Medicine and Health Sciences Commons^™

Gender Differences In The Associations Between Developmental Disabilities And Anxiety And Depression Symptoms Among U.S. Children: Insights From The 2021 National Health Interview Survey, Gloria Wang, Muyiwa Ategbole, Xingguang Luo, Kesheng Wang, Chun Xu

Health & Biomedical Sciences Faculty Publications

Background: Limited research has explored the associations between developmental disabilities and symptoms of anxiety and depression among U.S. children during the COVID-19 pandemic.

Objective: This study investigates the associations between developmental disabilities and symptoms of anxiety and depression among U.S. children and examines whether these associations differ by gender.

Methods: The analysis included 6092 children aged 5-17 from the 2021 National Health Interview Survey (NHIS). Key risk factors for anxiety and depression symptoms included attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), intellectual disability (ID), learning disability (LD), and developmental delay (DD). Weighted multivariable logistic regression (MLR) was conducted to evaluate …

Implementing The Patient Health Questionnaire-2 To Improve Referral Rates To Mental Healthcare Through Routine Depression Screening, Kelly Murakata

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Primary care settings often encounter patients with depression symptoms, characterized by feelings of sadness, lack of interest in activities, and functional impairment, impacting quality of life. At the project site, the PHQ-9 was only used during annual or new patient visits, resulting in low screening rates of 12% and a 33% referral rate. The lack of routine screening led to missed opportunities for mental health referrals and detection of depression.

Aim of the Project: The aim of the project was to increase mental health referral rates through early identification of depression symptoms by implementing routine PHQ-2 screens.

Review of …

Diagnostic Accuracy Of Screening Tools For Depression And Anxiety In Cervical Dystonia, Davide Martino, Mehrafarin Ramezani, Steven Bellows, Brian D Berman, Florence Ching-Fen Chang, Jeanne Feuerstein, Victor Fung, Gamze Kilic Berkmen, Irene A Malaty, Claire Maciver, Scott A Norris, Kathryn J Peall, Joel S Perlmutter, Sarah Pirio Richardson, Laura J Wright, Zahra Goodarzi, Hyder A Jinnah

Faculty, Staff and Students Publications

Introduction: Despite their high prevalence and impact, depression and anxiety are not routinely screened for, and accuracy of screening procedures is unknown in adult-onset dystonia. We evaluated accuracy parameters of selected self-rated scales for depression and anxiety in patients with idiopathic cervical dystonia (CD).

Methods: Two-hundred-and-ten patients with idiopathic CD were recruited from 10 movement disorders centers from the US, Canada, Australia, and UK. At the end of each botulinum toxin cycle, participants were administered the Adult Standard Mini-International Neuropsychiatric Interview (MINI) as reference standard for depression and anxiety. Participants completed 8 self-administered index instruments (2 for depression, 2 for …

Anxiety And Depression In Today's Youth: A Current Look Into Assessment And Treatment., Meredith J. Scafe, Meghan Kanya, Meaghan Flynn, Ram Chettiar

Manuscripts, Articles, Book Chapters and Other Papers

Following the COVID-19 pandemic, the American Academy of Pediatrics (AAP), the American Academy of Child and Adolescent Psychiatry, and the Children's Hospital Association declared a national emergency in child and adolescent mental health. Rates of anxiety and depression in youth continue at unprecedented levels, contributing to rising numbers of suicide attempts and lowered school attendance. Though many medical providers are trained to assess and provide recommendations for anxiety and depression, many report feeling ill-equipped to address these concerns in a timely, feasible, and effective manner. We review the existing literature on screening for anxiety and depression in the medical setting …

Fetal Body Composition And Organ Volume Trajectories In Association With Maternal Perceived Stress Or Depressive Symptoms In The Fetal 3d Study, Alexandra Jean-Louis, Jessica L Gleason, Zhen Chen, Kathryn A Wagner, William A Grobman, Roger B Newman, Wesley Lee, Robert Gore-Langton, Seth Sherman, John Owen, Deborah A Wing, Daniel W Skupski, Jagteshwar Grewal, Katherine L Grantz

Faculty, Staff and Students Publications

Objectives: Evaluate associations between maternal perceived stress and depressive symptoms, and fetal body composition and organ volumes.

Methods: In the NICHD Fetal 3D Study (2015-2019; n = 2457), stress and depressive symptoms were assessed at enrollment (10-13 weeks). High stress was defined as a Perceived Stress Scale (PSS) score ≥15 and high depressive symptoms, defined as an Edinburgh Postnatal Depression Scale (EPDS) score ≥10. Fetal body composition and organ volumes (cerebellar, lung, liver, and kidney) were measured up to five times between 15 and 40 weeks using three-dimensional (3D) ultrasound technology. Trajectories of body composition and organ volumes across pregnancy …

Incident Depression After Breast Cancer Among Older Asian, Native Hawaiian, And Pacific Islander Women, Alzina Koric, Chun-Pin Esther Chang, Yuan-Chin Amy Lee, Mei Wei, Catherine Lee, Jing Wang, Mia Hashibe

2020-Current year OA Pubs

BACKGROUND: Longitudinal studies examining mental health outcomes among older (≥66 years) Asian, Native Hawaiian, and Pacific Islander (ANHPI) women diagnosed with breast cancer are limited. We evaluated incident depression after breast cancer among specific groups of older ANHPI compared with older non-Hispanic White (NHW) women. Predictors of depression and the risk of death following early onset of depression after breast cancer were also evaluated.

METHODS: A cohort of 26 776 older ANHPI women in the United States diagnosed with breast cancer between 2000 and 2017 was identified from the SEER-Medicare linked claims. There were 6694 older ANHPI and 20 082 …

Effectiveness Of Digital Behavioral Activation Interventions For Depression And Anxiety: Systematic Review And Meta-Analysis, Eric Jia, Jushawn Macon, Michelle Doering, Joanna Abraham

2020-Current year OA Pubs

BACKGROUND: As digital interventions gain prominence in mental health care, they present opportunities to improve access and scalability. Despite their potential, the overall impact of digital behavioral activation (BA) interventions across different formats and populations is not yet fully understood.

OBJECTIVE: This systematic review examines the characteristics and functions of digital BA interventions and evaluates their effectiveness for mental health and other patient-related outcomes.

METHODS: A comprehensive search of databases (PubMed, Embase, Web of Science, APA PsycInfo, and ClinicalTrials.gov) was performed in November 2023 to identify randomized controlled trials (RCTs) assessing the effectiveness of digital BA interventions for depression and …

Evaluating Depression In Adults Undergoing Substance Abuse Treatment: A Program Evaluation Of Intensive Outpatient Program, Chidochomoyo E. Zvirawa

Dissertations

Problem: Depression and substance use disorders (SUDs) frequently co-occur, complicating recovery outcomes. Despite screening recommendations, depression remains underdiagnosed in many SUD treatment settings.

Methods: This mixed-methods program evaluation examined depressive symptoms among adults in an Intensive Outpatient Program (IOP) using the Patient Health Questionnaire (PHQ-8). Depression screenings were conducted at intake, four weeks, and eight weeks. Eight participants meeting inclusion criteria were assessed. Data included demographics, treatment engagement, and PHQ-8 scores.

Results: PHQ-8 scores significantly declined from baseline (M = 11.75, SD = 6.52) to eight weeks (M = 5.13, SD = 5.05), t(7) = 2.76, p = .028, indicating …

Predictors Of Nursing Students' Stress, Anxiety, And Depression During The Covid-19 Pandemic In A Hispanic-Serving University In South Texas: A Cross-Sectional Study, Maria I. Diaz, Eleftherios Gkioulekas, Nancy Nadeau

School of Mathematical & Statistical Sciences Faculty Publications

Background: In nursing education, there have been several studies on the impact of the COVID-19 pandemic on the ability of nursing students to cope while in nursing school.

Purpose statement: The goal of this study is to assess undergraduate nursing students' support mechanisms as predictors of stress, anxiety, and depression during the COVID-19 pandemic within a Hispanic-serving institution in South Texas.

Methods: Across-sectional design was used in this study. An online survey using self-reported questionnaires was used to gather data from an undergraduate nursing student cohort during the Fall 2021 semester. Linear regression was used to identify the predictors of …

Self-Management For People With Epilepsy And A History Of Negative Health Events (Smart): A Randomized Controlled Effectiveness Trial, Martha Sajatovic, Jessica Black, Jacqueline Krehel-Montgomery, Richard Barigye, Joy Yala, Clara Adeniyi

Faculty Scholarship

Objectives: This 2-site, 6-month randomized controlled trial of an epilepsy self-management (ESM) curriculum (SMART) vs. 6-month waitlist (WL) control assessed effects on epilepsy outcomes in 160 people with epilepsy (PWE). Methods: PWE had at least 1 negative health event (NHE) defined as a seizure, emergency department visit, hospitalization or self-harm attempt in the last 6 months. Primary outcomes were differences in proportions of PWE with reductions in NHEs from baseline to 6 months follow up and change in NHE/seizure counts between SMART and WL. Secondary outcomes included the Patient Health Questionnaire (PHQ-9), 36-Item Short Form Survey (SF-36), Quality of Life …

Staff Education On Physical Activity As A Therapeutic Option For Anxiety And Depression, Suja Paul

Walden Dissertations and Doctoral Studies

This project’s aim was to educate staff on physical activity (PA) as a therapeutic option for anxiety and depression to relieve psychotic symptoms, enhancing patients’ quality of life. PA enhances cognitive functioning, reduces anxiety and depression, and decreases the risk of cardiovascular conditions and early death. Patients with severe mental illnesses face barriers to PA and exercise, so providers and policymakers must create an environment that encourages participation. A knowledge gap for staff exists in promoting PA in mental health patients. Healthcare professionals should recommend the right amount of PA for each patient. This initiative aims to increase staff confidence …

Increasing Depression Risk Screening In Hospice And Palliative Care Patients, Elizabeth Kanini Michaels

Walden Dissertations and Doctoral Studies

This doctoral project was conducted as a staff education project. The practice problem involved inconsistent depression risk screening in hospice and palliative care patients. It was crucial to address this, as depression can be pervasive in this population. The practice-focused question was, For registered nurses who work in a palliative or hospice care unit, does education on depression risk screening increase depression screening rates as compared 12 weeks before to 12 after the education? The project aimed to improve depression risk screening rates through staff education. The Johns Hopkins nursing evidence-based practice model was used to assess 13 supporting articles …

Spravato® Fda-Approved As Monotherapy For Adults With Treatment-Resistant Depression, Rileigh Rahrig, Kennedy Kosikowski, Haylee Whyde, Kiley Devoll, Allie Honigford, Macy Davis, Joshua Honaker, Samantha Mccord, Manoranjan D'Souza

Pharmacy and Wellness Review

Treatment-resistant depression (TRD) is a challenging and possibly life-threatening condition that affects millions of people worldwide. Patients with major depressive disorder (MDD) are diagnosed with TRD once they have tried and failed to respond to two antidepressant treatments at the maximum dose for a full trial of six to eight weeks. Most traditional antidepressant therapies work by increasing the levels of monoamine neurotransmitters such as dopamine, serotonin, and norepinephrine in the brain. These medications have a delayed onset of action, ranging from two to eight weeks, and often fail to relieve depressive symptoms in a patient with TRD. Therefore, targeting …

Staff Education To Enhance Nurse Knowledge Of Depression And Screening Tool Using Patient Health Questionnaire-9, Oluwakemi Omotayo Aregbesola

Walden Dissertations and Doctoral Studies

Summary This staff education program focused on addressing a practice deficit regarding nonstandard depression assessment and substandard nurse knowledge of evidence-based screening tools, mainly the Patient Health Questionnaire-9 (PHQ-9), a nine-item, self-reporting test used to screen for depression and assess severity of the condition based on the Diagnostic and Statistical Manual of Mental Illnesses, 5th Edition. Depression exists as a familiar yet unidentified disorder among psychiatric inpatients, resulting in delayed treatment inferior outcomes. The staff education project targeted the nurses’ knowledge of depression identification while also teaching them to administer the PHQ-9 for prompt screening and intervention. I used an …

The Impact Of The Mediterranean Diet On Depression: A Narrative Review, Emma Kate Schaaf

Honors Theses

Background. The Western diet has extensive negative ramifications on physical health and emotional well-being. The Mediterranean diet, widely regarded as one of the healthiest eating patterns in the world, may have the ability to improve psychological conditions. This study aims to examine existing research from randomized control trials (RCTs) on the association between depression prevalence and the Mediterranean diet.

Methods. The following review was conducted using PRISMA guidelines and the Google Scholar and PsycInfo databases. The criteria for inclusion were that studies: 1) were randomized control trials (RCTs) examining the Mediterranean diet; 2) included samples of adults (i.e., > 18 years …

Effects Of Calcineurin Mediated Immunosuppressant Cyclosporine On Binge Alcohol Drinking And Stress Responsivity, Brock Goeden, Emily Dorn, Jennifer Agar, Thomas P. Beresford, Patrick J. Ronan

Scholarship Pathways Program

Stress and neuroinflammation are increasingly recognized as interdependent processes that contribute to the development of psychiatric disorders. This study investigates the bidirectional relationship between stress exposure and neuroimmune activation, focusing on the expression of pro-inflammatory cytokines and behavioral outcomes in rodent models. Using the learned helplessness (LH) paradigm, the authors demonstrate that stress-induced neuroinflammation, particularly elevated IL-1β expression in the hypothalamus, is associated with susceptibility to maladaptive behaviors. The immunosuppressant cyclosporine A (CsA) was shown to attenuate stress-induced expression of neuroinflammatory markers, including IL-1β, IL-6, and CRF. Furthermore, direct intracerebroventricular administration of lipopolysaccharide (LPS), a TLR4 agonist, induced LH-like behavioral …

Empathy And Psychological Outcomes In Informal Caregivers Of Community-Dwelling Older Adults: A Systematic Review And Meta-Analysis, Meng Huo, Thi Vu, Tomiko Yoneda, Jingkai Wei, Bruce Abbott, Joan K Monin

Faculty, Staff and Student Publications

Objectives: Scholars have increasingly recognized the crucial role that empathy plays as informal caregivers provide unpaid care to their older family and friends (i.e., care recipients). Yet, the existing literature exhibits substantial variability in study approaches and results, which limits the extent to which this literature can inform interventions intended to benefit informal caregivers. We sought to address this critical gap by synthesizing research that examined how caregivers' and care recipients' empathy were associated with caregivers' psychological health.

Methods: We conducted a literature search using PubMed, PsycInfo, CINAHL (Cumulative Index to Nursing and Allied Health Literature), EMBASE, and Scopus databases …

An Educational Intervention: Knowledge Acquisition Of Perimenopausal Mental Health Symptoms And Treatment Options For Women Aged 35 Years Plus, Allison M. Hopps

Doctor of Nursing Practice Scholarly Projects

Perimenopause is a span of four to six years preceding menopause when estrogen levels decline. Up to 40% of women experience depression during the perimenopause transition. Hormone replacement therapy (HRT) can be an effective treatment for depressive symptoms during perimenopause, but many healthcare practitioners prescribe antidepressants instead of HRT for the management of mood-related symptoms. Perimenopausal depression is associated with the progression of chronic conditions such as cardiovascular disease, diabetes, and dyslipidemia. The general population, including women and healthcare providers, lacks the education and awareness surrounding perimenopause symptoms and treatment. This project educated women between ages 35 to 55 on …

Investigating The Ability Of The Norepinephrine-Dopamine Reuptake Inhibitor Nomifensine To Reverse The Effort-Related Effects Of Tetrabenazine In Female Rats, Vivien Daytree

Honors Scholar Theses

Anergia, lassitude, and psychomotor retardation are core symptoms of motivational dysfunction that often accompany Major Depressive Disorder (MDD). While selective serotonin reuptake inhibitors effectively alleviate mood and anxiety symptoms, they remain relatively ineffective at alleviating motivational deficits. Compounds that elevate extracellular dopamine (DA) have shown promise in addressing these symptoms. Bupropion, a norepinephrine-dopamine reuptake inhibitor (NDRI), increases DA and is effective at attenuating motivational symptoms in patients. Another NDRI, nomifensine, has demonstrated potential antidepressant properties in preclinical research. Effort-based choice tasks, such as the FR5/chow choice task, serve as animal models for studying motivational dysfunction. Rats choose between exerting effort …

Maternal Depression And Covid-19: A Secondary Analysis Comparing Postnatal Depression Rates During And Before The Covid-19 Pandemic, Amanda A. Berney

2025 Spring Honors Capstone Projects - Archive

The COVID-19 pandemic created increased psychological vulnerability across the globe through isolation, fear of infection, and misinformation from various sources, including social media. Women giving birth during the pandemic, therefore, may be extremely vulnerable psychologically. Per the World Health Organization, the years 2020 to mid 2021were designated as an intense time during the COVID-19 pandemic. Thus, the objective of this secondary analysis was to compare depression scores among women giving birth during these intense years and women giving birth before 2020. However, due to a small window of time and sample size, statistical analysis failed to find a correlation between …

Depression, Anxiety, And Suicide Among Adolescents: Sex Differences And Future Perspectives, Giovana V.R. Toro, Paula Arias, Alejandro De La Torre-Luque, Jonathan B. Singer, Natalia Lagunas

Social Work: School of Social Work Faculty Publications and Other Works

Depression and anxiety are two disorders that significantly increase the risk of suicidal behavior. The disparity between females and males in the prevalence of these disorders becomes more pronounced from adolescence onwards. Specifically, risk factors associated with suicidal behavior in adolescent females are often linked to anxiety and depression, whereas in males, these behaviors are more frequently associated with other types of disorders, such as disruptive behavior. Furthermore, there are notable sex differences in the efficacy and acceptance of treatments aimed at preventing suicidal behavior. This review examines the sex differences in the relationship between depression, anxiety disorders, and suicidal …

Healthy Dietary Patterns’ Impact On Depressive Symptoms: A Meta-Analysis Of Randomized Controlled Trials, Angela Encardone

All Theses

As the search for innovative mental health treatments expands, dietary interventions have emerged as a promising approach for alleviating depressive symptoms. This thesis presents a meta-analysis of randomized controlled trials (RCTs) examining the efficacy of whole-of-diet nutritional interventions in reducing depression symptoms among adults. Grounded in Bronfenbrenner’s Bioecological Model and Engel’s Biopsychosocial Model, this study explores the intersection of biological, psychological, and social factors that influence mental health outcomes. A systematic review identified six eligible RCTs assessing the impact of healthy dietary patterns, including the Mediterranean diet and other plant-based interventions, on depression symptoms. A random-effects meta-analysis revealed a significant …

Polypharmacy As A Treatment Barrier In Autism Spectrum Disorder, Ahmed Aly

Rowan-Virtua Research Day

The purpose of the study is to assess the prevalence of polypharmacy in current literature in the Autism Spectrum Disorder (ASD) population. It is hypothesized to find patients with ASD over prescribed compared to the neurotypical counterparts.

The Correlation Between A Methylenetetrahydrofolate Reductase Deficiency In Autism Spectrum Disorder Patients And The Presence Of Mental Health Disorders, Hinal Joshi, Andrea Iannuzzelli

Rowan-Virtua Research Day

• Currently little literature exists on connection between Methylenetetrahydrofolate reductase (MTHFR) deficiency and mental health disorders

• Reduced enzyme activity associated with certain MTHFR variants contributes to altered folate metabolism, elevated homocysteine levels, and disrupted DNA methylation, all of which are implicated in mental health disorders

• Identifying genetic risk factors could facilitate earlier diagnosis and intervention, leading to improved outcomes

• Relevant results could help reduce stigma and promote greater understanding of challenges faced by patients on the spectrum

Examining The Mediating Effects Of Symptoms Of Depression, Anxiety, And Perceived Stress On The Association Between Bereavement And Inflammation, Kylee Faith Behringer

Master's Theses

Bereavement is a stressor that impacts the psychological well-being of an individual and their physical health. This study aimed to develop a more nuanced understanding of the association between bereavement and its psychological and biological consequences, and the potential mediating role of symptoms of depression, anxiety, and stress within the relationship between bereavement and inflammation. Data was collected through Midlife in the United States (MIDUS) Refresher 1, a longitudinal study that examines social, psychological, and biological vulnerabilities associated with potential health outcomes (Weinstein et al., 2019). The study consisted of 863 participants (bereaved=373, non-bereaved=490) who completed an in-person study visit …

To Heal A Mind: A Comparison Of Functional And Conventional Treatments In Major Depressive Disorder, Gillian Chambers

Senior Honors Theses

Incidence of major depressive disorder is increasing year over year, with little able to be done to halt the spread of the condition. However, there are many treatment possibilities considered unconventional by the healthcare system. This thesis examines the respective benefits and risks, in comparison to one another, between conventional pharmacological treatment and functional, holistic treatment of depression. This was done via integrative review of available clinical literature, synthesizing evidence on both conventional and functional treatments for depression, as dictated by Whittemore and Knafl (2005). Exploratory search methods revealed 758 records fulfilling inclusion criteria, which were screened and narrowed down …

Dr. Doctor: A Look At Life In Medicine, Alexandra Hausmann

Honors Program: Senior Projects (Public)

The life of a medical professional is not easy. The road to get there and the lifestyle when practicing is mentally draining and results in many physicians experiencing burnout. This project and paper explore the stigma surrounding mental health in medicine, examining how fear of professional repercussions prevents many physicians from getting help. Through research and interviews with medical professionals of various specialties, this project looks at the different mental health struggles that each specialty faces. Additionally due to increased social media, medicine continues to evolve at a fast rate. Looking forward, medical professionals will have to deal with increased …

#Toomuchcontent: A Quantitative Analysis On Social Media Time Usage And Its Impact On Young Adult Anxiety And/Or Depression In The United States, Sarah Juarez

Electronic Theses, Projects, and Dissertations

As technology continues to advance and grow, society has seen a surge in popularity of various social media sites. Social media has become increasingly popular among young adults, with some spending over 10 hours each day on social media. Social media can be utilized for community building, fostering relationships, providing safe spaces, inspiration, creative expression, and may even provide users with acceptance, validation, and a sense of belonging. Considering these factors, social media may also affect individuals negatively— specifically mental health-wise, in terms of anxiety and depression. This study aimed to identify whether a correlation exists between time spent on …

Navacaprant, A Novel And Highly Selective Kappa Opioid Receptor Antagonist, In Adults With Major Depressive Disorder: A Randomized, Double-Blind Phase 2 Clinical Trial, Sanjay J Mathew, Andrew J Cutler, Nicole C Visitacion, Michael Gold, Jason Yuan, Bill Aurora

Staff and Researcher Publications

PURPOSE/BACKGROUND: This phase 2a randomized, double-blind, placebo-controlled, 8-week trial assessed the efficacy and safety of navacaprant, a highly selective kappa opioid receptor antagonist, in adults with major depressive disorder (MDD).

METHODS/PROCEDURES: Participants with 17-Item Hamilton Depression Rating Scale (HAMD-17) scores of 14 to 30 were randomized 1:1 to once-daily navacaprant 80 mg or placebo (n = 102 each). The primary endpoint was HAMD-17 change from baseline (CFB) to week 8. Secondary endpoints included CFB in Snaith-Hamilton Pleasure Scale (SHAPS). No adjustment for multiple comparisons was made.

FINDINGS/RESULTS: At week 8, HAMD-17 CFB was not statistically significantly improved with navacaprant vs …

Polypharmacy And Pharmacogenomics In High-Acuity Behavioral Health Care For Autism Spectrum Disorder: A Retrospective Study, Sheldon R. Garrison, Sophie A. Schweinert, Matthew W. Boyer, Maharaj Singh, Sreya Vadapalli, Jeffery M. Engelmann, Rachel A. Schwartz, Madeline M. Hartig

College of Nursing Faculty Research and Publications

Background

This study evaluated pharmacogenomic (PGx) testing in children and adolescents with autism spectrum disorder (ASD). ASD frequently presents with co-occurring depression and anxiety. This complex phenotype often results in psychotropic medication polypharmacy. Incorporating PGx testing into the medical work-up may reduce polypharmacy and improve quality of life with symptom reduction.

Methods

A retrospective electronic health record (EHR) review between January 2017 and May 2023. Individuals either received PGx testing or treatment as usual (TAU). The co-primary outcomes were instance of polypharmacy and the Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q). Secondary outcomes included length of stay, average …