Psychiatry Commons^™

Exploring Risk Factors For Major Depressive Disorder For Female Patients Aged 18 Or Older Living In Ocean County, New Jersey, James Mack

Rowan-Virtua Research Day

Background: The incidence and prevalence of major depressive disorder has been increasing worldwide, in the United States of America, and on a local level. The population of Ocean County, New Jersey, a predominantly Caucasian, female, middle-aged population, may be at increased risk of developing major depressive disorder.

Purpose: To explore the social determinants of health and risk factors for major depressive disorder for female patients aged 18 or older living in Ocean County, New Jersey.

Methods: This literature review mainly used PubMed and Scopus for journal articles and utilized governmental databases for additional population data.

Results: Analyses conducted on social …

Seizure To Drug Induced Schizophrenia: A Rare Case Of Keppra-Induced Psychosis, Shadi Shams, Riddhima Issar, Nardin El-Shammaa, Munaza Khan

Rowan-Virtua Research Day

Levetiracetam is a broad-spectrum antiseizure medication and is approved as adjunctive therapy to treat focal-onset seizures in children and adults with epilepsy. Levetiracetam has a wide margin of safety and patient-friendly pharmacokinetics that distinguish it from other currently available antiepileptic drugs.

Most common side effects are fatigue, somnolence, dizziness, and upper respiratory infection. Neuropsychiatric symptoms are reported. Psychotic symptoms, paranoid ideation, hallucinations, and behavioral problems may occur in adult and pediatric patients. Among all adverse effects, the rate of psychosis is very low and ranges from less than 1% to 1.4%. A retrospective study showed that this rate is higher …

Supervision In Community Mental Health: Understanding Intensity Of Ebt Focus., Leah Lucid, Rosemary Meza, Michael D Pullmann, Nathaniel Jungbluth, Esther Deblinger, Shannon Dorsey

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

The goal of the present study was to examine clinician, supervisor, and organizational factors that are associated with the intensity of evidence-based treatment (EBT) focus in workplace-based clinical supervision of a specific EBT, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Supervisors (n = 56) and clinicians (n = 207) from mental health organizations across Washington State completed online self-report questionnaires. Multilevel modeling (MLM) analyses were used to examine the relative influence of nested clinician and supervisor factors on the intensity of EBT focus in supervision. We found that 33% of the variance in clinician report of EBT supervision intensity clustered at the …

Shared Genetic And Environmental Influences On Fear, Anxiety, Posttraumatic Stress, And Brain Morphometry, Chelsea Sawyers

Theses and Dissertations

Anxiety disorders (ADs) and stress-related disorders are some of the most common psychiatric disorders in the United States. Like other c0mplex psychiatric illness, genetics and neuroimaging research has focused on understanding their underlying neurobiology. Areas within the fear-network play important roles in threat perception, fear conditioning/learning, cognitive processing, and modulation of fear responses including contextual modulation and extinction and have been implicated in ADs as well as stress disorders such as posttraumatic stress disorder (PTSD). The primary gap in the current search for underlying biological mechanisms is in whether biomarkers associated with disorders share genetic influences with the disorders they …

Suicidal Ideation Assessment In Individuals With Premanifest And Manifest Huntington Disease., Melissa Wesson, Nicholas R Boileau, Joel S Perlmutter, Jane S Paulsen, Stacey K Barton, Michael K Mccormack, Noelle E Carlozzi

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

BACKGROUND: Huntington disease (HD) is associated with increased risk of suicide.

OBJECTIVE: This study compares suicide ideation in HD to the general population, assesses factors associated with increased prevalence of suicidal thoughts, and compares clinician-rated to self-reported assessments of suicidal ideation.

METHODS: We examined 496 participants with premanifest or manifest HD. Clinician-rated suicidal ideation was measured using the Problem Behaviors Assessment - short form. Self-reported ideation was measured using two items from the HDQLIFE Concern with Death and Dying item bank. Independent sample t-tests were conducted to compare the prevalence of suicidal thoughts between our HD sample and the U.S. …

Correspondence Between Self-Report And Interview-Based Assessments Of Antisocial Personality Disorder, Laura Guy, Norman Poythress, Kevin Douglas, Jennifer Skeem, John Edens

Norman Poythress

Antisocial personality disorder (ASPD) is associated with suicide, violence, and risk-taking behavior and can slow response to first-line treatment for Axis I disorders. ASPD may be assessed infrequently because few efficient diagnostic tools are available. This study evaluated 2 promising self-report measures for assessing ASPD--the ASPD scale of the Personality Diagnostic Questionnaire-4 (PDQ-4; S. E. Hyler, 1994) and the Personality Assessment Inventory (PAI; L. Morey, 1991, 2007)--as well as the ASPD module of the Structured Clinical Interview for DSM-IV Axis II (SCID-II; M. B. First, R. L. Spitzer, M. Gibbon, J. B. W. Williams, and L. S. Benjamin, 1997). The …

Factors Differentiating Successful Versus Unsuccessful Malingerers, John Edens, Laura Guy, Randy Otto, Jacqueline Buffington, Tara Tomicic, Norman Poythress

Norman Poythress

Relatively little is known about the processes in which "successful" malingerers engage to avoid detection. This study summarizes the response strategies used by participants (N = 540) instructed to feign a specific mental disorder while completing various self-report instruments designed to detect faking. Postexperiment questionnaires indicated that those who were able to appear symptomatic while avoiding being detected as feigning (n = 60) were more likely to endorse a lower rate of legitimate symptoms, to avoid overly unusual or bizarre items, and to base their responses on their own personal experiences.

Is It Abuse? Deaf Female Undergraduates' Labeling Of Partner Violence, Melissa Anderson, Caroline Kobek Pezzarossi

Melissa L. Anderson

The current study investigated the labeling of abuse experiences in a sample of 97 Deaf female undergraduate students, exploring the following questions: What is the prevalence of violent behaviors experienced by Deaf female undergraduates in their past-year relationships, what proportion of these relationships are identified as "abuse," and what scripts and strategies do Deaf female undergraduates utilize to label their experiences of partner violence? Results indicated that over half of the sample chose not to label past-year experiences of psychological aggression, physical assault, and sexual coercion as abuse, even when these experiences included severe violence. Implications for the Deaf education …

Black Deaf Individuals' Reading Skills: Influence Of Asl, Culture, Family Characteristics, Reading Experience, And Education, Candace Myers, M. Diane Clark, Millicent Musyoka, Melissa Anderson, Gizelle Gilbert, Selina Agyen, Peter Hauser

Melissa L. Anderson

Previous research on the reading abilities of Deaf individuals from various cultural groups suggests that Black Deaf and Hispanic Deaf individuals lag behind their White Deaf peers. The present study compared the reading skills of Black Deaf and White Deaf individuals, investigating the influence of American Sign Language (ASL), culture, family characteristics, reading experience, and education. (The descriptor Black is used throughout the present article, as Black Deaf individuals prefer this term to African American. For purposes of parallel construction, the term White is used instead of European American.) It was found that Black Deaf study participants scored lower on …

Managed Mental Health Care's Effects On Arrest And Forensic Commitment, William Fisher, Sharon-Lise Normand, Barbara Dickey, Ira Packer, Albert Grudzinskas, Hocine Azeni

Ira K Packer

No abstract provided.

Self-Reported Lifetime Psychiatric Hospitalization Histories Of Jail Detainees With Mental Disorders: Comparison With A Non-Incarcerated National Sample, William Fisher, Ira Packer, Steven Banks, David Smith, Lorna Simon, Kristen Roy-Bujnowski

Ira K Packer

Lack of access to hospitalization is an often-cited risk factor for incarceration among persons with severe mental illness. This proposition is examined by comparing self-reports of lifetime psychiatric hospitalization histories of mentally ill jail inmates with data from a national sample of non-incarcerated mentally ill. Roughly 52% of mentally ill jail detainees reported at least one psychiatric hospitalization, a rate nearly three times that of the comparison group. The data call into question the notion that mentally ill jail inmates have reduced access to psychiatric inpatient treatment, without addressing the adequacy of the treatment received. Longitudinal studies are needed to …

Community Mental Health Services And The Prevalence Of Severe Mental Illness In Local Jails: Are They Related, William Fisher, Ira Packer, Lorna Simon, David Smith

Ira K Packer

The excessive prevalence of severe mental illness noted in correctional settings has sometimes been attributed to the inadequacy of community based mental health services. This study examines the prevalence of severe mental illness in two jails situated within catchment areas featuring markedly different levels of community mental health services. We use these settings to test the hypothesis that greater levels of services in a community are associated with lower prevalence of severe mental illness in the community's jail. An epidemiologic approach, using standardized field instruments, was used to estimate the prevalence of major mental illness in detainees arriving at the …

Treatment Preferences Among Problem Drinkers In Primary Care., Daniel Z Lieberman, Anne Cioletti, Suena H Massey, Rochelle S Collantes, Brad B Moore

Psychiatry and Behavioral Sciences Faculty Publications

OBJECTIVE: Alcohol misuse is common among primary care patients, yet many do not receive treatment because doctors believe problem drinkers are "in denial," or are unwilling to change their drinking habits. The real problem, however, may be that patients are being offered treatment modalities that do not meet their needs. This study was designed to measure the acceptability of various treatment options among drinkers who were currently not receiving treatment.

METHOD: Patients in a primary care clinic were given a self-report questionnaire that included: (1) the Alcohol Use Disorders Questionnaire, (2) a measure of readiness to change drinking behavior, and …

A Pilot Study Of Qigong For Reducing Cocaine Craving Early In Recovery, David A. Smelson, Kevin W. Chen, Douglas M. Ziedonis, Ken Andes, Amanda Lennox, Lanora Callahan, Stephanie Rodrigues, David Eisenberg

Douglas M. Ziedonis

OBJECTIVES: This pilot study examined the feasibility, preliminary efficacy, and determined the effect sizes of external qigong therapy (EQT) in reducing cue-elicited cocaine craving and associated symptoms among recently abstinent cocaine-dependent (CD) individuals. METHODS: This study randomized 101 CD subjects to either a real EQT (n=51) or sham EQT control (n=50) group. Subjects underwent a baseline assessment and a weekly cue-exposure session for 2 weeks. Total EQT or sham treatments ranged from 4 to 6 sessions in 2 weeks. RESULTS: EQT-treated subjects displayed a greater reduction in cue-elicited craving (p=0.06) and symptoms of depression (p<0.05) with medium effect sizes. …

Insurance Status And Length Of Stay For Involuntarily Hospitalized Patients, William Fisher, Paul Barreira, Alisa Lincoln, Lorna Simon, Andrew White, Kristen Roy-Bujnowski, Marylou Sudders

Alisa Lincoln

General and private psychiatric hospitals are becoming increasingly common as sites for involuntary hospitalization. Unlike the public facilities that these settings are supplanting, these hospitals must pay strict attention to issues associated with reimbursement, insurance status, and managed care. This article examines the effects of insurance status on length of stay for involuntarily hospitalized patients in general and private hospitals in Massachusetts. Using a two-stage sampling procedure, data on episodes of involuntary hospitalization were gathered and assessed using multiple regression. The primary effect was found between patients with Medicare, who had the longest stays, and individuals who were uninsured, who …

Family Options For Parents With Mental Illnesses: A Developmental, Mixed Methods Pilot Study, Joanne Nicholson, Karen Albert, Bernice Gershenson, Valerie Williams, Kathleen Biebel

Joanne Nicholson

OBJECTIVE: The objective of this paper is to provide a description of Family Options, a rehabilitation intervention for parents with serious mental illnesses and their children focusing on recovery and resilience, and to report the findings from a pilot study at 6-months post-enrollment for participating mothers. METHODS: A developmental design, and mixed quantitative and qualitative methods facilitate an in-depth understanding of Family Options and its impact on parents early in the implementation process. RESULTS: Participating families faced significant challenges, including long-term mental health conditions in adults, and emotional and behavioral difficulties in children. Data from mothers (n = 22) demonstrate …

A Randomized Comparison Of Online And Paper Mood Charts For People With Bipolar Disorder., Daniel Z Lieberman, Tammas F Kelly, Lanny Douglas, Frederick K Goodwin

Psychiatry and Behavioral Sciences Faculty Publications

BACKGROUND: Longitudinal mood instability is the essential feature of bipolar disorder, however most rating scales are cross sectional in nature, and focus on acute symptoms. By contrast, the NIMH Life Chart Methodology (LCM) characterizes in detail the severity, duration, and frequency of mood episodes. Adherence to daily rating, however, tends to be low. In this study an online version of the LCM, designed to enhance adherence, was compared to the standard paper version.

METHODS: Patients from a mood disorders specialty clinic were randomized to the standard LCM or an online, open-source adaptation. The online version used hypertext links embedded in …

Antidepressant-Induced Mania With Concomitant Mood Stabilizer In Patients With Comorbid Substance Abuse And Bipolar Disorder., Daniel Z Lieberman, George Kolodner, Suena H Massey, Kenneth P Williams

Psychiatry and Behavioral Sciences Faculty Publications

Antidepressant use in the treatment of bipolar disorder is controversial due the risks of affective switching and cycle acceleration. Studies of non-comorbid samples suggest that the risk can be mitigated with the use of a concomitant mood stabilizer. However, the majority of patients with bipolar disorder will experience a comorbid substance use disorder and little is known about these individuals because they are typically excluded from clinical trials. Patients entering a substance abuse treatment program who had a history of bipolar disorder were interviewed to evaluate antidepressant-induced affective switching with and without concomitant mood stabilizer. Among 41 comorbid participants, the …

Evaluation Of The Stability And Validity Of Participant Samples Recruited Over The Internet., Daniel Z Lieberman

Psychiatry and Behavioral Sciences Faculty Publications

Research conducted via the Internet has the potential to reach important clinical populations of participants who would not participate in traditional studies. Concerns exist, however, about the validity of samples recruited in this manner, especially when participants are anonymous and never have contact with study staff. This study evaluated two anonymous samples that were recruited over the Internet to test an online program designed to help problem drinkers. The two studies were conducted 3 years apart, and different recruitment strategies were utilized. Despite these differences, the two samples were highly similar in demographic and clinical features. Correlations that have been …

Pathways To Change: The Effect Of A Web Application On Treatment Interest., Daniel Z Lieberman, Suena H Massey

Psychiatry and Behavioral Sciences Faculty Publications

Most individuals with drinking problems do not receive treatment, generally because they do not perceive the need for it. It is difficult to access this population of problem drinkers in order to encourage treatment-seeking. A Web-based program was written, designed to increase motivation for change. The program guided non-treatment-seekers through a multi-stage assessment and provided them with feedback. The level of interest in treatment was measured pre-and post-intervention. Compared to baseline, after the intervention, significantly more individuals rated themselves "very interested" in participating in some form of traditional treatment (19% vs. 28%), and their focus on a specific modality increased.

A Technological Approach To Reaching A Hidden Population Of Problem Drinkers., Daniel Z Lieberman, Suena W Huang

Psychiatry and Behavioral Sciences Faculty Publications

OBJECTIVE: The most common obstacle to the treatment of individuals with drinking problems is that most do not seek treatment. This study compared a group of treatment-seeking patients with users of an alcohol-evaluation Web site to determine whether an Internet application could reach a population of problem drinkers who are distinct from those served by currently available forms of care.

METHODS: An open-source application was developed that was modeled on the Drinker's Check-Up, which has been shown to increase motivation for behavior change while presenting itself as a nonthreatening evaluation. To recruit non-treatment seekers, the program was offered as a …

Effects Of A Personified Guide On Adherence To An Online Program For Alcohol Abusers., Daniel Z Lieberman

Psychiatry and Behavioral Sciences Faculty Publications

The quality of the therapeutic alliance has robust effects on the outcome of psychotherapy and psychopharmacologic interventions. Automated behavioral health programs that are being developed to increase access to mental health treatment are administered in the absence of direct human participation, thereby precluding the development of a traditional therapeutic relationship. The aim of this study was to develop a personified guide designed to stimulate reactions similar to those experienced in a therapeutic relationship, and evaluate the effect of the guide on adherence to and satisfaction with an online alcohol use evaluation program. After completing a battery of four standard questionnaires …

Clinical Characteristics Of Individuals Using An Online Alcohol Evaluation Program., Daniel Z Lieberman

Psychiatry and Behavioral Sciences Faculty Publications

Access to treatment for substance abuse disorders is limited, and practical strategies are needed to expand opportunities for individuals to receive effective interventions. Automated or semi-automated treatments have shown promise in other disorders. Identifying the characteristics of patients who will be able to benefit from this unconventional approach will increase the likelihood of success. The current study examined 1,297 individuals using an online alcohol evaluation program. Subjects had high scores on the Alcohol Use Disorders Identification Test (AUDIT) and a substantial amount of ambivalence about the possible harm that their drinking caused, but they also had very low levels of …

Determinants Of Satisfaction With An Automated Alcohol Evaluation Program., Daniel Z Lieberman

Psychiatry and Behavioral Sciences Faculty Publications

High rates of untreated mental illness cause serious health problems in the United States and worldwide. The use of computer-administered therapy has the potential to increase access to mental health care for certain patient populations. An online version of an alcohol check-up was developed that guided subjects through a series of standardized questionnaires, and provided them with feedback designed to enhance their appreciation of the negative aspects of their alcohol use. Ratings of the helpfulness of the questionnaires were evaluated in order to determine the characteristics of individuals who would potentially benefit from an automated substance abuse intervention, and to …

Internet Facilitation Of Opioid Dependence., D Z Lieberman

Psychiatry and Behavioral Sciences Faculty Publications

No abstract provided.