of childbirth-related PTSD may be a far more common phenomenon than previously suggested. Bowlby’s attachment theory and Ainsworth’s further development and expansion of the theory served as a framework which investigated the experiences of 10 biological females, aged 21 and over previously diagnosed with PTSD after …

Perceived Factors Of Intimate Partner Violence On Women Diagnosed With Post-Traumatic Stress Disorder, Angela M. Halcovich

Walden Dissertations and Doctoral Studies

Post-Traumatic Stress Disorder (PTSD) is a prevalent diagnosis, and many human and social services professionals strive to understand its components, to ensure that they serve the population properly. However, little is known about how PTSD may influence women’s vulnerabilities to and future experiences of intimate partner violence (IPV). Emphasizing relationship coaching, which provides tools to foster healthy relationships, within the therapeutic curricula on rehabilitation for women with PTSD may result in reduced chances to experience IPV as women integrate back into their everyday life after being diagnosed and treated for PTSD. The purpose of this generic qualitative study was to …

Perceived Factors Of Intimate Partner Violence On Women Diagnosed With Post-Traumatic Stress Disorder, Angela M. Halcovich

Walden Dissertations and Doctoral Studies

Post-Traumatic Stress Disorder (PTSD) is a prevalent diagnosis, and many human and social services professionals strive to understand its components, to ensure that they serve the population properly. However, little is known about how PTSD may influence women’s vulnerabilities to and future experiences of intimate partner violence (IPV). Emphasizing relationship coaching, which provides tools to foster healthy relationships, within the therapeutic curricula on rehabilitation for women with PTSD may result in reduced chances to experience IPV as women integrate back into their everyday life after being diagnosed and treated for PTSD. The purpose of this generic qualitative study was to …

The Psychological Impact Of An Intensive Care Admission On Survivors Of Acute Respiratory Distress Syndrome And Covid-19 Ards, Leah K. Shinn

Honors Undergraduate Theses

Background:

With the COVID-19 pandemic, there has been an influx of patients with acute respiratory distress syndrome (ARDS), an inflammatory lung condition. ARDS survivors are at high risk for developing post-traumatic stress disorder (PTSD) due to intensive care unit (ICU) medical treatments/procedures. They are known to have traumatic memories triggered by their sensorium months to years after being discharged from the ICU. One study found that 23% of ARDS survivors experienced long-term PTSD symptoms 2-3 years after hospital discharge (Bienvenu et al., 2018). Unknown is whether there are similarities in the memories and sensory triggers of PTSD amongst ARDS and …

Unique Posttraumatic Growth Expression Among Homeless Males Currently Enrolled In Chemical Dependency Treatment, Travis T. Mord

Theses and Graduate Projects

Posttraumatic growth (PTG) has gained considerable research and clinical attention for the past three decades. While the impact of PTG has been well-researched in relation to trauma exposure, medical ailments, or mood related conditions, there are still a number of mental health conditions requiring further analysis. The current study examined the relationship between PTG and key substance use significance indicators, including diagnostic severity of the use disorder and number of previous substance use treatment attempts, among a sample (N = 136) of adult men who were enrolled in a mental illness/chemical dependency (MICD) intensive outpatient program (IOP). This study also …

The Perceived Impact Of Childbirth Related Ptsd And Maternal Bonding, Sheila Baez

Walden Dissertations and Doctoral Studies

AbstractChildbirth has been increasingly viewed as a potentially traumatic event and process impacting both mother and infant. Previous research on childbirth has concentrated on the development of postpartum depression and its impact; research on posttraumatic stress disorder (PTSD) after childbirth has been limited. However, the results of this research study suggested that the development of childbirth-related PTSD may be a far more common phenomenon than previously suggested. Bowlby’s attachment theory and Ainsworth’s further development and expansion of the theory served as a framework which investigated the experiences of 10 biological females, aged 21 and over previously diagnosed with PTSD after …

Neurobiology Of Ptsd In Adults And Children: The Impact Of Stress-Induced Brain Abnormalities Across The Lifespan, Catherine Clover

Undergraduate Honors Theses

In the scholarly community, there is disagreement about the effects of PTSD or chronic stress on the brain of adults and children. Though PTSD or chronic stress are known to negatively affect neurobiological structures, specifically due to prolonged glucocorticoid excess, volumetric discrepancies between traumatized and control groups are not unanimously confirmed. This review sought to address the common understandings in academia of the effects of PTSD on the brains of adults and children. Literature on this topic indicated that, in adults, the hippocampus, cingulate gyrus, and prefrontal cortex bilaterally appeared to decrease in gray matter volume and the corpus callosum …

Physiological Responses Regarding Stress And Trauma: The Freeze Response, Emma Arie Von Holten

UNF Graduate Theses and Dissertations

Fight-or-flight is a commonly known response to threatening situations, but the freeze response is another defensive mechanism that might arise in such situations. There is also evidence that exposure to trauma can impact physiological reactions when defensive mechanisms are not required, such as freezing in response to non-threatening situations. The current study aimed to replicate and expand upon a limited number of previous studies on the human freeze response by implementing measurements of postural sway, heart rate, and infrared thermography while valenced images were shown to participants. Ninety-two participants were recruited from the University of North Florida and participants were …

Mental Health Screening After Trauma: A Concise Review, Christine Mcgahey

DNP Qualifying Manuscripts

OBJECTIVE: To gain a better understanding of the value of mental health screening for PTSD risk in hospitalized trauma survivors.

DATA SOURCES: Studies were pooled from a literature search performed on the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and the Cochrane Database of Systematic Reviews.

STUDY SELECTION: Relevant studies published between 2015 and 2022 in English, excluding traumatic injuries incurred during combat.

DATA EXTRACTION: Ten articles were selected for inclusion in this review.

DATA SYNTHESIS: There is a significant and widespread mental health burden following traumatic injury. Early screening to quantify the risk for PTSD can …

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 …

Multi-Method Approach To Examining Psychosocial Responses And Reactions To Covid-19 In The Us And China, Fan Li

Dissertations

Objective

The purpose is to examine health care providers’ psychosocial responses to COVID-19 in China and the US via exploring relationships among psychological responses and describing experiences of working at the epicenter during the pandemic.

Methods

In manuscript one, a cross-sectional study was conducted in nurse and physician volunteers who provided direct care to COVID-19 patients in Wuhan (volunteers) and those with no COVID-19 contact outside of Wuhan (non-volunteers). A path analysis theoretical model was developed to illustrate the relationships among psychosocial variables and was separately applied to volunteer and non-volunteer groups.

In manuscript two, a cross-sectional study was conducted …

The Role Of Calprotectin In T-Lymphocyte Driven Inflammation In A Mouse Model Of Psychological Trauma, Cassandra Moshfegh

Theses & Dissertations

Post-traumatic stress disorder (PTSD) is a debilitating psychological disorder that affects nearly 45 million Americans. This mental disorder is characterized by behavioral symptoms such as learned helplessness, hyperarousal, withdrawal, and flashbacks. The deleterious effects of PTSD are far-reaching and go beyond behavioral dysfunction, as these individuals are at a three-fold higher risk of comorbid inflammatory diseases. Autonomic, metabolic, and cardiovascular diseases plague these individuals later in their lifetime, however, the mechanistic link connecting psychological trauma to this systemic peripheral immunological dysfunction remains elusive. T-lymphocyte-induced inflammation plays a significant role in all these disease pathologies. Previous work from our laboratory demonstrated …

Psychological Trauma Alters T-Lymphocyte Inflammation And Redox Through Sympathetic Mechanisms, Safwan K. Elkhatib

Theses & Dissertations

Posttraumatic stress disorder (PTSD) is a devastating psychiatric disorder characterized by distinctive symptom clusters, including intrusive memories (i.e., flashbacks), avoidance of related stimuli, affective changes, and hyperarousal. Strikingly, patients with PTSD face a significantly increased risk for a number of inflammation-driven pathologies, ranging from cardiovascular to autoimmune disease. Yet, the exact etiology of this increased risk remains unknown. The immune system is known to be strongly influenced by the sympathetic nervous system, and sympathetic overactivity is a hallmark of PTSD. Lymphoid organs, such as the spleen, are richly innervated by sympathetic nerve fibers which terminate near adaptive immune …

Is Mdma A Safe And Effective Adjunct For Treatment Of Posttraumatic Stress Disorder, Angela Emerson

Physician Assistant Scholarly Project Papers

Background: Post-traumatic stress disorder (PTSD) is a common mental health disorder that affects many Americans and leads to considerable morbidity and mortality. While there are a range of therapies to treat PTSD, treatment resistance is high, leading to a chronic condition in many patients. In recent years, attention has been turned to the use of novel drugs, such as 3,4,- methylenedioxymethamphetamine (MDMA) as a treatment for PTSD.

Aim: The purpose of this literature review was to assess the safety and efficacy of MDMA use in the treatment of PTSD.

Results: MDMA is a schedule I drug, therefore research into its …

Self-Healing With Reiki For Homeless Individuals Suffering From Past Traumatic Events, Kathryn Piha

Theses and Graduate Projects

Living with symptoms that resemble PTSD from past trauma can be detrimental to health, healing, and quality of life. Symptoms that resemble PTSD are intrusive and disruptive to daily life and can cause anxiety, vivid flashbacks and nightmares, and intense memories. Homeless individuals navigate challenges and are at increased risk for developing symptoms that resemble PTSD. This project explored Reiki as a healing modality to improve health, healing, and quality of life from the negative implications of past traumatic experiences. Guided by Martha Roher's SUHB Theory, this project connects Reiki with energy as healing. Understanding energy and energy fields can …

The Impact Of Student Trauma: A Quantitative Investigation On Secondary Traumatic Stress And It's Effects On Nursing Faculty, Devon L. Luthens

Education Doctorate Dissertations

The increase in student trauma and mental illness is putting direct care professionals such as educators at risk of secondary traumatic stress. The purpose of this quantitative survey method research was to explore how nursing faculty within the Minnesota State system were affected by their work with traumatized students and if they experienced significant distress or impairment. The theoretical framework guiding this dissertation was the McCann and Pearlman’s Constructivist Self Development (CSD) theory. There were two research questions that led this study: Does the amount of exposure to student trauma relate to the level of secondary traumatic stress experienced by …

Evaluation Of Hippocampal Allostatic Load-Associated Factors In Animal Models Of Post-Traumatic Stress Disorder: Relevance To Human Ptsd, Dennis Parker Kelley

LSU Doctoral Dissertations

Post-traumatic stress disorder (PTSD) is associated with elevated allostatic load, nearly double the risk for metabolic syndrome, reduced hippocampal volume, and contextual memory processing deficits. Emerging evidence suggests that these stress effects may predispose individuals to the development of PTSD, and there is a known relationship between chronic stress and metabolic dysfunction. In this work, we utilized two rat models of PTSD to explore these connections. We used an acute predator odor stressor to investigate the relationship between PTSD-like behaviors and mitochondrial dysfunction in the hippocampus of rats, and we observed that conditioned place avoidance was associated with reduced mitochondrial …

The Experience Of Providing Direct Care To Children Victims Of Boko Haram Insurgencies In Nigeria, Felicia Etuke

Walden Dissertations and Doctoral Studies

The insurgency of terrorism leaves lasting economic, social, academics, spiritual, religious, and psychological effects, but often children’s psychological welfare is neglected in the aftermath of terrorist attacks. Boko Haram’s presence in Nigeria has left many children orphaned, displaced, and impoverished. Thus, there is a need to highlight the importance of the role that care providers play in securing the psychological health of the child victims of Boko Haram insurgency. This qualitative, phenomenological study explored the experiences of care providers to the child victims of Boko Haram insurgency in Nigeria. Compassion fatigue theory was used as a theoretical framework for the …

Tripping Over Trauma: A Proposal Of Psilocybin-Assisted Therapy For Comorbid Post-Traumatic Stress Disorder And Depression, Liam Paul Gomez

Senior Projects Spring 2022

Post-traumatic Stress Disorder (PTSD) is a widespread, often debilitating affliction that is only partially attenuated by current first-line treatment despite its heightened prominence in the sociopolitical arena. Since individuals with PTSD also experience high rates of depression comorbidity and resultant suicidality, it is essential that treatment is more holistically effective. A possible novel intervention, psilocybin-assisted therapy, has shown promising results for the improvement of depression, addiction, and other disorders; prospectively, when administered with non-directive therapy, it could prove to be an efficacious intervention for PTSD with comorbid depression. In the proposed study, there will be two participant groupings: the control …

Mental Health Concerns Of Frontline Registered Nurses Associated With The Covid-19 Pandemic, Julie Ingle

Dissertations

Problem

COVID-19 caused local healthcare facilities to admit patients with COVID-19 at increasing rates, critically overloading healthcare system resources. Caregiver-related stress associated with the COVID-19 pandemic placed frontline registered nurses (RNs) at risk for mental health consequences (Havlioglu & Demir, 2020; Shechter et al.,2020).

Methods

This quality improvement project used a descriptive design to administer a collection of validated instruments assessing anxiety, depression, posttraumatic stress disorder (PTSD), and demographics. A purposive sample of RNs were recruited from the COVID-19 units in a local hospital, and the survey was distributed via email.

Results

During the implementation period (April 4, 2021-May 15, …

Longitudinal Trauma Treatment Outcomes In An Immigrant And Refugee Sample, Shuen-En Ho

Clinical Psychology Dissertations

Refugee and immigrant populations are at an increased risk of having posttraumatic stress disorder (PTSD) and exhibit a significant amount of variance in trauma treatment outcomes that may be impacted by sociocultural factors. This study examines the impact of demographic variables on treatment outcome and trajectory of PTSD symptoms in a clinic setting with trauma-focused treatments in refugee/immigrant and general populations. Data was collected from the electronic medical record at the Harborview Center for Sexual Assault and Traumatic Stress. A total of 817 participants completed intake, 58 of which self-identified as immigrant/refugee. One-way ANOVAs were conducted to examine group differences …