Medicine and Health Sciences Commons^™

Collaborative Models Of Care In The Appalachian Region Of Tennessee: Examining Relationships Between Level Of Collaboration, Clinic Characteristics, And Barriers To Collaboration, Jeffrey Ellison

Electronic Theses and Dissertations

Decades of research have shown that there are significant advantages to maintaining close communicative and collaborative relationships between primary care and behavioral health providers. Fiscal, structural, and systemic barriers, however, often restrict the degree to which such interprofessional collaboration can occur. In the present study the authors examined relationships between primary care clinics in the Appalachian region’s characteristics (i.e., clinic type, rurality, and clinic size), barriers (i.e., fiscal, structural, and systemic) reported to using increased collaboration, and the level of collaboration used at a particular clinic.

For the present study 136 surveys were completed by providers working in primary care …

Mental Health Referral In Primary Care: Influence Of A Screening Instrument And A Brief Educational Intervention, Michael T. Miesner

Electronic Theses and Dissertations

Although less than half of all patients with mental disorders seek mental health treatment per se, approximately 80% of all people will visit their primary care physician (PCPs) within a year (Strosahl, 1998). However, it is not well understood how to best handle patients presenting with mental health issues in primary care practices. The purpose of this project was to implement an intervention involving a screening measure for anxiety and mood disorders in a primary care setting to increase the volume of anxiety and mood disorder screening, to increase the accuracy of disorder detection, and to also enhance PCPs patterns …

Basic Psychological Needs, Suicidal Ideation, And Risk For Suicidal Behavior In Young Adults, Peter C. Britton, Kimberly A. Van Orden, Jameson K. Hirsch, Geoffrey C. Williams

ETSU Faculty Works

Associations between the satisfaction of basic psychological needs of autonomy, competence, and relatedness with current suicidal ideation and risk for suicidal behavior were examined. Two logistic regressions were conducted with a cross-sectional database of 440 university students to examine the association of need satisfaction with suicidal ideation and risk for suicidal behavior, while controlling for demographics and depressive symptoms. Suicidal ideation was reported by 15% of participants and 18% were found to be at risk for suicidal behavior. A one standard deviation increase in need satisfaction reduced the odds of suicidal ideation by 53%, OR (95% CI) = 0.47 (0.33–0.67), …

Family Criticism And Depressive Symptoms In Older Adult Primary Care Patients: Optimism And Pessimism As Moderators, Jameson K. Hirsch, Kristin L. Walker, Ross B. Wilkinson, Jeffrey M. Lyness

ETSU Faculty Works

Objective: Depression is a significant global public health burden, and older adults may be particularly vulnerable to its effects. Among other risk factors, interpersonal conflicts, such as perceived criticism from family members, can increase risk for depressive symptoms in this population. We examined family criticism as a predictor of depressive symptoms and the potential moderating effect of optimism and pessimism.

Methods: One hundred five older adult, primary care patients completed self-report measures of family criticism, optimism and pessimism, and symptoms of depression. We hypothesized that optimism and pessimism would moderate the relationship between family criticism and depressive symptoms.

Results: In …

Neuromodulation Therapy Mitigates Heart Failure Induced Hippocampal Damage, Timothy P. Diperi

Undergraduate Honors Theses

Cardiovascular disease (CVD) is the leading cause of death in the United States. Nearly half of the people diagnosed with heart failure (HF) die within 5 years of diagnosis. Brain abnormalities secondary to CVD have been observed in many discrete regions, including the hippocampus. Nearly 25% of patients with CVD also have major depressive disorder (MDD), and hippocampal dysfunction is a characteristic of both diseases. In this study, the hippocampus and an area of the hippocampal formation, the dentate gyrus (DG), were studied in a canine model of HF. Using this canine HF model previously, we have determined that myocardial …

Rural Pediatric Primary Care Practice Patterns As A Result Of An On-Site Behavioral Health Consultant: A Retrospective Analysis, Kayla D. Mccarter

Undergraduate Honors Theses

Nationally, it has been estimated that 10 to 21% of children with psychosocial concerns are seen in primary care settings (Jellinek et al., 1999; McInerny, Szilagyi, Childs, Wasserman & Kelleher, 2000; Palermo et al., 2002). Often, however, children go undiagnosed with/treated for psychosocial concerns in pediatric primary care due to lack of physician time and poor referral rates to mental health providers. Evaluations of integrated care models, in which a behavioral health consultant is present in primary care practices, has shown to increase the availability of mental health services (Stancin, Perrin, & Ramirez, 2009). Using extant data from patient records …

Depression Is More Prevalent Throughout Pregnancy And The First Six Months Postpartum In Women Low In Religious Commitment And Social Support, Andrea D. Clements, Tifani A. Fletcher, Beth A. Bailey

ETSU Faculty Works

Abstract available through the Annals of Behavioral Medicine.

Optimism And Planning For Future Care Needs Among Older Adults, Silvia Sörensen, Jameson K. Hirsch, Jeffrey M. Lyness

ETSU Faculty Works

Aging is associated with an increase in need for assistance. Preparation for future care (PFC) is related to improved coping ability as well as better mental and physical health outcomes among older adults. We examined the association of optimism with components of PFC among older adults. We also explored race differences in the relationship between optimism and PFC. In Study 1, multiple regression showed that optimism was positively related to concrete planning. In Study 2, optimism was related to gathering information. An exploratory analysis combining the samples yielded a race interaction: For Whites higher optimism, but for Blacks lower optimism …

Health Behaviors Among College Students: The Influence Of Future Time Perspective And Basic Psychological Need Satisfaction, Preston L. Visser, Jameson K. Hirsch

ETSU Faculty Works

Health behavior change may prevent many fatal diseases, and may be influenced by social and motivational constructs. We assessed the interaction effect of future time perspective and basic psychological need fulfillment on positive and negative health behaviors. Future time perspective was associated with more positive, and less negative, health behaviors. Need fulfillment was associated with only positive health behaviors. In moderation analyses, individuals reporting both high need fulfillment and future perspective reported greater positive health behaviors, and were especially unlikely to smoke. Enhancing future-mindedness and supporting need satisfaction in interventions targeting modifiable health behaviors is encouraged.