Medicine and Health Sciences Commons^™

The Relationship Between Estimated Vo2max And Poor Mental Health: A Study Of Brfss Data, Angelina Somadina Oputa

Doctoral Dissertations and Projects

Mental health conditions are one of the leading contributors to the global burden of disease. Despite advancements in mental health therapies and psychiatric medications, significant numbers of patients continue to struggle with mental illness. Despite these challenges, exercise can serve as a powerful tool to address mental health concerns. Current literature has referenced the value of physical fitness to support mental health, however there is limited large-scale research assessing the estimated maximal oxygen uptake (VO2Max) as a predictor of poor mental health days. In response, this quantitative secondary analysis was conducted to examine the relationship between estimated VO2Max and poor …

A Place Where I Was Finally Seen, Pierina S. Barletti Benel

be Still

This piece reflects on my experience navigating depression during medical training and the unexpected ways community can foster healing. Healing does not always occur within clinical settings. Through this narrative, I explore how returning to faith and the support of a church community helped restore hope during a difficult season of my life. Writing this essay allowed me to reflect on how vulnerability and lived experience can shape a more compassionate and present physician.

From Combustion Emissions To Neurotoxicity: Brain Health Risks Of Military Burn Pits Exposure, Katherine M. Eggers, Zoe A. Keller, Paul Barach, Julie M. Tomáška, Joshua P. Nixon, Janeen H. Trembley, Tammy A. Butterick

College of Population Health Faculty Papers

Military burn pits used during post-9/11 U.S. military deployments functioned as uncontrolled combustion systems and were widely utilized to dispose of large volumes of outdoor waste by burning. Burn pits involved heterogeneous waste materials burned under variable temperature and oxygen conditions. These combustion environments generated complex, toxic, multipollutant airborne emission mixtures that included particulate matter (PM2.5), polycyclic aromatic hydrocarbons (PAHs), and volatile organic compounds (VOCs). This narrative review synthesizes epidemiologic, experimental, and mechanistic evidence linking burn pit emissions to disruption of the lung–brain axis and adverse neurological outcomes. We specifically aim to address a critical gap in understanding how combustion-derived …

Equine-Assisted Therapy For Dementia: A Pilot Rct On Standardizing Sessions To Improve Cognition, Mood, And Quality Of Life, Madeline Alford, Maria Dos Prazeres Da Silva Gonçalves Dr., Maria Manuela Da Silva Leite Dr.

People and Animals: The International Journal of Research and Practice

Objectives: This study aimed to evaluate the effects of incorporating equine-assisted therapy (EAT) into memory workshops for older adults with mild to moderate dementia. EAT is hypothesized to enhance cognitive function, promote physical activity, and improve mood through multisensory experiences. To ensure consistency and replicability, a standardized 8-session cognitive stimulation therapy (CST) protocol was developed, structuring interventions across cognitive, emotional, and motor domains.

Methods: A 3-arm, parallel-group, randomized controlled trial (ClinicalTrials .gov: NCT06662578) was conducted with 36 older adults diagnosed with mild to moderate dementia. Participants were randomly assigned to one of three groups: equine-assisted therapy workshop (EATW), traditional …

Polygenic Risk Scores, Sex, And Socioeconomic Factors As Predictors Of Age Of Onset For Major Depressive Disorder, Kaitlyn M. Nowak

USF Tampa Graduate Theses and Dissertations

Major Depressive Disorder (MDD) is a heterogeneous psychiatric condition influenced by genetic, sociodemographic, and environmental factors, yet the extent to which these factors jointly shape the timing of disease onset remains unclear. This study evaluated the effects of polygenic risk scores (PRS), sex, and socioeconomic status (SES) on age of onset for MDD across two independent cohorts: the Pharmacogenomics Research Network Antidepressant Medication Pharmacogenomics Study (PGRN-AMPS) (N = 486) and the All of Us Research Program (N = 8,014). Analyses were restricted to individuals of European genetic ancestry, and PRS were constructed using both European-ancestry (EA) and multi-ancestry (MA) genome-wide …

Evaluation Of Neuroplastic Changes In Psychological Intervention And Contemporary Treatments Of Depression, Taylor Severance

Dissertations

Major depressive disorder is one of the most prevalent mental health disorders worldwide. There is a vast range of treatment options for depression, with varying levels of effectiveness. Recent treatments for depression have expanded, increasing alternative treatments, and it is unknown which treatments have the largest impact on depression. This research was designed to examine the treatments of depression, with a focus on psychotherapy and contemporary treatments such as ketamine, psilocybin, and transcranial magnetic stimulation. A literature review was conducted to assess treatment outcomes and neuroplastic changes in these interventions, as well as combinations of the interventions. Data were evaluated …

Exercise Therapy For Mood Disorders In Retiring/Former Athletes, Christian Antos

Dissertations

This dissertation examined the potential integration of exercise therapy and psychotherapy as a treatment approach for mood-related difficulties experienced by former elite athletes during the transition out of competitive sport. Retirement from athletics is often associated with significant biopsychosocial challenges, including disruptions in identity, healthy routines, social support, and emotional well-being. Existing literature suggests that exercise may serve as an effective adjunctive intervention for improving mood and overall psychological functioning, though limited research has explored its application among retiring athletes within psychotherapeutic contexts. This literature review synthesized current research related to athletic retirement, neurobiological mechanisms associated with physical activity, and …

Perinatal Mental Health Screening And Care Among Those With Pregnancy Complications, Alison N Goulding, Terri L Fletcher, Emily S Miller

Faculty, Staff and Students Publications

Perinatal mental health conditions are common and, without effective treatment, can contribute to adverse maternal and child outcomes. In the United States, mental health conditions are a leading cause of maternal morbidity and mortality, contributing to over 20% of pregnancy-related deaths. This expert review aims to assess current literature and provide recommendations regarding mental health care in high-risk patients who experience pregnancy complications. Individuals experiencing pregnancy complications are at increased risk for perinatal mental health conditions, including depression, anxiety, and post-traumatic stress disorder, as compared to those with uncomplicated pregnancies. Despite this increased disease burden, there is limited research on …

Resilience And Social Support On Depression Risk For Chronic Obstructive Pulmonary Disease Patients In South Tangerang, Indonesia, Adhityawarman Menaldi, Sali Rahadi Asih, Farah Ainul Mardhiyyah

Kesmas

Chronic obstructive pulmonary disease (COPD) is a major public health concern with psychosocial impacts, such as reduced resilience and depression. This study examined the moderating role of perceived social support on the relationship between resilience and depression among individuals diagnosed with COPD in South Tangerang, Indonesia. A quantitative cross-sectional study was conducted between January and February 2024 using self-administered questionnaires. Participants were adult patients with clinically diagnosed COPD, recruited from all public health centers (PHC) in South Tangerang. A total of 125 participants met the inclusion criteria and were included in the analysis. Participants had a mean age of 41.46±15.69 …

Predictive Models Of Student Mental Health: The Correlation Between Academic Burnout And Depression In The Higher Education Environment, Hyejoon Song

Masters Theses

Importance: Over 80% of U.S. college students report significant emotional difficulties, and 58% endorse academic burnout as a persistent concern, yet institution-specific data at faith-integrated universities such as Liberty University remain scarce, limiting evidence-based programmatic response.

Objective: To examine the correlation between academic burnout and depressive symptomatology at Liberty University, identify the most predictive individual burnout item via Random Forest machine learning, and characterize distinct student risk profiles via KMeans clustering. Design, Setting, Participants: Cross-sectional survey (IRB-FY24-25-1491, Exempt) of 236 Liberty University students (mean age 36.9 ± 14.3 years; 84.0% female; 61.0% graduate-level), 2025–2026 academic year.

Main Outcome and Measures: …

The Impact Of Translated Phq-9 And Gad-7 Scales On Treatment Recommendations In An Adult Vietnamese Population: A 3-Month Primary Care Evaluation, Vivienne Bui

Doctor of Nursing Practice Final Manuscripts

Depression and anxiety are prevalent yet underdiagnosed in limited-English-proficient (LEP) populations due to language barriers, cultural stigma, and provider bias. Vietnamese-speaking patients are particularly vulnerable to under-recognition in primary care. This quality improvement project evaluated whether implementing Vietnamese-translated Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) tools would improve mental health diagnosis and referral rates. Guided by the Johns Hopkins Evidence-Based Practice Model, a pre–post design was conducted at a San Diego clinic from March 26 to June 26, 2025. Vietnamese-speaking adults (≥18 years) completed translated PHQ-9 and GAD-7 forms during intake. Providers used scores in conjunction with clinical …

Psychological Impact Of Career Roles On African American Women: A Qualitative Study On The Long-Term Effects On Behavioral Health Providers' Field, Yolanda Seals-Stewart

Doctoral Dissertations and Projects

There is an untold narrative regarding the levels of stress, anxiety, and depression. This leaves a gap in researchers understanding systemic, cultural, and social factors that shape mental health outcomes in a unique way. There is also a deeper need for exploration of resiliency and coping skills strategies utilized by African American women in the behavioral health field, as well as how behaviors such as discrimination, workplace dynamics, and microaggression impact the overall psyche. By addressing these gaps, a more thorough understanding of the long-term psychological effect can be addressed, and these women can receive support mechanisms and interventions that …

Subclinical Neuropsychiatric Trait Variation In Parents Of Children With Autism Spectrum Disorder: A Cohort Study, Lindsay J Mullin, Carolyn Lasch, Natasha Marrus, Et Al.

2020-Current year OA Pubs

BACKGROUND: Many neuropsychiatric conditions share overlapping features underpinned by shared genetics. In this study, we examined the co-aggregation of sub-threshold variation in neuropsychiatric phenotypes in biological parents of autistic children to provide insights into the intergenerational transmission of genetic liability for autism.

METHODS: Autistic, neuropsychiatric (i.e., anxiety, depression, ADHD), and cognitive traits were characterized in biological parents of children enrolled in a longitudinal developmental study: 189 families of autistic children and 100 families with no autistic children were included. Families were further characterized as having only one (simplex) or more than one (multiplex) autistic child. Maternal and paternal traits were …

Psychosocial Predictors Of Depression And Anxiety In Thai Stroke Caregivers, Chanatip Tongyonk, Sorawit Wainipitapong, Chavit Tunvirachaisakul, Aurauma Chutinet, Michael Maes, Thitiporn Supasitthumrong

Chulalongkorn Medical Journal

Background: Caregivers of stroke survivors often face significant psychological challenges, yet limited research in Thailand has explored how patient and caregiver characteristics jointly influence caregiver mental health outcomes.

Objective: To identify characteristics of ischemic stroke patients and their caregivers that may predict distress, sadness, and anxiety symptoms in the caregivers.

Method: To measure caregivers' burden, stress, depression, and anxiety symptoms, the Hospital Anxiety and Depression Scale (HADS), Zarit Burden Interview (22-item ZBI), and Perceived Stress Scale (PSS-10) were utilized. To define a multi-step mediation model, we used partial least squares structural equation modelling (PLS-SEM).

Result: 97 stroke patients and their …

Pharmacogenomic-Guided Prescribing And Polypharmacy Across Age Groups In Obsessive-Compulsive Disorder: A Retrospective Study, Sheldon R Garrison, Matthew W Boyer, Anthony W Zoghbi, Rachel A Schwartz, Nicolette Weisensel, Martin E Franklin, Madeline M Hartig, Maharaj Singh, Sreya Vadapalli

Faculty, Staff and Students Publications

Background: This study evaluated medication utilization in children, adolescents, and adults with obsessive-compulsive disorder (OCD), a chronic psychiatric condition characterized by intrusive thoughts and repetitive behaviors. Although first-line treatments include selective serotonin reuptake inhibitors (SSRIs) and cognitive behavioral therapy (CBT), the heterogeneous biological underpinnings contribute to suboptimal outcomes, with 40-60% of individuals not responding to SSRIs. This complex phenotype often leads to psychotropic polypharmacy, which may be mitigated by incorporating combinatorial pharmacogenomic (PGx) testing into protocol-based care to identify potential gene-drug interactions.

Methods: A retrospective review was conducted of individuals with OCD aged 8 to 65 years who received either …

Medication-Assisted Treatment For Patients With Substance Use Disorder And Depression: A Scoping Review, Josiane Deguenon Bsn-Rn, Elisabeth Fritz Bsn-Rn, Jesse Jean Bsn-Rn, Tucker Mckinney Bsn-Rn, Laura Reed Dnp, Aprn, Fnp-Bc, Cne, Fnap

Doctor of Nursing Practice Projects

Purpose/Background

Substance use disorder (SUD) frequently co-occurs with depression and increases relapse risk and healthcare utilization. Although medication-assisted treatment (MAT) is an evidence-based intervention for SUD, outcomes for adults with co-occurring depression remain inconsistently reported due to variation in study designs, treatment settings, and measures. This scoping review examines evidence on MAT use among adults with co-occurring depression and SUD and summarized reported clinical and healthcare utilization outcomes.

Methods

From August 2023 to November 2025, a scoping literature review was conducted on PubMed/MEDLINE, CINAHL, and the Cochrane Library, using MeSH search terms and Boolean operators to link the concepts defined …

Mental Health Comorbidities And Ibd Outcomes In Patients Treated With Anti–Il-23 Therapy, Jashanveer S. Johal, Archana Salek, Mahmoud Al-Bataineh, Bianca Patel, Om Patel, Yecheskel Schneider, Jason Hyman, Abdallah Hussein

Rowan-Virtua Research Day

Background: Depression and anxiety are prevalent in inflammatory bowel disease (IBD) and may adversely influence outcomes. We evaluated the impact of comorbid mood disorders on clinical outcomes among IBD patients treated with anti–IL-23 agents.

Methods: Using a global de-identified electronic health record network, adults with Crohn's disease or ulcerative colitis initiating an anti–IL-23 agent were identified. Cohort 1 included patients with a documented mood disorder (depression and/or anxiety) at or prior to treatment initiation; Cohort 2 included those without mood disorders. Propensity score matching (1:1) on demographics and comorbidities yielded 3,546 patients per cohort. Primary outcomes included inpatient/ED encounters, abscess/fistula, …

Refractory Catatonia In Schizoaffective Disorder (Bipolar Type) Successfully Treated With Electroconvulsive Therapy, Shreya Kadi, Victoria Coles

Rowan-Virtua Research Day

Background: Catatonia is a neuropsychiatric syndrome

associated with mood and psychotic disorders and may

become life-threatening if untreated. While benzodiazepines

are first-line therapy, some cases are refractory and require

electroconvulsive therapy (ECT).

Hypothesis: Early use of ECT in refractory catatonia leads to

improved clinical and functional outcomes.

Methods: We present a retrospective case analysis of a 62-

year-old female with schizoaffective disorder, bipolar type,

who developed severe catatonia during inpatient psychiatric

hospitalization. Clinical course, Bush–Francis Catatonia Rating

Scale scores, and response to treatment were reviewed.

Results: The patient presented with severe catatonia (Bush–

Francis score 19) and elevated creatine kinase …

Effects Of Subthalamic Nucleus Deep Brain Stimulation On Depressive Symptoms In Patients With Parkinson’S Disease: A Meta‑Analysis, Jamir Pitton Rissardo Md, Jarvish Shah, Nishant Patel, Daarsh Goradia, Pranaya Gade, Ana Leticia Fornari Caprara Md

Rowan-Virtua Research Day

Background: Depression is a prevalent non‑motor symptom of Parkinson’s disease (PD) and may adversely affect quality-of-life and overall treatment outcomes. Subthalamic nucleus deep brain stimulation (STN‑DBS) is an established therapy for motor symptoms, yet its impact on depressive symptoms remains controversial. This meta‑analysis aimed to evaluate the effect of STN‑DBS on depressive symptoms in PD. Methods: PubMed‑indexed studies meeting predefined eligibility criteria were identified and included. Random‑effects meta‑analyses were performed using REML. Mean differences (MDs) between STN‑DBS and control conditions were pooled separately for Beck Depression Inventory (BDI) and its revision (BDI-II), and the Hamilton Depression Rating Scale (HAMD). Heterogeneity …

What Are The Effects Of Exposure To Green Spaces On Attention, Adhd Symptoms, Depression, And Overall Mental Health?, Emily Marie Hackett

Rowan-Virtua Research Day

This poster is a literature review examining the relationship between green space exposure and mental health outcomes. Examples of green spaces include nature, hiking trails, city parks, tree cover, and gardens. This literature review finds that green space exposure has positive effects on the symptoms of ADHD, depression, and anxiety. Nature exposure may serve as a complementary intervention to improve patient well-being.

Mental Health Comorbidities And Ibd Outcomes On Anti-Tnf Therapy, Jashanveer S. Johal, Mahmoud Al-Bataineh, Archana Salek, Bianca Patel, Om Patel, Jason Hyman, Yecheskel Schneider, Abdallah Hussein

Rowan-Virtua Research Day

Background: Depression and anxiety are prevalent in inflammatory bowel disease (IBD) and may adversely affect biologic therapy outcomes. We evaluated the impact of comorbid mood disorders on clinical outcomes among IBD patients treated with anti-TNF agents.

Methods: Using a global de-identified electronic health record network, adults with Crohn's disease or ulcerative colitis initiating an anti-TNF agent between 2018–2023 were identified. Cohort 1 included patients with a documented mood disorder (depression and/or anxiety) at or prior to anti-TNF initiation; Cohort 2 included those without mood disorders. Propensity score matching (1:1) on demographics and comorbidities yielded 9,605 patients per cohort. Primary outcomes …

A Retrospective Chart Review: Screening Patients With Type 2 Diabetes For Depression, Jennifer Sheldon, Glynnis Haley, Monica Ketchie

The Corinthian

Type 2 Diabetes Mellitus is defined as an impaired production of insulin resulting in elevated blood glucose levels (Brutsaert E., 2020). Globally, approximately 8% to 9% of adults have diabetes mellitus, the majority of which (95%) have Type 2 Diabetes Mellitus, equating to between 624 million to 702 million people (WHO, 2020). Type 2 Diabetes Mellitus represents the seventh leading cause of death, with approximately 1.5 million new cases diagnosed annually in the United States (CDC, 2020).

Depression is clinically defined as a mental health disorder that presents with a continually depressed mood or a loss of interest in daily …

Music And Movement For Individuals With Parkinson's Disease, Jordan Butler

The Corinthian

Parkinson’s disease, affecting approximately 10 million people worldwide, causes deficits in fine motor function, speech, and movement, as well as many other secondary symptoms, such as depression (Parkinson’s Foundation, 2020, para. 1). Past researchers have outlined many different studies and interventions regarding Parkinson’s and the effects of various types of music therapy (Andrejeva et al., 2019; Bukowska et al., 2016; Tamplin et al., 2019; Thaut, Rice, Braun Janzen, Hurt-Thaut, & McIntosh, 2019; Zhang, Liu, Ye, Li, & Chen, 2017). This review includes numerous ways that music therapy has benefited, and assisted people diagnosed with Parkinson’s. Vocal practices, auditory stimulation, and …

A Retrospective Look At Self-Reported Mental Health Prevalence In Division Iii Student-Athletes, Jacob F. Neri

Masters Theses/Capstone Projects

Mental health concerns among collegiate athletes have gained increased attention, but there has been limited research focus on Division III student-athletes. This study aimed to examine the self-reported prevalence of anxiety, depression, anger, stalking/harassment, abuse/assault, alcohol/substance abuse, self-harm, suicide ideation, and suicide attempt to identify contributing factors amongst this population. A retrospective, cross-sectional study was conducted looking at data collected from the student-athlete mental health history & well-being questionnaire that was administered as part of their pre-participation exam (PPE) prior to the beginning of each academic year. A total of 554 Division III student-athletes were included in the study. Results …

Effectiveness Of Occupation-Based Mindfulness Strategies For Older Adults Experiencing Anxiety Or Depression, Jennifer G. Macnie, Kathryn Burke Otd, Otr/L

Occupational Therapy Doctorate Capstones

The purpose of this capstone is to gain an understanding of how sensory-based mindfulness strategies impact feelings of anxiety and depression amongst older adults living in an assisted living facility. Anxiety and depression are extremely prevalent among residents in assisted living facilities, with depression affecting 29% of older adults and anxiety affecting 20%. In light of the fact that mental health amongst older adults is often overlooked in assisted living facilities, it is necessary to evaluate the potential benefits of mindfulness strategies on feelings of anxiety and depression amongst this population. An investigation of how sensory based mindfulness strategies impact …

The Power Of Belief: Investigating The Intersection Of Religious Observance, Social Support, And Psychological Distress, Victoria R. Atwater

Undergraduate Honors Thesis Collection

Religion can act as a protective factor against stress and depression (Koenig et al., 2009; Krok, 2008) and can be examined through an individual’s relationship with religion or the efficacy of religious practices on mental health. In this study, 206 participants completed an online questionnaire that measured stress, depression, religious coping, religiosity (intrinsic religiosity, organized religious activities and non-organized religious activities), and social support using validated scales. The results indicate a positive correlation between stress, depression, and negative religious coping as predicted. While intrinsic religiosity and positive religious coping did not significantly influence stress or depression, organized religious activities were …

Factors Associated With Postpartum Depression Symptoms Following Antepartum Hospitalization, Alison N Goulding, Daniel Palacios, Sukru Aras, Hu Chen, Sasidhar Pasupuleti, Marika Toscano, Nicole Cirino, Israel C Christie, Zhandong Liu, Emily S Miller, Terri L Fletcher

Duncan NRI Faculty and Staff Publications

Background: Hospitalized antepartum patients are at increased risk for postpartum depression (PPD). Developing approaches to identify those at highest risk for PPD would enable timely and targeted intervention.

Objective: We aimed to identify factors associated with the development of PPD symptoms in hospitalized antepartum patients and to assess their predictive utility.

Study design: This retrospective cohort study included pregnant individuals hospitalized in a regional referral center due to medical or obstetric complications between 2012 and 2025. Data were extracted from the electronic health record, including demographics, medical and obstetric history, hospitalization characteristics, and postpartum Edinburgh Postnatal Depression Scale (EPDS) scores …

Exploring Exercise Motivation And Mental Well-Being In College Students, Elaine M. Lindesmith, Anqi Deng Dr

Health, Human Performance and Recreation Undergraduate Honors Theses

This study examined the relationship between physical activity, exercise motivation, and mental well-being among 48 undergraduate students at the University of Arkansas. Guided by Self-Determination Theory, the study used survey data to measure depression, anxiety, physical activity, and open-ended exercise motivation responses. Motivation responses were coded as autonomous or controlled.

Results showed that physical activity was weakly and negatively related to depression and anxiety, but these relationships were not statistically significant. There were also no significant differences in mental health between autonomous and controlled motivation groups, and motivation did not significantly predict mental health outcomes in regression analyses. Overall, the …

Drug Therapy Of Anxiety Disorders And Depression: Considerations For Dental Treatment, David Tindle Dds, Ms

The Journal of the Michigan Dental Association

This clinical article examines the dental implications for patients taking psychiatric medications. It reviews major drug classes, including SSRIs, SNRIs, and benzodiazepines, focusing on oral side effects like xerostomia and bruxism. The author details critical drug interactions with local anesthetic vasoconstrictors and macrolide antibiotics. Crucially, the source explores research suggesting that SSRIs may significantly increase the risk of dental implant failure by interfering with bone metabolism and osseointegration.

Antidepressant-Like Effects Of Extinction Learning As An Animal Model Of Behavioral Therapy, Jing Liu, Sarah E Bulin, David A Morilak

Faculty, Staff and Student Publications

Exposure-based behavioral therapy, the most effective treatment for posttraumatic stress disorder (PTSD), also reduces depressive symptoms. However, neurobiological mechanisms underlying the beneficial effects of exposure-based behavioral therapy on depression remain unknown. Our lab has established fear extinction as a rat model of exposure therapy to investigate the mechanisms underlying its therapeutic behavioral effects in chronically stressed rats. In this study, we demonstrated that extinction learning reduced immobility in the forced-swim test and reversed chronic stress-induced reduction in sucrose preference. Chemogenetic inactivation of pyramidal neurons in the ventral medial prefrontal cortex (vmPFC) prevented these antidepressant-like effects of extinction. Extinction learning enhanced …