Mental and Social Health Commons^™

Impact Of Traditional (Non-Affirming) Black Church Affiliation On Exploration Of Sexual Identity For Black Assigned Female At Birth Lgbq+ Individuals And The Associated Mental Health Risk, Aurielle J. Sutton

Doctoral Dissertations

This dissertation explored the impact of Black traditional church upbringing on the sexual and religious identity development, including the subsequent mental health risk, for Black assigned female at birth (AFAB) LGBQ+ individuals. Studies conducted on Black AFAB LGBQ+ individuals are limited, especially in terms of  assessing their experiences in sexual identity development based on religious upbringings. Studies have overlooked the experience of LGBQ+ Black AFAB individuals navigating sexual orientation development and religious and racial identities. Studies have greatly favored Black gay men and supported health risks such as HIV. In the present study, twelve Black AFAB Queer individuals participated in …

“It Feels Like Your Life Hinges On Me”: Lived Experience Of Being Next Of Kin To Someone Who Self-Harms, Kenneth Haugjord, John-Kåre Vederhus, Tore Dag Bøe, Kristine Dahl

The Qualitative Report

Through previous research, attention has been drawn to the burden experienced by next of kin to someone struggling with self-harm, yet less attention has been given to how they experience and make sense of the relational and existential complexity of this role in their everyday lives. We asked how next of kin experienced and made sense of caring for a loved one who self-harmed. We conducted in-depth interviews with fourteen next of kin, including parents, partners, and siblings, and analyzed the data through reflexive thematic analysis within an interpretive qualitative framework. Our analysis generated an overarching theme, "It Feels Like …

Calm, Connection, Or Just Compensation: A Qualitative Investigation Of Subjective Adolescent Experiences With Behavioral Health Interventions Within A Clinical Trial, Talia Thompson, Katherine Thompson, Sarah Perzow, Holly Spinner, Bentley Porterfield-Finn, Lauren D. Gulley, Rachel G. Lucas-Thompson, Isabel Thorstad, Laura Pyle, Molly Basch, Megan J. Moran, Marian Tanofsky-Kraff, Megan M. Kelsey, Eleanor R. Mackey, Lauren B. Shomaker

The Qualitative Report

Adolescent mental health and cardiometabolic concerns are at an all-time high, necessitating the development of acceptable, feasible, and effective interventions. Investigations of behavioral health interventions with teenagers must incorporate a means of understanding how adolescents perceive and engage with an intervention, and the relevance and meaning they ascribe to its therapeutic goals, as these potentially modifiable factors may ultimately influence future uptake, sustainability, and effectiveness of the interventions. Qualitative research methods provide well-established, rigorous frameworks for addressing these questions, but are underutilized in pediatric research. This qualitative study is part of a multisite, pilot, and feasibility randomized controlled trial of …

Beyond Screening In Amyotrophic Lateral Sclerosis: A Domain-Standardized, Measure-Flexible Framework For Comprehensive Neuropsychological Assessment, Etiane Navarro

Archives of Assessment Psychology

Amyotrophic lateral sclerosis (ALS) is a multisystem neurodegenerative disorder in which cognitive, behavioral, language, and social-cognitive changes may occur across clinical phenotypes, including the ALS-frontotemporal spectrum. Neuropsychological assessment is important for characterizing nonmotor manifestations and identifying changes relevant to autonomy, everyday functioning, and clinical management. This systematic review examined literature identified through APA PsycINFO, PubMed, Google Scholar, and supplementary searching to characterize neuropsychological domains, measures, phenotype-related findings, and disease-specific limitations relevant to comprehensive assessment. Two hundred records underwent title and abstract screening, 150 reports were reviewed in full text, and 61 resources were retained for synthesis. ALS-specific screening instruments, including …

Beyond Screening In Amyotrophic Lateral Sclerosis: A Domain-Standardized, Measure-Flexible Framework For Comprehensive Neuropsychological Assessment, Etiane Navarro

Archives of Assessment Psychology

Amyotrophic lateral sclerosis (ALS) is a multisystem neurodegenerative disorder in which cognitive, behavioral, language, and social-cognitive changes may occur across clinical phenotypes, including the ALS-frontotemporal spectrum. Neuropsychological assessment is important for characterizing nonmotor manifestations and identifying changes relevant to autonomy, everyday functioning, and clinical management. This systematic review examined literature identified through APA PsycINFO, PubMed, Google Scholar, and supplementary searching to characterize neuropsychological domains, measures, phenotype-related findings, and disease-specific limitations relevant to comprehensive assessment. Two hundred records underwent title and abstract screening, 150 reports were reviewed in full text, and 61 resources were retained for synthesis. ALS-specific screening instruments, including …

Intimate Partner Violence And Child Wasting Across Countries: An Ecological Cross-Sectional Study, Wanri Lumbanraja, I Ketut Kasta Arya Wijaya, Ruben Cornelius Siagian

Journal of Indonesian Health Policy and Administration

Intimate partner violence (IPV) is a public health issue that can affect the well-being of women, their families, and the child-rearing environment. Meanwhile, wasting in under-five children reflects acute malnutrition linked to food insecurity, infectious diseases, poverty, and access to healthcare services. This study aimed to analyze the relationship between the prevalence of IPV among women in the past 12 months and the prevalence of wasting in children under the age of five at the national level. This study addresses the gap in cross-national research, which remains limited in linking IPV as an indicator of social vulnerability with wasting as …

Good Grief: Finding Hope & Achieving Growth In The Face Of Loss, Daniel D. Cowell M.D.

Open Access Books

Grief has profoundly shaped Dr. Dan Cowell's life both professionally and personally. A board-certified psychiatrist, he spent 26 years in the U.S. Public Health Service, including leadership roles across federal health systems, before serving for 15 years as professor and chairman of psychiatry at the Marshall University School of Medicine, and was the Senior Associate Dean for Graduate Medical Education when he retired in 2009.  Throughout his career, he has accompanied individuals and families through some of life's most difficult losses. In his personal life, he has been touched by these losses himself, including the tragic deaths of an infant …

Gender Differences In The Association Between Marriage And Epigenetic Age, Theo O. Moran, Alina M. Kushner, Theodore F. Robles, Jennifer W. Robinette

Psychology Faculty Articles and Research

Introduction:

Being married is related to better health, but many studies reveal greater health benefits among men relative to women. Some research has indicated that married individuals exhibit decelerated epigenetic age relative to individuals who are not married, but questions remain regarding gender differences therein. The purpose was to investigate gender differences in associations of marital status to epigenetic age (ing) assessed on three clocks/algorithms (PhenoAge, GrimAge, and DunedinPACE).

Methods:

Data from 762 participants in the national Midlife in the United States Study (MIDUS II; men N = 382, women N = 380) were used. Weighted linear regressions were conducted …

The Development And Piloting Of A Novel Client-Rated Trans And Gender Expansive Clinical Competence Scale For Mental Health Providers, Karen Abraham

Dissertations, Theses, and Capstone Projects

Transgender and gender expansive individuals (TGEI) are people who encompass a broad and comprehensive set of experiences of gender diverse individuals and identities that exist both within and beyond a binary framework. In the United States, the Williams Institute identified a proportion of 0.5% of American adults identifying as transgender (Herman et al., 2022). TGE samples report poorer physical and mental health than their cisgender counterparts across the lifespan (Rastogi et al., 2025; Reisner et al., 2015; Reisner, Poteat, et al., 2016). Health disparities of TGEI relative to their non-TGE counterparts can be seen in the prevalence of mood disorders …

Coping Beyond Cancer: Exploring Fear Of Recurrence In Colorectal Cancer Survivors—A Pilot Investigation, Emily M. Su, Steve Paciorek, Erica L. Laipply, Anuja L. Sarode

HCA Healthcare Journal of Medicine

Background

Evidence is limited on the fear of cancer recurrence (FCR) among colorectal cancer (CRC) survivors in the US, especially regarding patterns and trends of post-recovery coping mechanisms. This pilot mixed-methods study quantified FCR, examined its associations with Brief COPE domains, and contextualized coping through qualitative analysis.

Methods

Twenty-three patients who successfully underwent CRC surgery were included in this pilot study. Fear of cancer recurrence was measured using the FCR Inventory (FCRI) Short Form, and coping strategies were assessed with the Brief Coping Orientation to Problems Experienced (COPE) survey. Descriptive statistics summarized participant characteristics, FCR, and COPE scores. Spearman correlation …

Breaking The Cycle: From Victimization To Offending Through The Lens Of Human Services, Colette R. Penalosa

Master of Arts in Human Services

The victim-offender overlap challenges the common view that victims and offenders are separately labeled by recognizing that both groups have experienced significant childhood trauma, physical, emotional, and psychological abuse, neglect, and other adverse childhood experiences (ACEs). Current research implies these experiences can increase the risk of offending as they all influence cognitive and behavioral development while leaving criminal behavior undetermined. The purpose of this capstone is to analyze the relationship between childhood victimization and offending from a human service perspective; analyzing the pathways a victim takes on the road to offending. Research conducted will focus on exploring the victim-offender overlap, …

Trauma Processing And Sleep Inconsistencies In Firefighters: A Proposed Program To Bridge Gaps And Set Heroes Up For Success, Megan Griffin

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This doctoral paper presents a comprehensive review of the literature supporting the need for an integrated training program addressing sleep disruption, trauma exposure and processing, and substance use as a self-medication strategy among firefighter populations. Drawing on empirical research, the paper examines the prevalence and interaction of posttraumatic stress disorder (PTSD), moral injury, sleep disturbances, and substance use within this occupational group. The introduction provides operational definitions of PTSD and moral injury and synthesizes existing research on trauma exposure, sleep impairment, and substance use functions among firefighters. The literature review also highlights evidence-based, exposure informed interventions to facilitate adaptive trauma …

Diagnosis And Treatment Of Trauma In Adolescents: A Doctoral-Level Clinical Psychology Course, Jasmine M. Cervantes

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Adolescent trauma is a significant mental health concern that can profoundly disrupt emotional, cognitive, social, and developmental functioning. Although evidence-based interventions for adolescent trauma are well established, doctoral-level psychology training programs may provide limited instruction focused specifically on the unique developmental, cultural, and clinical considerations required when treating traumatized adolescents. This paper presents the development of a ten-week doctoral-level elective course designed to address this gap in clinical training. The curriculum provides foundational knowledge regarding the prevalence, developmental impact, diagnosis, and treatment of adolescent trauma, with an emphasis on posttraumatic stress disorder (PTSD) and complex posttraumatic stress disorder (CPTSD). Students …

Racial Trauma And Posttraumatic Growth: Implications For Counselors, Margaret M. Poandl, Nowoola Awopetu, Paul C. Harris Dr.

Journal of Counselor Preparation and Supervision

Racial trauma is ubiquitous among Black, Indigenous, and People of Color (BIPOC) and people who belong to other marginalized groups. It is likely that counselors will work with individuals who have experienced racial trauma. Aligned with the counseling profession’s values, counselors can take a strengths-based approach that incorporates facilitation of a historical trauma posttraumatic growth (HT-PTG) framework. This paper presents evidence-informed practices that can foster growth on individual and collective levels. A case example is provided that integrates individual- and collective-level interventions bidirectionally, along with implications for counselor training pedagogically, through supervision, and continuing education. Counselors can identify, encourage, and …

The Safe Fishbowl Model: Psychological Safety By Design In Counseling Skills Training, Mike Mariska

Journal of Counselor Preparation and Supervision

Skills training in counselor education can be constrained by performance anxiety, which may reduce participation, limit deliberate practice repetitions, and shift demonstrations to the instructor. This applied-practice manuscript introduces the SAFE (Structured Avatar and Feedback Experience) Fishbowl model, a simulation architecture designed to address performance anxiety while scaling participation. SAFE Fishbowl integrates rotating counselor roles, a real-time coaching loop, structured observation grounded in experiential learning theory, and purposeful debriefing. An implementation example for group counseling leadership skills is provided, along with adaptation guidance across multiple skill domains and delivery modalities. Descriptive course-evaluation feedback illustrates feasibility and perceived usefulness. Implications include …

Integrating Consensual Non-Monogamy In Counselor Education: Practical Guidelines And A Pilot Descriptive Study, Yun-Zhuo (Zoey) Liu, Lena Salpietro

Journal of Counselor Preparation and Supervision

Consensual non-monogamy (CNM) is a prevalent and diverse relationship structure, yet mononormative assumptions persist in counselor training and practice, contributing to stigma and inadequate care. Research indicates that counselors’ CNM-specific knowledge and attitudes are critical to positive therapeutic outcomes (Schechinger et al., 2018), highlighting the need for clear guidance. In response, this paper presents Guidelines for Incorporating CNM in Counseling Curricula. Three domains are grounded in multicultural and social justice principles: foundational knowledge and terminology, challenging bias and promoting self-reflection, and application informed by attachment theory. Additionally, findings from a survey of counselor educators (N = 54) are presented. Results …

U.S. Service Member To Counseling Student, Nicole Marie Arcuri Sanders, Kellie Forziat-Pytel

Journal of Counselor Preparation and Supervision

This qualitative descriptive study examines the absence of military career pathways for licensed mental health counselors (MHCs) and the impact of this structural limitation on service members' career transitions. Findings indicate that both combat and non-combat veterans pursued mental health counseling due to personal service-related mental health experiences and dissatisfaction with available care while in service. Despite these challenges, many participants expressed a strong desire to continue serving their country as professional counselors. Over half of the participants reported separating from the military because no occupational role existed for licensed MHCs. At the same time, most indicated they would have …

“Something Else To Focus On”: Perinatal Havening And Stress Coping In Pregnant Black Women, Brittany L. Ferrell Young

WUSM Theses and Dissertations – All Programs

Black women in the United States experience maternal mortality at more than three times the rate of white women, a disparity driven by chronic stress rooted in structural racism rather than individual behavior or biology. Accessible, culturally responsive tools for managing stress during pregnancy remain scarce. This mixed-methods pilot feasibility study examined Perinatal Havening, a self-administered psychosensory technique, as a stress management intervention for pregnant Black women. Guided by Lazarus and Folkman's Transactional Theory of Stress and Coping, the study addressed three questions: how Black women experience acute and chronic stress during pregnancy, the acceptability and preliminary influence of Perinatal …

"Help Me Live It The Way You Do": Grounding Singaporean Responses To The Rorschach Situation, Casey Y. Lee

Electronic Theses and Dissertations

Contemporary research on the Rorschach and culture is striking for the latter’s disappearance as a variable of significance (Meyer et al., 2015; Meyer et al., 2007; Mihura et al., 2013; Viglione & Hilsenroth, 2001). This erasure is chronicled and reproduced in the narratives of universal objectivity, of extensive international meta-analyses, of replications, of standardized norms (Ritzler, 2004; Smith et al., 2018; Smith et al., 2020; Weiner, 2004). A different story emerges, however, when we ask, how has culture disappeared? The proposed study is a multimethod qualitative analysis of Singaporean responses to the Rorschach, aimed at generating sensitive yet critical discourses …

Kindergarten Teachers’ Perceptions, Experiences, And Challenges Using Visual Supports For Children With Autism, Jasmine M. Mcnair

Electronic Theses and Dissertations

This qualitative case study examined kindergarten teachers’ perceptions, experiences, and challenges related to the use of visual supports for students with autism spectrum disorder in East Texas. Grounded in cognitive load theory, the study explored whether visual supports enhance learning outcomes by reducing cognitive overload. Four research questions addressed teachers’ perceptions of effectiveness, implementation challenges, the influence of teacher attitudes, and differences based on teaching experience. The researcher collected data through semistructured interviews with 10 kindergarten inclusion teachers and supplemented by classroom observations. Thematic analysis revealed five primary themes: emotional impact and student growth, visual supports as essential instructional tools, …

Association Between Stress Mindset, Psychological Symptoms, And Psychosocial Risk In Liver Transplant Patients, Sarah Kay Brill

Dissertations

Psychosocial functioning is a central component of liver transplant evaluation, yet less is known about how cognitive factors, such as stress mindset, relate to transplant readiness. The present study examined the association between stress mindset and psychosocial risk, as well as its relationship with depressive symptoms, anxiety, and perceived stress among patients undergoing liver transplant evaluation. Patients included 62 adults completing standard pre-transplant assessment measures, including the Stress Mindset Measure–Specific (SMM-S), Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Perceived Stress Scale (PSS). Hierarchical logistic regression analyses indicated that stress mindset was …

Loss Of Pleasure (Anhedonia): A Sex-Dependent, Cross-Species Consequence Of Unpredictable Signals To The Perinatal Brain, Anna M. Zhou, Madison R. Tetzlaff, Laura M. Glynn, Curt A. Sandman, Hal S. Stern, Tallie Z. Baram, Elysia Poggi Davis

Psychology Faculty Articles and Research

Reward seeking is an essential component of human behavior. Anhedonia (reduced motivation for and pleasure in reward) is a core feature of several mental illnesses. Early life adversity associates with later impairments in reward behaviors and related psychopathology; however, specific aspects of early adversity that lead to disrupted reward behaviors are unknown. Capitalizing on evidence that unpredictable signals to the developing brain constitute adversity and influence neurodevelopment, we examined whether exposure to perinatal unpredictable maternal signals associated with diminished reward responsivity, and probed causality using experiments in mice. We analyzed a longitudinal human study (N=158 mother/child dyads) and a …

The Primary Care Brief Intervention Competency Assessment Tool (Bi-Cat): Examining Reliability And Validity, Arielle Guillod

Dissertations

Within primary care, the Primary Care Behavioral Health (PCBH) model integrates behavioral health services into medical settings through brief, population‑based interventions delivered by behavioral health consultants (BHCs). Although effective performance in this role requires competencies distinct from traditional mental health practice, few psychometrically sound tools exist to assess clinical skills in primary care. The Brief Intervention Competency Assessment Tool (BICAT) is commonly used for this purpose but lacks published evidence supporting its reliability and validity. This dissertation examined the psychometric properties of the BICAT across two studies. Study 1 evaluated factor structure, internal consistency, and construct validity in a heterogeneous …

Mapping Dna Methylation Signatures To Identify Epigenetic Variation Across Subcortical Regions Of The Human Posttraumatic Stress Disorder Brain, Hongyu Li, Yujing Liu, Yiming Shi, Jiawei Wang, Tuan P Nguyen, Yuhan Xie, Wangjie Zheng, Youshu Cheng, Dianne A Cruz, Jennifer L Modliszewski, Rosemarie Terwilliger, Alexa-Nicole Sliby, José Jaime Martínez-Magaña, Janitza L Montalvo-Ortiz, John D Roache, Lynnette A Averill, Stacey Young-Mccaughan, Paulo R Shiroma, Bertrand R Huber, David A Lewis, Jill Glausier, Paul Holtzheimer, Matthew J Friedman, Jing Zhang, Alan L Peterson, Chadi G Abdallah, Amir Valizadeh, Xinyu Zhang, Ke Xu, John H Krystal, Ronald S Duman, Hongyu Zhao, David L Corcoran, Douglas E Williamson, Matthew J Girgenti

Staff and Researcher Publications

Background: Posttraumatic stress disorder (PTSD) is a mental disorder that may occur in the aftermath of severe psychological trauma. Epigenetic changes in the brain may play a critical role in understanding the neurobiology of PTSD by linking environmental traumatic stress exposure to lasting alterations in gene expression that shape neuronal function.

Methods: We examined 1,065,750 DNA methylation (DNAm) sites from 171 donors including neurotypical controls and PTSD and major depressive disorder (MDD) cases across 6 regions implicated in the fear circuitry of the brain. We performed RNA sequencing (RNA-seq) to examine changes in gene expression and linked these changes to …

Social Phobia, Coping Strategies, And Socio-Demographic Associations Among Late Adolescents: A Cross-Sectional Study, Ezhilan B U, Jesymol Joy, Smitha Chandrashekarappa Dr.

Digital Journal of Clinical Medicine

Background: Adolescence is a transitional period from childhood to adulthood, often marked by psychological challenges such as social anxiety, also known as social phobia. It is characterized by excessive fear of social interactions and can lead to impaired functioning or depression. Globally, its prevalence ranges from 6-10% in developed countries and 10-44% in developing countries. Coping strategies play a crucial role in managing social phobia, varying by individual characteristics. This study aimed to determine the prevalence of social phobia, identify coping strategies, and evaluate their association with socio-demographic factors among late adolescents.

Methodology: A cross-sectional study was conducted …

Using In-Home Air Quality Monitoring To Reduce Cannabis Secondhand Smoke Exposure In Children: Quantitative Pilot Feasibility Study, Vincent Berardi, Bradley N. Collins, Laura M. Glynn, Eusabeia Silfanus, Darby G. Lyons, Stephen J. Lepore

Psychology Faculty Articles and Research

Background: An estimated 5 to 8 million US children live with a parent who uses cannabis, and most cannabis users report smoking cannabis inside their homes, placing children at risk for cannabis secondhand smoke (cSHS) exposure. Indoor air quality (IAQ) monitoring provides real-time feedback on airborne pollutants and has shown promise in reducing in-home tobacco secondhand smoke exposure, suggesting its potential as an effective harm reduction strategy for cSHS.

Objective: This pilot study evaluated the feasibility, acceptability, and preliminary effectiveness of using low-cost, off-the-shelf IAQ monitors to increase caregivers’ awareness of children’s cSHS exposure risk and to change …

(Re)Claiming Homeplace: Dance As Embodied Resistance & Healing For Health & Spatial Justice, Preeya G. Kannan

University Honors Theses

This thesis argues that dance functions as both an upstream public health intervention and a form of radical spatial resistance; creating healing, agency, and belonging among historically marginalized communities. Drawing on bell hooks' concept of homeplace, Jasbir Puar's assemblage theory, Nancy Krieger's eco-social theory, and Katherine McKittrick's Black geographies, I position the body as both an ecological and political landscape shaped by histories of colonialism, racial capitalism, displacement, and resilience.

Through this community-based participatory research study, Homeplace, I explore dance as a form of social prescription that centers liberation rather than pathology. Movement is often reduced in public health discourse …

Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef

Theses and Dissertations

Corporal punishment (CP) and severe physical punishment (SPP) remain a major public health, child rights, and child protection policy concern. In Egypt, despite legislative reforms, survey-weighted analysis of the 2021 Egypt Family Health Survey (EFHS) 2021 (CAPMAS, 2022) reveals prevalence rates of 60.5% for CP and 27.4% for SPP among children aged 1–14 (author’s calculations using EFHS-2021, n=7623), yet evidence distinguishing the determinants of routine corporal punishment from escalation to severe physical punishment remains limited in low- and middle-income contexts. Guided by Bronfenbrenner’s ecological framework, this mixed-methods study identifies key drivers of CP and its escalation to SPP among Egyptian …

Psychogastroenterology: An Introduction For Behavioral Health And Healthcare Professionals, Jerrod Brown Ph.D., M.A., M.S., M.S., M.S., M.S., M.S., Jeremiah B. Schimp Phd, Ma, Lpcc, Leanne Skehan Dcn, Msacn, Mph, Mba, Cns, Ches, Shelley Mydra Dmft, Lmft, Jonathan Ward Dc, Phd(C), Ms, Dibcn, Tiffany Flaten Cns, Ldn

Nutritional Neurocriminology Today

Although often difficult to discuss with clients, gastrointestinal (GI) issues affect an estimated 60 to 70 million Americans (American Gastroenterological Association, 2022). Yet only about 25% of those experiencing these conditions receive treatment. This is troubling because GI issues frequently co-occur with clinically significant consequences for physical health, psychological well-being, daily functioning, and overall quality of life. Designed for behavioral health and healthcare professionals, this brief article introduces the field of psychogastroenterology, with emphasis on symptoms, stigma, diagnosis, and treatment. Key topics include the gut-brain axis, common digestive health conditions, and the mental health implications associated with gastrointestinal disorders.

Evaluating Behavioral Intervention Strategies For Reducing Hyperactivity In Children Diagnosed With Autism Spectrum Disorder And Comorbid Adhd, Murtadha M. Abd Noor, Dunya Habeeb Shnain

Maaen Journal for Medical Sciences

One of the most difficult and complex symptoms in children with autism spectrum disorder (ASD) and comorbid attention deficit hyperactivity disorder (ADHD) is hyperactivity. This has a substantial negative impact on daily functioning, learning, and responsiveness to therapy interventions, as well as on intervention programs that aim to manage behavior in schools and clinical settings, thereby restricting children's engagement in these programs as management behaviors become more emphasized. Given marked heterogeneity in clinical presentations and a lack of consensus on the most effective behavioral strategies, there remains an imperative to systematically evaluate targeted, specific strategies for reducing hyperactivity in this …