Medicine and Health Sciences Commons^™

Designing And Implementing A De-Escalation Toolkit To Improve Staff Education And Competency On De-Escalation Within A Mental Health Outpatient Setting, Balraj Bajwa

Doctor of Nursing Practice (DNP) Projects

Background: The purpose of this study is to develop and implement a de-escalation toolkit to help improve memory, retention, and utility of de-escalation techniques within an outpatient mental health crisis stabilization unit.

Problem: The aforementioned crisis stabilization unit has elevated rates of patient aggression/violence and staff present with difficulty recalling de-escalation techniques due to the lapse in memory and/or retention.

Methods: The project was introduced to the stakeholders of the crisis stabilization unit and input was obtained on the design and components of the toolkit. Various analyses were conducted to ensure the appropriate implementation of the project.

Intervention: A de-escalation …

The Ecology Of Mental Health And The Impact Of Barriers On Mental Health Service Utilization, Alisha Aggarwal

Theses & Dissertations

Mental health has emerged as a major public health concern in recent times with several disparities and barriers related to adequate health service utilization. Different age groups experience diverse symptoms and face distinct barriers in accessing and utilizing healthcare. Policies like Mental Health Parity and Addiction Equity Act and the Patient Protection and Affordable Care Act were launched to improve insurance coverage and delivery of mental health services. However, a large gap of unmet needs exists for adequate mental health service utilization in the country. This dissertation aims to describe the financial and non-financial barriers to mental health service utilization …

Giving Birth At A Critical Time: Assessing Perinatal Depression Among Syrian Refugees In Low Resource Settings, Nada Alnaji

Theses & Dissertations

Refugee mothers are at an increased risk of suffering from stress and mental health conditions during the first year after giving birth to a child. The objective of this study is to enhance the early identification of treatable mental health conditions among perinatal women living within humanitarian settings. The central hypothesis is that a culturally specific approach can be helpful for the long-term success of mental health efforts. In this study, we use qualitative interview methods to understand the cultural paradigms and predisposing factors for perinatal depression related to being a Syrian refugee in Lebanon during the COVID-19 pandemic. In …

The Influence Of Comorbid Gad On Er Utilization In Urban Youth With Asthma, David A. Karpe

Theses and Dissertations

Current literature indicates a strong association between asthma and the early onset of comorbid generalized anxiety disorder (GAD) in minors and their primary caregivers. Studies show that asthma prevalence increases with certain demographic factors, such as ethnicity, socioeconomic status, and housing quality. Evidence also suggests that GAD influences decision-making, especially when deciding to utilize emergency room (ER) services for asthma-related concerns. This study analyzed the effect of comorbid GAD on minors with asthma and ER utilization. The data were provided by an earlier Stress & Justice Study (S&J) baseline survey, an investigation aimed at understanding the impact of parental criminal …

Depression As A Moderator Of The Relationship Between Perceived Injustice And Neuropsychological Performance Validity Among Individuals Previously Diagnosed With A Concussion, Jeremiah Lum

Clinical Psychology Dissertations

Concussion is one of the most common conditions seen within rehabilitation and neuropsychology. Given that many concussions are diagnosed following litigation-associated injuries, it is unsurprising that malingered neurocognitive deficit (i.e., deliberate underperformance on cognitive instruments in the interest of secondary gain) has dominated the concussion literature. Although the identification of malingering is essential to ethical assessment, its presence or absence is not the sole determinant of performance validity as a whole. Rather, performance validity is a broad construct involving effort, which refers to examinees’ investment in performing at capacity levels; emerging research suggests this can be affected by psychological factors …

Moderate Prenatal Ethanol Exposure, Sex, And Housing Modify Spatial Navigation Behavior And Hippocampal Cell Firing In Adult Rodents, Christy Magcalas

Psychology ETDs

Prenatal alcohol exposure (PAE) is associated with structural and physiological changes that impact the central nervous system and can result in persistent negative consequences in a broad spectrum of cognitive and behavioral domains including deficits in spatial learning and memory and behavioral flexibility. The current study focuses on examining the behavioral and mechanistic consequences of PAE, sex and housing. Rats were tested in the Morris Water Task where they were trained to navigate to a goal location and tested in a pool shift manipulation. There were no significant differences between PAE treatment, sex, or housing groups during training, but there …

Therapeutic Potential Of Psychedelic Drugs, Specifically Magic Mushrooms, Marijuana, And Mdma With Veterans Who Suffer From Post-Traumatic Stress Disorder (Ptsd), Misty Schutterle

Counselor Education Capstones

Post-Traumatic Stress Disorder (PTSD) is a stress-based condition that a person develops after being exposed to an overwhelmingly traumatic event. Military troops frequently experience stress and trauma, making them highly susceptible to psychopathology. This paper evaluates nine clinical trials that used either magic mushrooms, marijuana, or MDMA as an adjunct to traditional psychotherapy to treat veterans who suffer from anxiety, depression, PTSD, suicidality, and other psychopathologies. Multiple scholarly journals and articles were read and analyzed, which show support for the therapeutic potential of psychedelic drugs in treating veterans with PTSD. After receiving psychedelic-assisted psychotherapy, the research showed participants experienced a …

Peer-Led Building Resilience And Enhancing Social-Emotional Skills Program, Danielle K. Enrico

Department of Occupational Therapy Entry-Level Capstone Projects

The purpose of the Capstone experience was to develop and implement a five-week peer-led building resilience and social-emotional skills training program at a public high school. This program addressed high school students' knowledge, skills, and attitudes regarding resources, social-emotional skills, and resilience. A questionnaire was administered pre and post-program to measure effectiveness. The results indicated an increase in scores, demonstrating a clearer understanding in all three areas.

Change Project Using A Fall Prevention Action Program To Decrease Falls On A Behavioral Health Unit, Amy Shuptrine

Student Scholarly Projects

Practice Problem: Fall rates are increasing in the behavioral health units of the East Texas hospital. Due to the worldwide COVID-19 pandemic, the units are short-staffed, which further supports the urgent need for a targeted intervention to reduce fall risk.

PICOT: The PICOT question that guided this project was: “In adult behavioral health patients (P), what is the effect of the Edmonson Psychiatric Fall Risk Assessment Tool (I), compared with previous use of the Morse Fall Risk tool (C), on the fall rate (O), in 8 weeks (T)?”

Evidence: Falls are the most reported incidents in acute care hospitals and …

Direct And Indirect Effects Of Alcohol Craving And Demand On Obsessive And Compulsive Drinking Characteristics: The Role Of Impulsivity, James V. Turner Iv

Theses and Dissertations

This study’s goal was to test a novel model of obsessive-compulsive thoughts about drinking. Young adults completed tasks measuring potential drinking characteristics. Findings indicated demand was related to higher OCTD, a significant effect of CIC on OCTD via demand, and that the relationship was particularly strong for impulsive individuals.

Implementation Of An Interprofessional Fall Prevention Program To Reduce Falls On An Older Adult Inpatient Psychiatric Unit, Teresa Woodson

Doctor of Nursing Practice

Background. Falls are the most reported incidents in the hospital setting, especially among older adults. According to the National Database of Nursing Quality Indicators (NDNQI), the number of falls in inpatient psychiatric units is 13-25 per 1,000 patient days, compared to 4 per 1,000 days for medical-surgical units. This DNP project aims to implement an interprofessional fall risk team to reduce falls in an older adult inpatient psychiatric unit. Problem. The psychiatric inpatient units had a total of 31 falls, with 13 (40%) occurring on the older adult unit. Interventions. Education of nursing staff, providers, and physical therapy (PT) …

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 …

Investigating The Role Of Targeted Memory Reactivation In Sleep Spindle Production, Justin W. Hopper

Electronic Thesis and Dissertation Repository

In ‘targeted memory reactivation’ (TMR) paradigms, information learned during wakefulness is paired with a cue, and reactivated during sleep by presenting that same cue. TMR improves memory. In a prior study (Antony et al., 2012), participants learned two melodies. One melody was cued during a nap, and performance was better than for the uncued melody. The current study reanalyzed these data to characterize sleep spindle density during TMR cue-periods relative to non-cued periods, and whether spindle density correlated with performance. During TMR stimulation, spindle density was significantly higher than during non-stimulation in four time windows. Compared to the non-TMR group, …

Physical Therapy And Occupational Therapy Well-Being, Jenna Pilkington, Dara Musher-Eizenman, Cindi Baum, Elizabeth Emley

Honors Projects

There is a lack of research in the professions of physical therapy and occupational therapy. To be more specific, the areas of stress and burnout have been topics of research within the healthcare field for medical physicians and nurses, but currently there is little research looking at stress and burnout for physical therapists and occupational therapists. (Anderson 2015; Berry 2019). The current study aims to look at the emotional connections between patients and professions, along with the related emotional stress experienced by these professionals. A survey was administered to 59 physical therapists and occupational therapists for the purpose to give …

Depression Screening In Primary Care: Implications For Practice, Donna Pittman

Doctoral Projects

Depression is a mood disorder that has affected lots of people worldwide. Depression is a disease that affects an individual's social functioning, relationships, and finances. Individuals with depression may have feelings of sadness, loss of interest in formerly enjoyed activities, hopelessness, irritability, decreased energy, difficulty concentrating and sleeping changes in appetite, or chronic generalized aches and pains. Over the recent year, there has been a rise in individuals presenting to the primary care providers with symptoms of depression. Mental disorders attribute to one of the leading causes of disability in the United States.

Healthcare providers in the primary care setting …

Passing As White: The Experiences Of Bipoc Supervisees, Bridget Anton

Seton Hall University Dissertations and Theses (ETDs)

Cross-racial supervisory dyads are becoming more prevalent due to the increased diversity of graduate students in psychology. However, research has not adequately examined the narratives of BIPOC supervisees who pass as White. People who pass as White might not be seen as a person of color and their identities might be ignored because it is considered invisible. Due to the lack of research on BIPOC supervisees with a passing identity experience within the context of the supervisory dyad, this study explored the subjective experiences of BIPOC supervisees who pass as White in cross-racial supervisor dyads. Furthermore, an exploration into conversations …

The Functional And Structural Consequences Of Aberrant Microglial Activity In Major Depressive Disorder, Jasmine D. Cakmak

Electronic Thesis and Dissertation Repository

Major depressive disorder (MDD) is a highly debilitating neuropsychiatric illness which has been linked with increases in both peripheral and central inflammation, as well as with changes in connectivity. Although countless studies have investigated these two topics, the relationship between neuroinflammation and functional/structural connectivity has not been explored. Using [¹⁸F]FEPPA PET imaging, we measured translocator protein-related (TSPO) microglial activity in the subgenual anterior cingulate cortex (sgACC) and insula and confirmed significantly increased [¹⁸F]FEPPA uptake in depressed patients (N=12) compared to healthy controls (N=23). Using a seed-based ROI analysis of fMRI data, we found that patients show …

Associations Between Parent Characteristics And Acceptability Of Exposure-Based Treatments For Child And Adolescent Anxiety, Allison Rumelt

Selected Full Text Dissertations, 2011-

Cognitive-behavioral therapy (CBT), particularly exposure therapy, is the most effective treatment for anxiety disorders in children and adolescents (Kendall et al., 2005). Little research has been done to explore parent acceptability of treatment for anxiety in children and adolescents, and no research has explored the acceptability of exposure for this population. The purpose of the present study was to examine parent acceptability of exposure for child and adolescent anxiety as well as variables associated with acceptability. Parents completed a demographic questionnaire, the Clinically Useful Anxiety Outcome Scale (Zimmerman et al., 2010), and the Family Accommodation Scale – Anxiety (Lebowitz et …

Managing Health Locus Of Control In Patient-Provider Relationships, James Wallace

USF Tampa Graduate Theses and Dissertations

Patient locus of control is a strong determinant of health outcomes, yet health care professionals do not typically address it in care plans. In fact, management of most medical conditions is hindered because the treating physician has little information about the patient’s locus of control. This research addresses the question “How can locus of control be used to enable health care practitioners to improve medical outcomes?”

Research Methodology. Using an engaged scholarship approach incorporating the Elaborated Action Design Research methodology, the research drives the guided, emergent design of a novel protocol and two separate artifacts for management of health locus …

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 …

Effects Of Prenatal Cannabis Exposure On Offspring Emotional Development And Stress Response, Alexandra Pritchett

Dissertations, Theses, and Capstone Projects

While cannabis may be used by women during pregnancy, its effects on their offsprings’ developing stress response system are still largely unknown. The binding sites for the active chemicals in cannabis are operational at early time points in fetal development and are expressed in key limbic brain structures. The body’s natural endocannabinoid system serves as an important regulator of the stress response. Longitudinal studies have associated prenatal exposure with increased fearfulness and mood disturbances in offspring, but, despite the growing evidence of emotional dysfunction, there remains a critical gap in knowledge explaining how early prenatal exposure may lead to future …

Training And Individual Predictors Of Attitudes Toward Serious Mental Illness Amongst Clinical Psychology Doctoral Students, Lauren K. O'Connor

Dissertations, Theses, and Capstone Projects

Clinical psychologists are grossly underrepresented in treatment provision for individuals with serious mental illness (SMI; Roe, Yanos, Lysaker, 2006). Systemic (e.g., emergence of managed care) and training-based (e.g., limitations to SMI specific training) factors contribute to the establishment of this underrepresentation, while mental health stigma amongst psychologists may play a role in perpetuating it. Many individual and experiential factors have been found to impact clinicians’ attitudes toward those with SMI (Henderson et al., 2014; Schulzes, 2007). Though many of these factors are present and relevant from the beginning of one’s career and may involve elements related to training, little research …

Food Restriction And Body Image Distortion In Pregnant Mothers: Outcomes For Exposed Children, Kathryn M. Dana

Dissertations, Theses, and Capstone Projects

Background: Developmental trajectories in the growing child do not originate at birth. Rather, critical periods may exist in pregnancy, during which the determinants of malnutrition are especially vulnerable to the effects of stress and other complications. Prenatal malnutrition has been consistently associated with negative consequences for the growth, development, and overall physical and mental health of affected offspring in both human and animal models. While most available literature on human prenatal malnutrition comes from famine research, there is some evidence that restrictive eating disorders in pregnant women may be associated with similar outcomes.

Hypotheses: We hypothesize that prenatal exposure to …

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 …

Improved Psychological Services For American Indian Communities, Grace Anna Hofer

Honors Thesis

The importance of mental health care is growing. Inadequate psychological aid in underserved areas creates an environment for health disparities. There is a needed emphasis for outreach in rural and ethnically diverse communities with a lack of healthcare professionals to service those afflicted by mental illness. One such group is the American Indian communities of indigent populations that experience multifactorial inequalities. The treatment and reception of mental health care continue to face many challenges such as access to care, lack of education, and stereotypes. To provide effective mental health services to the American Indian population, a collaboration in designing interventions …

An Empirical Research On Developing The Framework For Managing Sexual Abstinence Issues Of The Chinese Male Seafarers, Bin Dong

Maritime Safety & Environment Management Dissertations (Dalian)

No abstract provided.

Inter-Subject Correlation Using Movie-Driven Fmri In Drug-Resistant Epilepsy, Hana H. Abbas

Electronic Thesis and Dissertation Repository

Treating drug-resistant epilepsy with surgery requires the localization of the epileptic focus. We explored the potential for movie-driven functional magnetic resonance imaging (fMRI) to act as a sensitive, non-invasive, and cost-effective tool to identify functionally disturbed networks. We assessed neural synchronization (inter-subject correlation; ISC) between presurgical epilepsy patients (n = 18) and healthy controls (n = 24) as they watched a suspenseful movie clip in the scanner. To optimize denoising, we compared ISC values with and without an automated Independent Components Analysis-based denoising step (ICA-AROMA). We found that denoising with ICA-AROMA elicited augmented correlation values, supporting its use …

Asking The Experts: Perception Of The Relative Importance Of Antecedents Of Optimal Financial Behavior, Chad M. Jones

USF Tampa Graduate Theses and Dissertations

Although there is ample research on financial behavior, the inclusion of financial planners in the sample frames of such research is rare. This study used certified financial planners (CFPs) as the sole sample population to identify antecedents of optimal financial behavior and their relative importance. Data from a nationally representative sample of 167 CFPs indicated that (a) financial literacy lost relative importance as CFP tenure increased, (b) romantic partnership closely rivaled financial literacy in importance, (c) financial literacy was more weakly correlated with romantic partnership than with the other antecedents investigated, and (d) romantic partnership was universally accepted as a …

Community Based Participatory Research Informed Manualization And Piloting Of E-Training Of A Modified Dialectical Behavior Therapy Intervention, Annika M. Miyamoto

Doctoral Dissertations

This study explores the efficacy of delivering modified dialectical behavior therapy (m-DBT) to direct support staff who work with seriously mentally ill patients with neurocognitive deficits using remote web-based technology. The partnering facility for this study is a residential skilled-nursing facility that provides 24-hour care to individuals under conservatorship. Using a previously piloted m-DBT protocol, qualitative feedback was gathered from four participants with background training in psychology and varying experiences with DBT. All participants had direct knowledge of the treatment environment and experience working with the patient population. Gathered feedback was used to revise the m-DBT protocol to be used …