Mental and Social Health Commons^™

The Ecology Of Mental Health And The Impact Of Barriers On Mental Health Service Utilization, Alisha Aggarwal

Theses & Dissertations

Mental health has emerged as a major public health concern in recent times with several disparities and barriers related to adequate health service utilization. Different age groups experience diverse symptoms and face distinct barriers in accessing and utilizing healthcare. Policies like Mental Health Parity and Addiction Equity Act and the Patient Protection and Affordable Care Act were launched to improve insurance coverage and delivery of mental health services. However, a large gap of unmet needs exists for adequate mental health service utilization in the country. This dissertation aims to describe the financial and non-financial barriers to mental health service utilization …

Giving Birth At A Critical Time: Assessing Perinatal Depression Among Syrian Refugees In Low Resource Settings, Nada Alnaji

Theses & Dissertations

Refugee mothers are at an increased risk of suffering from stress and mental health conditions during the first year after giving birth to a child. The objective of this study is to enhance the early identification of treatable mental health conditions among perinatal women living within humanitarian settings. The central hypothesis is that a culturally specific approach can be helpful for the long-term success of mental health efforts. In this study, we use qualitative interview methods to understand the cultural paradigms and predisposing factors for perinatal depression related to being a Syrian refugee in Lebanon during the COVID-19 pandemic. In …

Designing And Implementing A De-Escalation Toolkit To Improve Staff Education And Competency On De-Escalation Within A Mental Health Outpatient Setting, Balraj Bajwa

Doctor of Nursing Practice (DNP) Projects

Background: The purpose of this study is to develop and implement a de-escalation toolkit to help improve memory, retention, and utility of de-escalation techniques within an outpatient mental health crisis stabilization unit.

Problem: The aforementioned crisis stabilization unit has elevated rates of patient aggression/violence and staff present with difficulty recalling de-escalation techniques due to the lapse in memory and/or retention.

Methods: The project was introduced to the stakeholders of the crisis stabilization unit and input was obtained on the design and components of the toolkit. Various analyses were conducted to ensure the appropriate implementation of the project.

Intervention: A de-escalation …

The Influence Of Comorbid Gad On Er Utilization In Urban Youth With Asthma, David A. Karpe

Theses and Dissertations

Current literature indicates a strong association between asthma and the early onset of comorbid generalized anxiety disorder (GAD) in minors and their primary caregivers. Studies show that asthma prevalence increases with certain demographic factors, such as ethnicity, socioeconomic status, and housing quality. Evidence also suggests that GAD influences decision-making, especially when deciding to utilize emergency room (ER) services for asthma-related concerns. This study analyzed the effect of comorbid GAD on minors with asthma and ER utilization. The data were provided by an earlier Stress & Justice Study (S&J) baseline survey, an investigation aimed at understanding the impact of parental criminal …

Depression As A Moderator Of The Relationship Between Perceived Injustice And Neuropsychological Performance Validity Among Individuals Previously Diagnosed With A Concussion, Jeremiah Lum

Clinical Psychology Dissertations

Concussion is one of the most common conditions seen within rehabilitation and neuropsychology. Given that many concussions are diagnosed following litigation-associated injuries, it is unsurprising that malingered neurocognitive deficit (i.e., deliberate underperformance on cognitive instruments in the interest of secondary gain) has dominated the concussion literature. Although the identification of malingering is essential to ethical assessment, its presence or absence is not the sole determinant of performance validity as a whole. Rather, performance validity is a broad construct involving effort, which refers to examinees’ investment in performing at capacity levels; emerging research suggests this can be affected by psychological factors …

Therapeutic Potential Of Psychedelic Drugs, Specifically Magic Mushrooms, Marijuana, And Mdma With Veterans Who Suffer From Post-Traumatic Stress Disorder (Ptsd), Misty Schutterle

Counselor Education Capstones

Post-Traumatic Stress Disorder (PTSD) is a stress-based condition that a person develops after being exposed to an overwhelmingly traumatic event. Military troops frequently experience stress and trauma, making them highly susceptible to psychopathology. This paper evaluates nine clinical trials that used either magic mushrooms, marijuana, or MDMA as an adjunct to traditional psychotherapy to treat veterans who suffer from anxiety, depression, PTSD, suicidality, and other psychopathologies. Multiple scholarly journals and articles were read and analyzed, which show support for the therapeutic potential of psychedelic drugs in treating veterans with PTSD. After receiving psychedelic-assisted psychotherapy, the research showed participants experienced a …

Peer-Led Building Resilience And Enhancing Social-Emotional Skills Program, Danielle K. Enrico

Department of Occupational Therapy Entry-Level Capstone Projects

The purpose of the Capstone experience was to develop and implement a five-week peer-led building resilience and social-emotional skills training program at a public high school. This program addressed high school students' knowledge, skills, and attitudes regarding resources, social-emotional skills, and resilience. A questionnaire was administered pre and post-program to measure effectiveness. The results indicated an increase in scores, demonstrating a clearer understanding in all three areas.

Implementation Of An Interprofessional Fall Prevention Program To Reduce Falls On An Older Adult Inpatient Psychiatric Unit, Teresa Woodson

Doctor of Nursing Practice

Background. Falls are the most reported incidents in the hospital setting, especially among older adults. According to the National Database of Nursing Quality Indicators (NDNQI), the number of falls in inpatient psychiatric units is 13-25 per 1,000 patient days, compared to 4 per 1,000 days for medical-surgical units. This DNP project aims to implement an interprofessional fall risk team to reduce falls in an older adult inpatient psychiatric unit. Problem. The psychiatric inpatient units had a total of 31 falls, with 13 (40%) occurring on the older adult unit. Interventions. Education of nursing staff, providers, and physical therapy (PT) …

The Functional And Structural Consequences Of Aberrant Microglial Activity In Major Depressive Disorder, Jasmine D. Cakmak

Electronic Thesis and Dissertation Repository

Major depressive disorder (MDD) is a highly debilitating neuropsychiatric illness which has been linked with increases in both peripheral and central inflammation, as well as with changes in connectivity. Although countless studies have investigated these two topics, the relationship between neuroinflammation and functional/structural connectivity has not been explored. Using [¹⁸F]FEPPA PET imaging, we measured translocator protein-related (TSPO) microglial activity in the subgenual anterior cingulate cortex (sgACC) and insula and confirmed significantly increased [¹⁸F]FEPPA uptake in depressed patients (N=12) compared to healthy controls (N=23). Using a seed-based ROI analysis of fMRI data, we found that patients show …

Associations Between Parent Characteristics And Acceptability Of Exposure-Based Treatments For Child And Adolescent Anxiety, Allison Rumelt

Selected Full Text Dissertations, 2011-

Cognitive-behavioral therapy (CBT), particularly exposure therapy, is the most effective treatment for anxiety disorders in children and adolescents (Kendall et al., 2005). Little research has been done to explore parent acceptability of treatment for anxiety in children and adolescents, and no research has explored the acceptability of exposure for this population. The purpose of the present study was to examine parent acceptability of exposure for child and adolescent anxiety as well as variables associated with acceptability. Parents completed a demographic questionnaire, the Clinically Useful Anxiety Outcome Scale (Zimmerman et al., 2010), and the Family Accommodation Scale – Anxiety (Lebowitz et …

Training And Individual Predictors Of Attitudes Toward Serious Mental Illness Amongst Clinical Psychology Doctoral Students, Lauren K. O'Connor

Dissertations, Theses, and Capstone Projects

Clinical psychologists are grossly underrepresented in treatment provision for individuals with serious mental illness (SMI; Roe, Yanos, Lysaker, 2006). Systemic (e.g., emergence of managed care) and training-based (e.g., limitations to SMI specific training) factors contribute to the establishment of this underrepresentation, while mental health stigma amongst psychologists may play a role in perpetuating it. Many individual and experiential factors have been found to impact clinicians’ attitudes toward those with SMI (Henderson et al., 2014; Schulzes, 2007). Though many of these factors are present and relevant from the beginning of one’s career and may involve elements related to training, little research …

Community Based Participatory Research Informed Manualization And Piloting Of E-Training Of A Modified Dialectical Behavior Therapy Intervention, Annika M. Miyamoto

Doctoral Dissertations

This study explores the efficacy of delivering modified dialectical behavior therapy (m-DBT) to direct support staff who work with seriously mentally ill patients with neurocognitive deficits using remote web-based technology. The partnering facility for this study is a residential skilled-nursing facility that provides 24-hour care to individuals under conservatorship. Using a previously piloted m-DBT protocol, qualitative feedback was gathered from four participants with background training in psychology and varying experiences with DBT. All participants had direct knowledge of the treatment environment and experience working with the patient population. Gathered feedback was used to revise the m-DBT protocol to be used …

Bharatanatyam, An Effective Psychotherapeutic Intervention In Dance/Movement Therapy, Maanasa Marghashayam Bharath

Dance/Movement Therapy Theses

Dance/movement therapy is a psychotherapeutic modality that acknowledges the human body as a window to the human mind and spirit. Through creative and dynamic interventions, it fosters a healthy unification of the mind and body to enhance an individual's holistic health. This research focuses on the traditional dance form of India, Bharatanatyam, and its influence on the body and mind of the practitioner. Journeying through the history of the dance form to its relevance in the field of dance/movement therapy, the thesis explores how Bharatanatyam can be useful as an alternate method, in a therapeutic session to facilitate navigation through …

Why Do People Engage In Eating Disorder Behaviours?, Abbigail Kinnear

Electronic Thesis and Dissertation Repository

Eating disorders (EDs) are serious mental illnesses often with poor prognosis. Personalizing evidence-based treatments based on an individual’s reasons for engaging in ED behaviours – or the functions of EDs – may improve treatment outcomes; however, no validated measures assessing these functions exist. The goal of this study was to complete the initial steps in developing a measure of ED functions. Individuals who engage in ED behaviours (n = 16) and clinicians who treat EDs (n = 14) were interviewed, and a thematic analysis was conducted to determine key functions of EDs. Four main functions of EDs were …

Postpartum Depression: Development Of A Screening Protocol In The Neonatal Intensive Care Unit, Kelsey T. Langdale

Doctor of Nursing Practice Projects

Postpartum depression (PPD) affects approximately 19% of all postpartum women. Evidence indicates an increased risk for mothers of hospitalized infants, with estimates ranging from 28% to 67%. The American Academy of Pediatrics and Bright Futures recommend mothers be screened for postpartum depression at the infants’ well-child appointments. During hospitalizations, there are no well-child appointments; thus, no postpartum depression screening. This project aims to 1) improve knowledge of PPD in the staff of the Neonatal Intensive Care Unit (NICU) and 2) investigate the staff’s interest level in implementing a PPD screening protocol. Utilizing the Plan-Do-Study-Act (PDSA) framework, a protocol was developed …

Cerebellum-Seeded Functional Connectivity Changes In Trait-Anxious Individuals Undergoing Attention Bias Modification Training, Katherine Elwell

All NMU Master's Theses

Anxiety and anxiety related disorders are increasing at a drastic rate in the past decade, with the NIMH reporting that 31.1% of U.S. adults will experience an anxiety disorder at some point in their lives. Anxiety is commonly characterized by increased attention bias to threat. Attention Bias Modification (ABM) is a new treatment used to reduce individual’s attention bias towards threat. The extent to which ABM leads to underlying neural changes is still unknown. The cerebellum is a neglected brain structure, with new research provides evidence that cerebellum’s functional connectivity and shared networks with threat processing regions has a direct …

A Multi-Faceted Approach To Understanding Acceptability Of Docs K-5: A Qualitative Analysis, Andrea Guarnieri

USF Tampa Graduate Theses and Dissertations

This qualitative study investigated the acceptability of DOCS K-5, a behavior parenting program adapted for parents of elementary aged children. Despite proven efficacy in preventing maladaptive behaviors, parenting programs have historically suffered from low attendance and engagement. Participants (N = 13) attending the pilot DOCS K-5 program took part in six group interviews while enrolled in the program to examine the facilitators and barriers to attendance, perceived effectiveness, and collateral benefits received from participation in the program. This study considered possible cognitive, affective, instructional, and pragmatic facilitators or barriers to attendance and engagement. Participants described motivations to learn various types …

Longitudinal Trauma Treatment Outcomes In An Immigrant And Refugee Sample, Shuen-En Ho

Clinical Psychology Dissertations

Refugee and immigrant populations are at an increased risk of having posttraumatic stress disorder (PTSD) and exhibit a significant amount of variance in trauma treatment outcomes that may be impacted by sociocultural factors. This study examines the impact of demographic variables on treatment outcome and trajectory of PTSD symptoms in a clinic setting with trauma-focused treatments in refugee/immigrant and general populations. Data was collected from the electronic medical record at the Harborview Center for Sexual Assault and Traumatic Stress. A total of 817 participants completed intake, 58 of which self-identified as immigrant/refugee. One-way ANOVAs were conducted to examine group differences …

Exploring The Therapeutic Relationship As A Central Focus Through Expressive Arts Therapy In Oncology, Akshata Parekh

Expressive Therapies Capstone Theses

The treatment for cancer can be physically, mentally, emotionally and socially challenging. These treatments have side effects like physical body pain, hair loss, changes in weight, energy, nausea and more. These physical changes impact the social, mental and emotional well-being of the patient and makes this journey of the life-threating prognosis of cancer very tough to confront. Expressive arts therapy provides a safe space for the patients to address their mental health concerns as a result of this treatment. The Capstone Thesis Project explored expressive arts therapy interventions with 95 patients through single or multiple sessions while going through their …

Language As The Medium: A Literature Review. Harnessing The Prolific Power Of Dramatic Language As A Therapeutic Tool In Drama Therapy, Edward Freeman

Expressive Therapies Capstone Theses

Language in and of the theatre, with its palate of variegated writing styles and playwrights from throughout time, has the potential to be harnessed, focused, and systematized for use as a therapeutic tool within drama therapy – the field’s artistic medium. Drama therapy could benefit from having a specific medium germane to its artform which has the potential to provide practitioners with a common resource and means of communication, assessment, diagnosis, and treatment planning, as well as align the field with other creative arts therapies. Language encompasses all forms of human communication – speaking, writing, signing, gesturing, expressing facially – …

Making Room: Addressing The Counter-Therapeutic Nature Of Psychiatric Hospitalization Through Containment- Based Group Expressive Therapy, Max Sandor Copans

Expressive Therapies Capstone Theses

The process of hospitalization and the environment of a typical psychiatric hospital is often counter-therapeutic. To challenge this problem, clinicians may introduce the concept of psychological containment. To elaborate, being hospitalized anywhere can be disorienting, frightening and even traumatic. This problem is only further exacerbated in psychiatric hospitals where patients may be disorganized, manic, or struggling with psychosis. Furthermore, psychological containment is essentially the ability for psychiatric patients to prevent their intense emotions from effecting others negatively, and to act with resiliency when other patients are unable to contain their own disruptive behaviors. This paper utilizes both an initial literature …

Storytelling As An Expressive Arts Therapy Intervention With Children Via Telehealth, Sidney Marie Joines

Expressive Therapies Capstone Theses

As an expressive arts therapist in training working in the midst of a global pandemic, I sought to develop a creative, safe, accessible, and effective intervention for children via telehealth during a time of great uncertainty. Coronavirus 2019 has had a massive impact on mental and physical health and disrupted the lives of billions across the globe; the pandemic also forced mental health professionals to online formats. I found a significant lack of literature around expressive arts therapy via telehealth. Through considering theoretical approaches from cinematherapy, narrative therapy, metaphor therapy, play therapy, and expressive arts therapy, I developed an eight-week …

Exploring The Usefulness Of Mindfulness Practices Through Zoom Meetings In Reducing Anxiety And/Or Stress Of Adults With Learning And Developmental Disabilities During The Covid-19 Pandemic, Thatiane Abra

Expressive Therapies Capstone Theses

This thesis explored which mindfulness meditations or mindfulness practices could be beneficial in the online sessions, the extent to which adults with learning and developmental disabilities could learn the practices remotely, and how stress and anxiety disorders could be reduced through online mindfulness interventions. Furthermore, it was also necessary to address the online sessions as the only mental health treatment possibility during the Coronavirus pandemic for the clients observed and the benefits and limitations of these interventions. Additionally, the importance of structure and routine for this population, the multi-modal structure of the interventions, and how attunement plays an important role …

The Effect Of Implementing A Generalized Anxiety Disorder Protocol For Anxiety And Depression Symptoms In The Primary Care Setting, Bailey J. Hinman

Evidence-Based Practice Project Reports

Generalized anxiety disorder (GAD) is very prevalent in the United States with 5.7% of citizens affected (National Institute of Mental Health [NIMH], 2017). This number is expected to be even higher because individuals avoid care due to stigma of mental illness (Andrews et al., 2018). GAD can have significant implications such as decreased ability to function, decreased quality of life and increased risk of suicide (Fong, 2018; Lizarondo, 2018). The purpose of this project was to improve outcomes for adult patients with GAD in the primary care setting by improving treatment to follow best practice recommendations. The Johns Hopkins Evidence …

Art And Empathy: Self Discovery In A Dark Forest, Younser Lee

Graduate School of Art Theses

According to the National Institute of Mental Health, 40 million people report feelings of depression, anxiety, and stress as the world moves at an increasingly rapid pace and faces unprecedented challenges. However, many ignore these negative thoughts and fail to acknowledge them as a serious issue. My art, which shares my own experiences, creates safe, cathartic places for viewers to think about their own emotional experiences. Crucial to this process is my use of daily objects and the creation of individualized, participatory, and multisensory experiences.

My art relates to daily life and the negative emotions that we experience daily. I …

Death Anxiety, Artmaking And The Facilitation Of Death Discourse, Heather Conley

Art Therapy Counseling Final Research Projects

Discussion about death, known as death discourse, has been historically limited to the confines of the palliative care, elderly and hospice arenas (Bradshaw, 1996; Granek, 2013; Safrai, 2013; Zimmerman, 2012). This study examined the impact of artmaking on facilitating death discourse in college-aged students from a midwestern United States campus. A mixed methods design was implemented in which participants completed the Communication Apprehension about Death Scale (CADS; Carmack & DeGroot, 2016), an artmaking directive addressing feelings about death, followed by a Post-Artmaking Reflection about their artwork. Following a 10-day time period after the artmaking session, participants were re-administered the CADS …

The Power, (Problem), And Potential Of Prayer, Meghan E. Stretar

School of Theology and Seminary Graduate Papers/Theses

This paper illuminates the complex and nuanced relationship between mental health and prayer, particularly seeking theologically grounded understandings of prayer and of our relationship with God in times of mental distress that goes beyond intercessory prayer. The paper begins with an evaluation of social structures that cause mental health problems (notably in college students). A discussion on emotional agility, scarcity, and vulnerability serves as a transition to examining this question from a theological perspective, the second main section of this paper. In this section, I claim that a misunderstanding of the divine-human relationship and of prayer is one potential source …

How College Men Describe Their Understanding Of Sexual Assault, Sarah Anolik

Dissertations, 2020-current

Despite the proliferation of many vital bystander intervention programs across the country, approximately one in four college women will experience sexual violence. Though it was once believed that a small minority of men were responsible for the vast majority of sexual violence, an estimated 12%-25% of college men report having used sexual violence as an undergraduate student. Research across disciplines suggests several factors associated with the perpetration of sexual violence. While numerous studies have explored these constructs quantitatively on and off college campuses, there have been far fewer qualitative studies that provide insight into how men who have perpetrated violence …

A Tailored Multicomponent Intervention In Primary Care For Survivors Of Adverse Childhood Experiences (Aces), Rebecca L. Peterson

Evidence-Based Practice Project Reports

Adverse childhood experiences (ACEs) include 10 traumatic events of abuse, neglect, and household dysfunction that occur before 18 years of age. Adverse childhood experiences affect greater than 60% of the population, and approximately one in six individuals affirm that they have experienced four or more types of ACEs. They are associated with negative, long-term health outcomes in adults, including 9 out of the 10 leading causes of death in the United States (Centers for Disease Control and Prevention, n.d.; Felitti et al., 1998). The purpose of this evidence-based practice project was to implement a tailored, multicomponent intervention to mitigate the …

Examining Physical Activity Behaviors And Psychometric Beliefs Of College Students Before And After The Covid-19 Shutdown, James White Iii

Graduate Theses

Objectives: The purpose of this study was to examine PA behaviors, social support and self-efficacy for PA, Rosenberg self-esteem, and perceptions of body weight before and after the COVID-19 shutdown (March 15, 2020) among the college demographic.

Participants: 311 college students from a four-year, comprehensive, southeastern university in the United States were included in the study from December 1, 2020 until March 5, 2021.

Methods: Surveys were conducted via Qualtrics, an online survey system, and consisted of approximately 40 items, including demographic information, PA behaviors, social support and exercise, self-esteem, self-efficacy to exercise, and perceptions of body weight and self-image. …