Behavioral Medicine Commons^™

Evaluating Spect Neuroimaging In Psychiatric Diagnosis: A Critical Review And Proposed Randomized Controlled Study, Kiley Carter

Senior Honors Theses

Mental illness affects a substantial proportion of adults in the United States, yet psychiatric diagnosis remains subject to diagnostic variability. Single-photon emission computed tomography (SPECT) is a neuroimaging technique that measures cerebral blood flow and has been proposed as an adjunctive tool for psychiatric evaluation. Existing literature reports group-level perfusion patterns associated with certain psychiatric conditions, suggesting potential utility in diagnosing complex or treatment-resistant cases. However, critics of SPECT emphasize the absence of randomized controlled data demonstrating improved patient outcomes. To address this gap, a prospective randomized controlled trial comparing standard psychiatric care with SPECT-guided evaluation is proposed. The proposed …

Drd2 Rs6276 Polymorphism And Trait Impulsivity In Individuals With Mixed Behavioral And Substance Addictions, Gabriela Zdunek, Remigiusz Recław, Aleksandra Suchanecka, Krzysztof Chmielowiec, Dariusz Larysz, Patryk Ilków, Kinga Łosińska, Jolanta Chmielowiec, Łukasz Jaworski, Anna Grzywacz

Baltic Journal of Health and Physical Activity

Background/Objectives: Impulsivity is a key transdiagnostic trait linked to dysregulated reward processing in both behavioral and substance-related addictions, as recognized in DSM-5. Dopaminergic genes, including DRD2, may modulate individual differences in impulsivity, particularly under conditions of increased addiction vulnerability. This study examined whether the DRD2 Exon 8 rs6276 polymorphism predicts impulsivity levels in men with mixed addictive behaviors compared with healthy controls. Methods: A total of 328 males (128 with mixed behavioral and substance addictions and 200 controls) were assessed. Diagnoses were confirmed using the MINI interview, and impulsivity was measured with the Barratt Impulsiveness Scale (BIS-11). Genotyping of …

Exploring The Relationship Between Behavioral Health Early Prediction Model And Patient Outcomes In The Emergency Department, Karen M. Richendollar, Kathie M. Zimbro

Knowledge and Creativity Expo

Problem: Emergency departments (EDs) are increasingly utilized for mental health (MH) care, often resulting in overcrowding and delayed access to specialized services. A significant proportion of MH patients are discharged without a psychiatric consult, raising concerns about safety and readmission rates. This trend places additional strain on already limited behavioral health resources and contributes to care delays for patients in acute crisis. Moreover, the lack of standardized discharge criteria for MH patients increases variability in care and may compromise patient outcomes. Purpose: This study evaluates the effectiveness of the Behavioral Health Early Discharge Prediction Model (BHEDPM) in identifying MH patients …

Family Mental Health – A Case Report, Vikrant Arora, Medha Kosireddy, Mathumitha Ananth, Kishor M. Manohar Rao

Digital Journal of Clinical Medicine

Psychiatric illness in India is estimated to be 15% as per National Mental Health Survey 2015-16.  Mental health challenges within families, especially depression, anxiety disorders that are not common and when unaddressed exert cascading effects on all members, disrupting emotional cohesion, relational functioning, and socioeconomic stability. There are few case reports on entire family presenting to psychiatry department.

With informed consent a city-based middle-class family of non-consanguineous origin, where the 40-year-old female, presented with intractable limb pains and health anxiety, she had multiple consultation in last few months and her 48-year-old husband also had with episodic pains, irritability and her …

Educational Attainment And Symptom Improvement In Treatment-Resistant Depression: A Longitudinal Cohort Analysis Across Treatment Modalities, Marjorie Harrison, Giselli Scaini Msc, Phd, Aspen Viamontes

Summer Research Program Abstracts

No abstract provided.

Wilson’S Disease Psychosis In A Young Man With Autism Spectrum Disorder: A Case Report And Focus On Management, Landon C. Sowell, Barbara L. Gracious

HCA Healthcare Journal of Medicine

Introduction

Wilson's disease is a rare autosomal recessive disorder, affecting approximately 1 in 30 000 individuals and is characterized by abnormal copper accumulation in the body, primarily affecting the liver and brain. Psychiatric manifestations as a first presentation, particularly psychosis, are less commonly recognized resulting in failure to begin treatment early in the course of the disease. This case report highlights a patient that presented to the hospital with psychosis, who was later diagnosed with Wilson’s disease. This case underscores the importance of considering organic causes in first-episode psychosis.

Case Presentation

An 18-year-old man with a history of autism spectrum …

Psych Assessment In The Er, Bailey J. Thompson, Addie Cowger, Hailie Hollis

Scholars Week

An immense amount of patients who enter the emergency department, whether for a psychiatric illness or not, struggle with mental health challenges. By creating a standardized routine and checklists for the care of high-risk psychiatric patients, the new quality and consistency can enhance patient experiences. This process will start at the triage stage and continue throughout their stay. Presenting the supportive research to the emergency department staff and introducing these changes gradually will help with staff buy-in and become a more sustainable process. Finally, with a structured approach, psychiatric patient outcomes will benefit significantly.

Binge Eating Disorder: A Clinical Review, Michell Mcdiffett Mshs, Pa-C

Lynchburg Journal of Medical Science

Binge eating disorder (BED) is the most common eating disorder (ED) in the United States (U.S.) and is characterized by recurrent episodes of eating a larger than normal amount of food in a discrete period of time and includes a sense of loss of control over food intake. BED is often comorbid with serious somatic and psychiatric disorders and is associated with reduced quality of life and excess mortality. Some consider BED a public health concern due to frequent co-occurrence with obesity and worse outcomes in those populations. The diagnosis is often delayed due to shame and underreporting of symptoms …

The Role Of Ect In Ocd: A 10-Year Review (2014-2024), Mariana Sales, Tainiz Polanco, Amy Nguyen

Rowan-Virtua Research Day

Background: Obsessive-compulsive disorder (OCD) affects up to 2.5% of the population with significant impacts on everyday functioning and relationships. First-line treatment includes selective serotonin reuptake inhibitors (SSRI) and cognitive behavioral therapy; however, studies have found that up to 40-60% of patients do not respond to SSRIs. ECT is an alternative approach that has demonstrated limited efficacy in OCD.

Objective: The current review aims to summarize the results of published work between 2014-2024 to assess the efficacy of ECT in the treatment of OCD.

Methods: A literature review was conducted using eight studies from 2014-2024 to assess the effectiveness of ECT …

How Does Exposure To Early-Life Stressors Shape Eating Behaviors In Adulthood?, Surabhi Panda

Rowan-Virtua Research Day

The objective of this literature review is to explore the relationship between early-life stress and the development of disordered or dysregulated eating in adulthood. A search was conducted across PubMed, CINAHL, Embase, and PsycINFO databases. Results from each study were compared and synthesized. Twelve studies were analyzed including case reports, systematic reviews, cohort studies, and cross-sectional studies. Research indicates that childhood emotional abuse, often more prevalent than other forms of maltreatment, is a significant risk factor for eating pathology, with studies investigating psychological mediators such as anger, anxiety, and dissociation in this relationship. Adverse Childhood Experiences (ACEs) and early life …

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

The Effectiveness Of Gad-7 Screening In High School Students, Tamara L. Smith, Allison Darnell, Margaret Harvey, Phd, Acnp-Bc, Chfn, Jacqueline Sharp Dnp, Aprn, Pmhp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Adolescent mental health is a growing concern, with anxiety disorders being particularly prevalent among high school students. Left untreated, anxiety can significantly impact academic performance, social functioning, and long-term mental health. The COVID-19 pandemic exacerbated these challenges, highlighting the critical need for effective screening and intervention strategies. The Generalized Anxiety Disorder 7-item scale (GAD-7) is a validated tool for identifying anxiety disorders, yet its application in high school settings is limited. This scoping review explores the effectiveness of GAD-7 in increasing mental health referrals and improving anxiety outcomes in high school students.

Methods

A comprehensive search was conducted across …

Evaluating The Efficacy Of Predischarge Referrals In Preventing Emergency Mental Health Hospital Readmissions: A Scoping Review, Pretia Carpenter Bsn, Rn, Stephanie Mays Bsn, Rn, Jacqueline Sharp Dnp, Aprn, Pmhp-Bc, Sharon H. Little, Dnp, Fnp-Bc, Aprn

Doctor of Nursing Practice Projects

Background

Emergency mental health hospital readmissions present significant challenges to healthcare systems, often resulting in increased costs, prolonged hospital stays, and poor patient outcomes. Continuity of care through predischarge referrals to outpatient mental health services, psychosocial support, and community resources has been proposed as a strategy to reduce readmissions. However, the effectiveness of these interventions remains inconsistent across different populations and settings.

Objective

This scoping review aims to evaluate the effectiveness of predischarge referrals in reducing 30-day emergency mental health hospital readmissions, identify key components of successful programs, and assess the influence of demographic factors on readmission rates.

Methods

A …

Long-Acting Injectables: A Strategy To Mitigate Nonadherence In Bipolar Disorder, Justin Faden, Elina Maymind

Rowan-Virtua School of Osteopathic Medicine Departmental Research

No abstract provided.

A Compelling Case Of The Use Of Electroconvulsive Therapy In Severe Treatment Resistant Depression With Suicidality, Neha Narayanan, Ryan Tam, James Mead

Advances in Clinical Medical Research and Healthcare Delivery

Treatment-resistant depression is a condition that occurs when an individual, experiencing major depressive disorder episodes, has failed the first line of treatment with medication therapy of adequate dose and duration. This is important to be addressed as there is a high likelihood of progression to having thoughts and an intended plan for suicide. Electroconvulsive therapy is a recommended option for those who have failed medication therapy, but it has been controversial in its use due to its stigma and side effects of memory impairment. Here, we present a case of a patient who had undergone several sessions of ECT with …

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …

Ketamine Infusion Treatment For Depression, Isabella Schwing

Capstone Showcase

Depression remains a significant public health challenge in the U.S., affecting millions of adults and contributing to both psychological and financial burdens. Major depressive disorder impacts approximately 14.5 million U.S. adults, with about 30% of cases classified as treatment-resistant depression. Traditional antidepressant therapies, including selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors, often have delayed onset and limited efficacy, leaving a substantial portion of patients without adequate relief. Given these limitations, there is an urgent need for alternative treatment options.

Recent research has highlighted ketamine as a promising intervention for Major Depressive Disorder and Treatment Resistant Depression. Initially identified as …

Weighted Family History Density Of Substance Use: Influence On Participant Substance Use Onset, Escalation, And Duration, Carleigh A. Litteral

Theses and Dissertations--Psychology

Substance use disorders impose a staggering toll on the United States (U.S.), straining healthcare systems, destabilizing communities, and profoundly impacting both individuals and families. Approximately one in six Americans aged 12 and older had a past-year substance use disorder in 2022 (Key Substance Use, 2022), and nearly one-third of adults experience a substance use disorder in their lifetime (Wu, 2010), contributing to an economic burden exceeding $400 billion annually (National Drug Threat Assessment, 2011). Family history of substance use disorders is a key predictor of vulnerability, with individuals who have affected relatives being 2–8 times more …

Motivators And Barriers To Help-Seeking And Treatment Adherence In Major Depressive Disorder: A Patient Perspective, Rahn K. Bailey, Kristin M. Clemens, Bex Portela, Hannah Bowrey, Samantha N. Pfeiffer, Gabrielle Geonnotti, Anna Riley, Jay Sminchak, Susan Lakey Kevo, Ronaldo R. Naranjo

School of Medicine Faculty Publications

Understanding patients’ lived experiences can identify knowledge gaps, informing better care. The objective of the study was to gain a better understanding of the lived experiences of patients from diverse backgrounds diagnosed with major depressive disorder (MDD). US patients aged ≥18 years who self-reported having MDD diagnosed by healthcare professionals (HCPs) completed demographic surveys and one-on-one (1:1) semi-structured interviews. Participants were recruited from a Patient Engagement Research Council and the study was classified as market research. Transcripts were evaluated with thematic analyses using the Braun and Clarke approach, quantifying theme frequencies across demographic categories. Among 14 interview respondents, key motivators …

Correspondence To "A Preliminary Study Of Collaborative Group Intervention With Recovered Peer Supporters For Eating Disorders: Analyses Including Comparisons Between In-Person And Online Sessions", Nirjal Thapa, Don D Shamilov, David F Lo

Rowan-Virtua School of Osteopathic Medicine Departmental Research

We read with pleasure the article by Mochizuki et al., ¹ titled “A preliminary study of collaborative group intervention with recovered peer supporters for eating disorders: Analyses including comparisons between in‐person and online sessions.” We would like to offer additional commentary on the conclusions regarding group intervention and peer support and its heavy influence on combating eating disorders. We hope these perspectives may provide insight into areas that may require further research and improvement.

Bridging The Gap: Psychopharmacologic Education And Side Effect Screening For Non-Prescribing Mental Health Professionals, Elaine Fitzgerald

Dissertations

Abstract

Problem: The United States is experiencing a growing demand for pediatric mental health support. Surges in mental health diagnoses and psychotropic medication prescriptions have occurred, compounded by a shortage of psychiatric providers. Non-prescribing mental health professionals are well-positioned to recognize psychotropic medication side effects. However, psychologists and counselors lack formal pharmacology education.

Methods: The quality improvement (QI) initiative was guided by the Plan-Do-Study-Act (PDSA) model. The evidence-based psychopharmacologic education for non-prescribers utilized a quasi-experimental pre- and post- test design. Data collected from clinicians included knowledge, confidence, and skill concerning psychotropic medications. The Psychotropic Medication Monitoring Checklist (PMMC) screen clients …

A Population Health Approach To Workplace Mental Health: Rationale, Implementation And Engagement, Kaylee T. Woodard, Allison M. Bailey, Aaron I. Esagoff, Maren S. Fragala, Joanna I. Hayward, Jennifer L. Hunter, Yea Jen Hsu, Paul M. Kim, Matthew E. Peters, Susan M. Carr

School of Medicine Faculty Publications

Objectives: To describe a population health-based program to support employee and dependent mental health and learn from engagement trends. Methods: Retrospective analysis of a program utilizing an assessment of mental health risk. For scoring “at risk,” a Care Concierge is offered to connect users with resources. Results: Participation was offered to 56,442 employees and dependents. Eight thousand seven hundred thirty-one completed the assessment (15%). Of those, 4,644 (53%) scored moderate or higher. A total of 418 (9%) engaged the Care Concierge. Factors that negatively influenced the decision to engage care included bodily pain, financial concerns. Positive influences were younger age, …

The Utility Of Interventional Anesthesia, Kylie Daguio, Kiley Jackson, Samantha Boever, Andrew Chang, James Keane, Leonard B. Goldstein

SOMA Faculty Publications

no abstract

Advancing Virtual At-Home Care For Community Health Center Patients Using Patient Self-Care Tools, Technology, And Education [Letter], Cheryl Modica, Joy H. Lewis, Curtis Bay

SOMA Faculty Publications

Abstract

Introduction

Health centers are community-based, patient directed primary care providers that offer accessible, high-quality primary care within medically underserved communities. Screening for cancer and managing complex chronic conditions such as diabetes, hypertension, obesity, and depression are vital services for the vulnerable populations seen by community health centers. Delivering care for complex chronic conditions and preventive services using virtual models that integrate self-care tools and technology is an important approach to increasing access for hard-to-reach patients served by health centers.

Objective

This study aimed to explore the use of a virtual care model, applied using a systems approach and patient-driven …

Glutamate Optimization As A Treatment For Depression: A Clinical Guideline, Luisa Angeles Collins Villares

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Based on the use of drugs to treat hypertension and tuberculosis for depression, the monoamine hypothesis led to the development of antidepressants in 1952. Serotonin was recognized as a deficiency associated with depression in 1967. As a fine-tuning orchestration of neurotransmitters and neuromodulators, the glutamate system became known using Spravato in 2019 and Auvelity in 2022. In this pilot study, mental health experts rated the importance of 24 science-based recommendations to optimize glutamatergic therapy in depression for a proposed guideline on a Likert scale from zero to four. The results were analyzed using a non-parametric predictive modeling method called Chi-Square …

The Effects Of Controlled Breathing And Physical Postures On Anxiety And Stress In Mental Health Patients, Kristen Killingsworth

DNP Research Projects

Objective: Anxiety and stress are debilitating disorders that have been on the rise in recent years following the COVID-19 pandemic. Medication alone has not been shown to be successful in mitigating the disorders, necessitating research into other alternatives for anxiety and stress management. The purpose of this project was to assess if a single complementary and alternative medicine (CAM) relaxation session had an impact on stress and anxiety levels. Method: A comprehensive literature review was conducted to identify strategies for reducing stress and anxiety. Guided by the Holistic Care Model of Self-Regulation, the nurse-led CAM relaxation session was developed. The …

Pro- And Anti-Inflammatory Biomarkers As Predictors Of Response To Valproate In Patients With Comorbid Alcohol Use And Bipolar Disorder-Preliminary Findings, Ilya Blokhin, Lisa Harlow, Eleonore Beurel, Feng Miao, Dana Ascherman, Claes Wahlestedt, Ihsan Salloum

Research Symposium

Objective/Hypothesis: Bipolar disorder (BD) has the highest association with alcohol and other substance use disorders compared to other major psychiatric disorders. This patient population is particularly challenging to treat. We have previously shown that some patients with co-occurring alcohol use and bipolar disorders respond to the GABAergic agonist valproate (VPA), which is known to modulates the dopaminergic system, and also as an epigenetic modifier. Predictors of therapeutic response to VPA in patients with AUD/BD are not known, and the subgroup which would benefit from VPA is still to be identified. Recent evidence suggests that AUD promotes a pro-inflammatory state while …

Improving Depression Screening Completion Rates For Medicare Patients In A Primary Care Setting, Kenneth J. Haluska

Evidence-Based Practice Project Reports

The United States Preventative Services Task Force recommends screening the general adult population for depression (Siu et al., 2016). Despite increasing clinical practice guidelines recommending depression screening, only 40-50% of depressed older adults are recognized and treated (Phoh et al., 2017). The purpose of this evidence-based practice (EBP) project was to implement a medical assistant (MA) depression screening protocol, using the PHQ-9 and staff education, to improve depression screening completion rates in Medicare patients in a primary care setting. An exhaustive literature search of eight databases yielded 14 pieces of evidence that made recommendations for best practice. The evidence was …

A Phenomenological Take On Mirror Self-Face Perception In Schizophrenia, Giovanni Pennisi

Journal of Mind and Medical Sciences

Studies concerning social deficits in schizophrenia has often been restrained to exploring facial recognition. Various investigations have shown that those diagnosed with schizophrenia have difficulties in perceiving the identities and emotions of those around them merely through observing their facial features. A few others have also taken into account the issue of self-face recognition in individuals with schizophrenia, finding that their capacity to associate photos or videos of their own face to themselves is hindered due to the illness. However, to my knowledge, only a few studies have so far delved into the intricacies of how individuals with schizophrenia or …

Skin Stories And Family Feelings: The Contradictions Of Skin Picking In Mother And Daughter, Katrina Jacinto

Crossings: Swarthmore Undergraduate Feminist Research Journal

Skin picking, otherwise known as dermatillomania, is considered to be a medical disorder by the DSM-5. However, the embodied experiences of skin picking in myself and my mother do not align with the neat definitions offered by psychiatry. Through autoethnographic material and an ethnographic interview with my mother, I argue that skin picking is a bodily technique that is pathologized through stigma. In particular, I suggest that skin picking reveals the body as a polyvalent entity, in which the same features and practices take on different meanings in different bodies. This frames the discrepancies between mine, and my mother's, experiences. …