Mental and Social Health Commons^™

Are Rural Health Clinics Part Of The Rural Safety Net?, David Hartley Phd, Mha, John A. Gale Ms, Al Leighton Ba, Stuart Bratesman Mpp

Rural Health Clinics

Key Findings: 86% of independent RHCs offer free care, sliding fee scales, or both; 97% were currently accepting new Medicaid/SCHIP patients; RHCs' patient mix has a higher proportion of Medicaid/SCHIP patients in counties not served by a federally funded Community Health Center (CHC). Lacking the grant funds and federal technical assistance provided to CHCs to build service capacity, few RHCs have had the resources to expand their scope of services. The Affordable Care Act has made it clear that partnering with CHCs is an option for RHCs that find themselves serving safety net populations. More study is needed laying out …

Client/Therapist Feedback And The Role Of The Alliance On Psychotherapy Outcomes, Elizabeth Preston Cisneros

Loma Linda University Electronic Theses, Dissertations & Projects

Through a system of patient-focused outcomes research which has employed a quality assurance system for tracking client progress in therapy, there has been consistent evidence that utilizing the system to identify those who are not responding to treatment and warning their therapist about the client’s risk significantly improves client outcomes in psychotherapy. Although outcomes have been improved, significant proportions of clients have treatment failures or see no improvement in therapy. Moreover, feedback to therapists appears to be most effective in improving outcomes for the minority of clients who are already at risk of treatment failure.

Attempts to augment the feedback …

Diagnosing And Treating Adhd: Discipline Differences, Lisa Marie Lliteras

Loma Linda University Electronic Theses, Dissertations & Projects

According to Barkley (2005), attention deficit hyperactivity disorder (ADHD) is one of the most common reasons children are referred to mental health workers in the United States and is now one of the most prevalent psychiatric disorders associated with childhood. The diagnostic criteria and labels for ADHD have changed over the last several decades, and with each change the prevalence rate for ADHD has increased (Wolraich & Baumgaertel, 1997). This increase in the prevalence of ADHD has led to a need for clinicians from different disciplines to assess and treat ADHD. As such, several guidelines from professional associations have been …

Safety Net Activities Of Independent Rural Health Clinics, David Hartley Phd, Mha, John A. Gale Ms, Al Leighton Ba, Stuart Bratesman Mpp

Rural Health Clinics

Rural Health Clinics (RHCs) are an important part of the rural health care infrastructure as they provide a wide range of primary care services to the rural residents of 45 states. Since RHCs are located in underserved rural areas and serve vulnerable populations, many consider them safety net providers. In this paper we explore whether and to what extent independent RHCs are serving a safety net role, or have the capacity to serve that role. We address this question through a telephone survey of 392 randomly selected independent RHCs. Response rate for the survey was 93%. We investigated whether and …

Life History And Narrative Analysis: Feminist Methodologies Contextualizing Black Women's Experiences With Severe Mental Illness, Marya R. Sosulski, Nicole T. Buchanan, Chandra M. Donnell

The Journal of Sociology & Social Welfare

This paper discusses a methodological approach to research that enhances critical analysis by contextualizing qualitative research findings within participants' individual experiences. We demonstrate the combined use of life history methods and feminist narrative analysis to explore Black women's everyday experiences with mental illness, from their perspectives. These interpretive methods reach beyond pathologized conceptions of identity and adjustment that often narrowly characterize mental illness among Black women. Instead, these methods holistically describe a participant's experiences and strategies she uses to pursue goals and enhance her life. The use of the methods is illustrated with examples from the life narrative of "Maria," …

Narcissism And Binge Drinking: Exploring The Role Of Overconfidence And Confidence-Based Risk-Taking., Alicia M. Wood

Electronic Theses and Dissertations

Binge drinking (BD) entails excessive alcohol intake in a short time period. Despite numerous negative outcomes associated with BD and efforts to curtail it, rates remain steady. Thus, it is important to identify "who" binge drinks and "why" it occurs. Drawing from past research, I sought to replicate the link between trait narcissism and BD; moreover, I examined if overconfidence and confidence-based risk-taking assessed via the Georgia Gambling Task (GGT), explained why they did so. The results generally supported my hypotheses. As expected, narcissism related to poor GGT performance and high levels of BD; likewise, poor GGT performance related to …

Chhs August Enewsletter, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, Wku College Of Health & Human Services

College of Health & Human Services Publications

No abstract provided.

The One-Pager: A Practical Policy Advocacy Tool For Translating Community-Based Participatory Research Into Action, Betty T. Izumi, Amy J. Schulz, Barbara A. Isreal, Angela G. Reyes, Jenifer Martin, Richard L. Lichtenstein, Christine Wilson, Sharon L. Sand

Community Health Faculty Publications and Presentations

The multiple and diverse perspectives, skills, and experiences inherent in community–academic partnerships make them uniquely positioned to educate policy makers and advocate for health equity. Effective communication tools are critical to successfully engage in the policy-making process. Yet few resources emphasize the development and use of practical tools for translating community-based participatory research (CBPR) findings into action. The purpose of this article is to describe a CBPR process for developing and using a one-page summary, or “one-pager,” of research findings and their policy implications. This article draws on the experience of the Healthy Environments Partnership (HEP), a community–academic partnership in …

Mental Health And Women’S Receipt Of Recommended Preventive Care, Melanie M. Race

Muskie School Capstones and Dissertations

Recent studies have suggested that individuals with mental health conditions experience higher morbidity and mortality than individuals without mental disorders (Colton and Manderscheid, 2006; Osborn et al., 2007). Improving health outcomes for individuals with mental health conditions may require that providers, policymakers, and insurers pay particular attention to the primary care provided to these individuals. High-quality primary care means having a usual source of care and receiving appropriate preventive care, including routine physical examinations and recommended screenings. Some studies suggest that women with mental health conditions receive preventive care at lower rates than women without mental health conditions.

Mental Health Crisis Questionnaire, Roger A. Lohmann

Faculty & Staff Scholarship

This questionnaire was developed for use in a study of the need for additional mental health crisis services in North Central West Virginia. It is made available for others interested in studying mental health crises.

An Investigation Of Interpersonal Disruptions And Secondary Traumatic Stress Among Mental Health Therapists, Rachael Ann Robinson-Keilig

College of Education and Human Sciences: Dissertations, Theses, and Student Research

Mental health therapists who work with victims of trauma are often exposed to vivid descriptions of traumatic events and strong emotional expressions from their clients. Research within the last fifteen years has started to explore the impact of this indirect form of trauma exposure on therapists who treat trauma clients.

The purpose of this study was to explore the prevalence of interpersonal and sexual disruptions as symptoms of secondary traumatic stress/vicarious trauma among practicing mental health therapists, to understand how various therapist characteristics predict interpersonal and sexual disruptions, and to explore the role that gender and prior trauma history play …

Lgb-Affirmative Therapists' Use Of Developmental Models Of Lgb-Identity In Therapy. A Phenomenological Investigation, Victoria E. Cane

Dissertations

Socially sanctioned hostility toward sexual minority persons continues to be a reality in the United States and worldwide. Therapists working with sexual minorities have responsibility to provide non-pathologizing, affirmative therapy to these clients. A central aspect of affirmative therapy is therapists' recognition and understanding of sexual orientation (SO) identity and developmental models of sexual minority identity have a played a vital role in promoting this understanding. Although such models have been central to the practice and training of affirmative therapy, therapists' applied use of the models has not been empirically investigated. For this phenomenological study, nine affirmative therapists were interviewed …

Tongueless: Representation Of The Mentally Disabled And The Novel, Brent Walter Cline

Dissertations

This study examines the representation of the mentally disabled in the novel for two related outcomes. The first is to prove that the representation of the mentally disabled is not merely a subset of the representation of the disabled in general. This is intended less as a political statement as it is a literary one. Acknowledging and building off the work of writers in disability studies such as David Mitchell, Sharon Snyder, and Tobin Siebers who concentrate on the body of the disabled, this study shows that attempts to represent the mentally disabled are fundamentally different than those who are …

Examining The Interrater Reliability Of The Comprehensive Inventory Of Mental Health And Recovery And Rehabilitation Services (Cimhrrs), Robert W. Johnson

Department of Psychology: Dissertations, Theses, and Student Research

This dissertation is one step in the continuing development, evaluation, and validation of the Comprehensive Inventory of Mental Health and Recovery and Rehabilitation Services (CIMHRRS). The CIMHRRS is an instrument to guide comprehensive assessment of programs that provide integrated services to people with serious mental illness (SMI).

The project described in this dissertation evaluated three key aspects of its performance in real world application: practical feasibility, internal consistency and reliability, and ability to distinguish between different programs. Investigators utilized a combination of principles and methods, associated with psychometric scale development, field methods, and program evaluation. Using a structured site review …

Chhs July Enewsletter, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, Wku College Of Health & Human Services

College of Health & Human Services Publications

No abstract provided.

The Role Of Gender In Single Vs Married Individuals With Bipolar Disorder., Daniel Z Lieberman, Suena H Massey, Frederick K Goodwin

Psychiatry and Behavioral Sciences Faculty Publications

BACKGROUND: Despite the importance of marriage as a source of social support, it has been largely neglected in studies of bipolar disorder; and differential effects on men and women have not been explored.

METHODS: Data on episodes of depression, mania, and mixed states were collected for the previous 2 years from a sample of 282 bipolar individuals using the National Institute of Mental Health Life Chart Methodology.

RESULTS: Effects unique to women included the following: Bipolar women were significantly more likely to be married. Married women had fewer episodes of depression during the past 2 years than never-married women, and …

Family Functioning And The Development Of Trust And Intimacy Among Adolescents In Residential Treatment, Kenneth M. Coll, Stephanie Powell, Patti Thobro, Robin Haas

Counselor Education Faculty Publications and Presentations

This study examined relations between family cohesion and adaptability (as measured by the Family Adaptability and Cohesion Scales-III) and the formation of trust and intimacy (assessed with the Measure of Psychosocial Development) among adolescents in residential treatment. Bivariate correlation revealed a significant association between family cohesion and adaptability and psychosocial stages of trust and intimacy. Regression analyses revealed that family cohesion predicted trust, and that trust is significantly influential in the formation of intimacy. Discussion and treatment implications are included.

Reducing Heavy Drinking Among First Year Intercollegiate Athletes: A Randomized Controlled Trial Of Web-Based Normative Feedback, Diana M. Doumas, Tonya Haustveit, Kenneth M. Coll

Counselor Education Faculty Publications and Presentations

This study evaluated the efficacy of a web-based personalized normative feedback program targeting heavy drinking in first year intercollegiate athletes. The program was offered through the Athletic Department first year seminar at a NCAA Division I university. Athletes were randomly assigned to either a web-based feedback group or a comparison condition. Results indicated high-risk athletes receiving the intervention reported significantly greater reductions in heavy drinking than those in the comparison group. Additionally, intervention effects were mediated by changes in perceptions of peer drinking. Findings support the use of web-based normative feedback for reducing heavy drinking in first year intercollegiate athletes.

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 …

Sexual Harassment At Work Place: Are You Safe?, Anila Naveed, Ambreen Tharani, Nasreen Alwani

School of Nursing & Midwifery

In today's world women are increasingly participating in the realm of work force, yet they are facing many obstacles in their way. Sexual harassment is one of those obstacles. Sexual harassment at work place is prevalent in every society. It could happen to anyone but women are the targeted victims. Sexual harassment is considered as a traumatic event and the victim may end up in having physical and mental sufferings that hinders a person to work effectively. At an organisational level this may result in decrease work effectiveness, decreased work productivity, high absenteeism, high turnover, and low staff morale. Hence …

Women's Compliance In Outpatient Substance Abuse Treatment: The Role Of Children And Mental Health, Cathy Gertrude Cooke

Psychology Theses & Dissertations

The purpose of this study was to examine the role of children and mental illness in women's compliance in a treatment program for substance abuse. Information was retrieved from medical records of female clients ( N=221) who took part in a community-based day treatment program for substance abuse in a large city in southeastern Virginia during a 32-month period. It was anticipated that, as compared to women who resided with minor children, women who did not reside with minor children would have greater treatment success defined as: (1) more days in the treatment program; (2) higher percentage of negative …

Desvenlafaxine In Major Depressive Disorder: An Evidence-Based Review Of Its Place In Therapy., Daniel Z Lieberman, Suena H Massey

Psychiatry and Behavioral Sciences Faculty Publications

INTRODUCTION: Desvenlafaxine, the active metabolite of venlafaxine, is a serotonin norepinephrine reuptake inhibitor (SNRI) recently approved for the treatment of major depressive disorder. It is one of only three medications in this class available in the United States.

AIMS: The objective of this article is to review the published evidence for the safety and efficacy of desvenlafaxine, and to compare it to other antidepressants to delineate its role in the treatment of depression.

EVIDENCE REVIEW: At the recommended dose of 50 mg per day the rate of response and remission was similar to other SNRIs, as was the adverse effect …

Perceptions Of The Long-Term Effects Of Childhood Sexual Abuse, Cynthia Mellitz

Theses and Dissertations

The perceptions of how Childhood Sexual Abuse (CSA) survivors perceive themselves and are perceived by others was evaluated. The aims of the study were to use Attribution Theory and the Traumagenic Model in evaluating whether perceptions were mediated by assertiveness, self-esteem, and interpersonal relationships. Additionally examining if CSA survivors differ in perceived levels of these attributes from non-CSA individuals within a college sample was of interest. 35% of the sample exhibited a variety of CSA experiences, with the majority being minimal contact experiences (i.e. sexual invitations or sexual hugging/kissing). Regression analyses indicated that CSA survivors did not differ in their …

Taking Charge Of Adult Adhd, P. S. Mcmillen

Library Faculty Research

Barkley is one of the leading researchers and most prolific writers on attention deficit/hyperactivity disorder (ADHD) across the life span, having produced materials for mental health professionals and self-help books like this volume.

Psychological Adjustment: Are Adopted Adolescents At Greater Risk For Negative Outcomes?, Caroline Tozzi Reppold, Aida Hutz, Claudio Simon Hutz

Counselor Education Faculty Publications and Presentations

During the last decades several authors have indicated that being an adopted child resulted in a higher risk of psychological maladjustment. The objective of this research was to investigate the changes in perception of parental styles in adopted and no-adopted adolescents Brazilians. The sample comprised 524 adolescents (68 were adopted and 456 were raised by their biological parents). The instruments used were a demographic questionnaire and the Responsiveness Scales and Parental Demands. The findings indicated that adoptive parents are significantly more indulgent than biological parents. In comparison, the adolescents described their biological parents as more negligent. The findings corroborated the …

Marital Satisfaction And Intimacy: Gender Role Attitudes And Spousal Support In Botswana, Kagelo Henry Rakwena

Loma Linda University Electronic Theses, Dissertations & Projects

In this study, the predictors of marital satisfaction and intimacy were examined within an African context that is characterized by a fast growing economy, migrant population, urbanization and industrialization. Specifically, this study examined the role of two relational variables, gender role attitudes and spousal support and two demographic variables, age and gender in predicting the variance in marital satisfaction and intimacy, after controlling for number of children, religion, occupation, education, length of marriage and household income among married individuals in Botswana. The results of this study reveal the importance of gender role attitudes and spousal support as key predictors of …

A Critical Constructionist View Of "At-Risk" Youth In Alternative Education, Rachelle Silverstein Touzard

Loma Linda University Electronic Theses, Dissertations & Projects

Family therapists and school counselors are increasingly called upon to provide services for youth in alternative education (Carver, Lewis, & Tice, 2010). Alternative education systems are programs for youth who have been defined as at risk. This study explored the at-risk discourse and asked the questions (a) how do youth and staff define the term at risk, (b) construct their experience in alternative education systems, and (c) experience their relationships with each other.

Combined elements from critical theory and a social constructionist perspective guided this study. A qualitative, grounded theory method was used that included semi structured interviews with …

Therapeutic Modalities And Educational Approaches In Clergy Stress Reduction, Shaun Tress Campbell

Loma Linda University Electronic Theses, Dissertations & Projects

Clergy are listed among administrators, social workers, healthcare providers, fire fighters, and police officers as professionals with high levels of occupational stress (Hill et al., 2003; Greenberg, 1990). Clergy are valuable resources to the American culture in that they perform an array of services to comfort and assist others. From natural catastrophes to personal misfortune, pastors are often expected to be present to offer consolation or to extend ecclesiastical services. Researchers have found that pastors are the primary mental health counselors for tens of millions of Americans (Weaver et al., 2002). Darling et al. (2004) report, "Clergy in U.S. culture …

Psychosocial Factors Associated With Nicotine Dependence Among College Students : Are There Differences Between Social And Regular Smokers?, Devan Rae Romero

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Cigarette smoking, the primary source of tobacco used by adults 18-25, has remained stable, at around 21-25%, in the college population since 2003. Many college students report their smoking as primarily a “social” behavior, which may reflect an emerging type of smoker. Ambiguity exists in defining and categorizing smokers in the college population.

Purpose. The purpose of this study was to examine psychosocial perceptions related to smoking among college students who currently smoke and those who do not smoke, and among different types of smokers. In addition, validation of self-reported smoking behavior with saliva cotinine was conducted in …

Fetal Alcohol Spectrum Disorder, Mary (Katie) Busmire

Psychology and Child Development

This is a senior project about fetal alcohol spectrum disorder (FASD). Fetal Alcohol Spectrum Disorder (FASD) is the term given to a child who has been affected by exposure to prenatal alcohol. Drinking during pregnancy can lead to several physical, neurological and behavioral effects. However, there are several interventions that can help minimize the effects of prenatal alcohol. Focusing on family interventions and therapies will best benefit the lives of children with FASD and their families.