Mental and Social Health Commons^™

Gen Z Perspectives On Mental Health Service Interaction: A Qualitative Content Analysis Of Reddit Discourse, Victor A. Aguiar

Honors Undergraduate Theses

Compared to prior generations, Generation Z engages with mental health and mental health service interaction in distinct ways, frequently using social media platforms to share experiences, concerns, and opinions. Previous research has examined mental health discourse on Reddit; however, much of this work relies on inductive thematic approaches and offers limited focus on mental health service interaction and the factors influencing utilization. Guided by the Theory of Planned Behavior (TPB), this study examines how Generation Z discusses mental health service use through online discourse. Public Reddit posts authored by users identifiable as Generation Z, based on self-reported age, school enrollment, …

Perceptions Of Illicit Drug Use And Perceived Drug Misuse Risks Among Individuals With Military Experience, Emilia Havlicek

Honors Undergraduate Theses

This study investigates perceptions of illicit drug use and perceived drug misuse risks among individuals with military experience in the United States, highlighting how military service shapes attitudes toward substance misuse. Using data from the National Survey on Drug Use and Health (NSDUH), this research examines the influence of military status, combat exposure, PTSD, gender, and sociodemographic factors on perceptions of drug-related risk. Findings indicate that while most individuals perceive illicit drug use as highly risky, important differences exist among subpopulations, particularly female veterans, who are more likely to perceive lower levels of risk. The study explores how military culture, …

Social Determinants Of Health Affecting Cardiovascular Health Among South Asian Americans, Ann Mary Thomas

Honors Undergraduate Theses

Background: South Asian Americans experience disproportionately high rates of cardiovascular disease, yet the social determinants contributing to these disparities remain understudied.

Objective: This systematic review examines the role of social determinants of health (SDOH) in shaping cardiovascular outcomes among South Asian Americans.

Methods: A systematic literature search was conducted across PubMed, MEDLINE, and Web of Science using predefined search terms related to South Asian populations, cardiovascular health, and SDOH. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 reporting guidelines, and study screening and management were performed using Covidence. A total …

Socioeconomic Stressors And Their Association With Anxiety And Depression In Undergraduate And Graduate Students, Shreyaashri Selvakumar

Honors Undergraduate Theses

Socioeconomic status (SES) is a social determinant of mental health that may influence the prevalence of anxiety and depression in undergraduate and graduate students. Students from lower socioeconomic backgrounds often encounter financial, academic, and social stressors, which may contribute to poorer mental health outcomes. This study investigates the association between SES-related factors and symptoms of anxiety and depression in undergraduate and graduate students. Data were collected from a large national survey of students in various degree programs and included measures of financial circumstances, food and housing insecurity, access to mental health services, and other demographic variables. Symptoms of depression and …

The Impact Of Gastric Sleeve And Roux-En-Y Gastric Bypass On Chief Cell Function And Protein Digestion In Obese Patients, Garikoitz Mikel Gainza

Honors Undergraduate Theses

Obesity has become one of the largest global health concerns of the 21^st century, correlating with numerous associated diseases. To help address the growing prevalence and burden of obesity, sleeve gastrectomy and Roux-en-Y gastric bypass have become two commonly performed surgical procedures done to promote weight loss by altering the anatomical structure of the stomach and surrounding organs of the gastrointestinal system. Although the benefits of improved metabolism linked to these surgical procedures are well studied, their impact on the physiology of gastric cells, and more specifically chief cells as they relate to protein digestion post-surgery, is yet to …

Caregiver Training: Improving Social Determinants Of Health, Patient Safety, Empowerment Through Improving Elder Care Education And Skills, Kathleen Thimsen

Nursing Faculty Research

Caregiver training (CaGi TRaining) is a time-tested intervention aimed at improving safety in elders living and aging in place in the community. While elder abuse and maltreatment was the intial purpose of the project, with over 3500 Caregivers graduated from this program since 2009, the course has addresses social determinants of health, and improved workforce pipelines by providing stable employment, improved self-efficacy, and confidence demonstrated by self-reports at graduation and in follow up surveys. Previously learners without a high school diploma retruned to school to obtain a GED (40%), with an additional return to school for bacalaureate and degrees (27%) …

Hallucinogen Use Among Parents Of Children In The United States: Associations With Mental Health And Substance Use, Maggie K. Richardson

Theses and Dissertations--Educational, School, and Counseling Psychology

Hallucinogen use has reemerged in the United States amid expanding clinical research and shifting social and policy contexts. However, population-based evidence remains limited regarding hallucinogen use among adults living with children and its relationship with mental health impairment severity in caregiving environments. Therefore, this study’s objective was to examine associations between past-year hallucinogen use and past-year mental health impairment among U.S. adults, and to test whether associations differ by parental status and number of children in the household. A secondary aim examined correlates of co-occurring substance use among those reporting hallucinogen use.

Data were drawn from the 2023 National Survey …

Legislative Debate-Attributed Suicidality Among Lgbtq+ Adults: The Buffering Effect Of Community Belongingness, Keith J. Watts, Shawndaya S. Thrasher, Laneshia R. Conner, Nicole Campbell, Louis G. Baser, Dekeitra Griffin, Sydney P. Howard, Missy Spears, Justin X. Moore

Counseling & Human Services Faculty Publications

Background: In recent years, the sociopolitical landscape in the United States has shifted due to an increase in state-level legislation regarding LGBTQ+ rights, a trend that has been particularly pronounced in the Commonwealth of Kentucky. While the mental health impacts of enacted laws are increasingly documented, a critical gap remains in understanding the psychological toll of the legislative debates themselves—the prolonged periods of public discourse surrounding the restriction of rights. Methods: Utilizing data from the 2025 Queer Kentucky Survey (N = 817), this exploratory study examined the association between LGBTQ+ community belongingness and acute suicidality attributed specifically to anti-LGBTQ+ legislative …

Counseling And The Neurodiversity Paradigm: A Call To Action, Emily Goodman-Scott, Rawn Boulden, Aaron Albright, Jenna Alvarez, Betsy M. Perez

Counseling & Human Services Faculty Publications

The counseling profession is rooted in prevention, wellness, mental health, and a critical social justice approach to serving historically marginalized communities, including people with disabilities. The overarching construct of disability comprises subtypes, such as neurodivergence. Given the prevalence of neurodivergent individuals worldwide (approximately 15%-20%), the counseling profession must be prepared to support this community. At the same time, there is a dearth of peer-reviewed literature on neurodiversity specifically for the counseling profession. In this article, we address a timely topic in the profession. We discuss utilizing a critical counseling lens and centering marginalized identities, such as people with disabilities; prominent …

Editorial For Issue 20(2), Jeff Moe, Peighton Corley, Aaron Albright

Counseling & Human Services Faculty Publications

[Introduction] Hello to the readers of the Journal of LGBTQ Issues in Counseling. Like many counselors, counselors-in-training, scholars, and other individuals you may be coming to the journal looking for insights into your counseling work. Along with publishing original research that creates space for exploring LGBTQ+ lifeways from an open and affirmative perspective, the manuscripts published in the journal have always been grounded in application.

Counselors' Lived Experiences Of Moral Injury: A Social Ecological Perspective, Lisa M. Belknap

Antioch University Dissertations & Theses

This study explores the lived experiences of counselors who encountered moral injury when sociopolitical, institutional, and organizational conditions constrained their ability to practice in alignment with their personal morals, professional values, and the counseling profession’s code of ethics. Participants (N = 15) included licensed counselors who self-identified as having experienced moral injury in response to directives from legitimate authorities that conflicted with professional ethics, social justice commitments, or client welfare. Grounded in social ecological systems theory, this phenomenological study employed a confidential, cross-sectional online survey. Reflexive thematic analysis identified seven themes: (a) Profit Over People, (b) Structural Forces Contributing to …

Bridging Worlds Of Care: A Qualitative Exploration Of Integrating Non-Western Healing Modalities With Mental Health Counseling, Douglas Valdez

Antioch University Dissertations & Theses

The aim of the study is to explore the experiences of practitioners who treat individuals presenting with depression and anxiety using culturally integrative non-Western healing modalities. Participants included 15 experienced practitioners (minimum five years of practice) who identified as Traditional Chinese Medicine providers (e.g., acupuncturists, herbalists) and/or Curandero/x/as. The approach was qualitative, utilizing open-ended survey responses collected electronically and analyzed with thematic analysis. Results indicated six primary themes: (a) Philosophies in Healing, highlighting culturally grounded conceptualizations of depression and anxiety; (b) Traditional Chinese Medicine Interventions, including acupuncture, botanical, nutritional, manual, and movement-based practices; (c) Curanderismo Pláticas and Integrative Western Healing …

A Delphi Study Of Ethical Best Practices For Psychedelic Assisted Therapy, Alyssa K. Griskiewicz

Antioch University Dissertations & Theses

The purpose of this Delphi study was to establish areas of ethical consensus regarding psychedelic-assisted therapy (PAT) from the perspectives of an expert panel of practitioners, with attention to issues of equity and access. Participants (N = 29) include individuals with two or more years of experience in one or more of the following domains of psychedelic expertise: clinical/professional practice, scholarly/research contributions, or guided community/ceremonial facilitation. In Round 1, qualitative data were collected through open-ended questions and analyzed using thematic analysis to generate Delphi statements. In Round 2, panelists (N = 24) rated these statements using a Likert-type scale to …

"Why Don't I Talk To A Therapist?": Motivations And Reflections Of Female-Identifying Chinese Immigrants Seeking Psychotherapy For Depression, Qiuyi Wei

Antioch University Dissertations & Theses

This phenomenological study explored the lived experiences of Chinese immigrants and temporary residents struggling with depressive symptoms and their process of seeking and accepting psychotherapy support. The study aimed to describe the factors that motivated participants to enter therapy for depression while also addressing their internal concerns about treatment. Nine female-identified Chinese immigrant adults with such experiences were recruited. Participants’ perceptions of their depressive symptoms and the factors contributing to their decision to seek professional therapy were explored through in-depth, semi-structured qualitative interviews conducted in Mandarin. The interview transcripts were analyzed in Mandarin using interpretative phenomenological analysis, through which four …

Bi+ Cismale Experiences With Straight Cismale Friends, Taylor M. Hardock

Antioch University Dissertations & Theses

Minority Stress Theory (2006) posits that individuals with a marginalized sexual identity have unique challenges and stressors. Bisexual+, or bi+, individuals have particular stressors related to not holding a monosexual identity, including specific mental health challenges. Research has shown that friendship can have many positive benefits on individuals, though the literature looking at friendship among bi+ identifying people is very limited. This qualitative study investigates the experiences of friendship between bi+ and straight cis men, especially as they may relate to minority stress and experiences of resilience and community belongingness. A thematic analysis was utilized to understand the personal experiences …

Beyond The Rabbit Hole: Dmt, Death, And The Hereafter, Abby Molina

Antioch University Dissertations & Theses

This dissertation explores a proposed relationship between death and N,N-dimethyltryptamine (DMT) within the context of contemporary clinical psychology and the current psychedelic renaissance. Building on Rick Strassman’s hypothesis that DMT may be released at the moment of death and Imants Barušs’ conceptualization of death as an altered state of consciousness, this project examines the phenomenological similarities between DMT-induced experiences (psychedelic “trips”) and near-death experiences (NDEs). Through review of neurobiological research, psychedelic-assisted therapy literature, religious and cultural ceremonial practices, and documented DMT trip and NDE reports, this work evaluates the plausibility that endogenous DMT contributes to altered states of consciousness observed …

Improving The Continuity Of Care For Opioid Use Disorder: Investigating Fentanyl Overdose Outcomes And Pharmacy-Level Buprenorphine Access, Lyn Yuen Choo

Graduate Theses, Dissertations, and Problem Reports (ETD)

Opioid overdose (OD) deaths remain a leading cause of injury-related death in the United States (US) and approximately 76,516 drug OD deaths were predicted in the past year prior to April 2025. While previous research has focused on fatal opioid ODs, less is known about outcomes following non-fatal opioid ODs (NFOO) involving fentanyl. Patients who experienced a fentanyl OD may develop significant morbidity and inpatient mortality due to fentanyl’s high potency, rapid onset of action, and decreased response to naloxone. Research efforts to improve continuity of care for opioid use disorder (OUD) are highly needed to ensure appropriate follow-up care …

Navigating Family, Culture, And Well-Being: A Qualitative Study Of First-Generation Adult Children Of Middle Eastern Immigrants In The United States, Ramona Amely

Antioch University Dissertations & Theses

The purpose of this study is to explore the lived experiences of first-generation adult children of Middle Eastern immigrant parents/caregivers living in the United States. This was a phenomenological study with reflexive thematic analysis. Participants (N=10) were interviewed via Zoom, and transcripts were analyzed using Reflexive Thematic Analysis (RTA). The results included four themes: (1) Migration Contact and Cultural Formation, (2) Bicultural Identity Development, (3) Family System Adaptation, and (4) Emotional Socialization and Psychological Impact. This study highlights how first-generation adult children of Middle Eastern immigrants navigate complex, interwoven processes of bicultural identity development, family adaptation, and emotional socialization shaped …

The Effects Of Meditation On Compassion And Cultural Humility In Mental Health Professionals, Jamie Kostek

Antioch University Dissertations & Theses

The purpose of this study was to examine the effects of a brief, secular, Buddhist-inspired meditation program on self-compassion, compassion for others, and cultural humility on mental health professionals. Using a single-group pretest-posttest design, licensed clinicians (N = 13) participated in a five-week Anytime Anywhere Meditation (Tergar International, 2024) program. Results indicated statistically significant increases in mindfulness, self-compassion, and cultural humility. Additionally, strong positive correlations were found between mindfulness and self-compassion, and between self-compassion and compassion for others. Findings suggest that brief, secular meditation programs rooted in traditional Buddhist practices may support both clinician well-being and culturally responsive practice.

Exploring Relational Leadership And Psychological Safety During Ai Integration In The Workplace, Solmaz Kaynama

Antioch University Dissertations & Theses

This study explores employee psychological safety, or its lack, during artificial intelligence (AI) integration in the workplace through a relational leadership lens. The population included employees of for-profit business corporations currently integrating or adopting AI technologies (N = 14). Participants completed in-depth, semi-structured interviews. Results showed eight themes: relational leadership creates a psychologically safe workplace climate; unsupportive and dysfunctional leadership erodes trust and psychological safety; psychological safety determines whether employees speak up openly or hold back; employees’ experience daily work through workplace culture, pace, and remote or hybrid conditions; AI may delivers immediate productivity benefits while introducing new psychological and …

The Lived Experience Of Survivors Of Narcissistic Abuse, Jessica Williams

Antioch University Dissertations & Theses

The purpose of this study is to explore the lived experiences of narcissistic abuse survivors through a grounded theory approach to generate a model that can assist people in recognizing patterns and traits of narcissistically abusive relationships. Guided by relational-cultural theory, this study further seeks to examine the ways narcissistic abuse damages relational connections and to highlight elements of healthy, growth-fostering relationships. The population of focus included self-selected narcissistic abuse survivors who are adults over the age of 18 (N = 8). The results indicated three themes, each with additional subthemes, which include: (a) early behavior – performative displays and …

Beyond The Diagnosis: A Qualitative Exploration Of Men Living With Hiv, David R. Romanelli

Antioch University Dissertations & Theses

This qualitative study explored the lived experiences of men (18+ years old) living with HIV to better understand how they navigate identity, mental health, relationships, and healthcare systems after diagnosis. The method included a qualitative thematic analysis with 10 participants. Eight themes emerged from the data: (1) reactions, reflections, and meaning-making after diagnosis; (2) managing medication, treatment, and co-occurring conditions; (3) stigma, disclosure, and negotiation of identity; (4) substance use, housing instability, and socioeconomic stressors; (5) navigating the changing HIV landscape; (6) experiences with family and intimate relationships; (7) implications for mental health counseling; and (8) the role of community …

A Qualitative Exploration Of Counselor Traits And Wellness Practices, Emily Velidow

Antioch University Dissertations & Theses

This study is a qualitative thematic analysis of counselor wellness practices as well as how selfidentified personal traits are part of how a counselor practices and prioritizes wellness. Theoretical underpinnings of the study integrate trait activation theory (Tett & Burnett, 2003), Martin Seligman’s wellbeing theory (Seligman, 2011), and Urie Bronfenbrenner’s ecological systems theory (Bronfenbrenner, 1977). Participants included nineteen licensed counselors (N=19). Analyzed responses lead to four main themes, each with two to four subthemes. Resulting themes included (1) intentional caseload and workday structure, (2) deliberately emphasizing physical wellness, (3) setting boundaries attending to mental and emotional energy, and (4) the …

How To Reduce Inpatient Violence: A Theory Synthesis From Four Models, Arthur Walker

Antioch University Dissertations & Theses

Working in an inpatient setting inherently involves an increased risk of violence. This violence can affect both staff and patients alike and can lead to psychological trauma, serious bodily injury, and even death. To mitigate this risk, many models for preventing inpatient violence have been proposed for hospitals to implement. However, the evidence for the efficacy of these methods is inconsistent, and the theoretical underpinnings are varied and slim. This dissertation seeks to improve these models by re-examining the theoretical structures for common themes of four models for inpatient violence reduction and proposing additional recommendations informed by this synthesis. First, …

Emergency Department-Initiated Standard Versus High-Dose Buprenorphine Induction (Envision): A Randomised Clinical Trial Protocol, Kathryn Hawk, Andrew Herring, Marek Chawarski, Erik S. Anderson, Michael Baumann, Alyrene Dorey, August F. Holtyn, Christopher Jones, Shara Martel, Patricia Owens, Kaitlin Kmiecik, Tania D. Strout, Peter Taillac, Michelle R. Lofwall, Sharon L. Walsh, Gail D’Onofrio

Center on Drug and Alcohol Research Faculty Publications

Introduction: The initiation of buprenorphine for patients with opioid use disorder (OUD) in the emergency department (ED) has been associated with improved outcomes including reduced ED visits and increased treatment engagement. Though both standard-dose (8 mg buprenorphine equivalent) and high-dose (24 mg buprenorphine equivalent) strategies to initiate buprenorphine have been used in the ED, no prospective trials comparing outcomes among patients receiving these treatments have been reported.

Methods and analysis: This multisite randomised clinical trial is a multisite double-blind, double-dummy, randomised clinical trial enrolling 360 emergency department patients with moderate-to-severe OUD. Enrolled patients will be randomised to one of two …

Facebook As A Strategy To Deliver A Peer Navigation Intervention For Recently Incarcerated Women With Opioid Use Disorder: A Mixed Methods Descriptive Profile, Martha Tillson, Jaxin Annett, Marguerite A. Webster, Amanda Fallin-Bennett, Mandi Webster, Amber Clemons, Cynthia Robinson, Kevin Crabtree, Casey Baker-Romans, Michele Staton

Center on Drug and Alcohol Research Faculty Publications

Recovery support and treatment linkages are critical during transitions from incarceration to community but can be challenging to deliver to hard-to-reach populations. This paper will examine Facebook contacts between peer navigators (PNs) and women with opioid use disorder (OUD) following jail release to explore women’s use of PN services, including purpose and content of Facebook messages. As part of a larger clinical trial under the Justice Community Opioid Innovation Network (JCOIN), PNs provided OUD treatment navigation and recovery support for 12 weeks following women’s release from jail, using remote options such as Facebook. Facebook Messenger transcripts between PNs and participants …

Targeting Ptp4a3 And Kvx-053 Mitigates Alcohol-Amplified Sars-Cov-2 Spike Protein-Induced Acute Lung Injury, Pavel A. Solopov, Ruben Manuel Luciano Colunga Biancatelli, Elizabeth R. Sharlow, John S. Lazo, John D. Catavas

Bioelectrics Publications

Introduction: Chronic alcohol exposure is associated with increased vulnerability to acute respiratory distress syndrome (ARDS), and emerging evidence suggests that this susceptibility extends to the severe respiratory manifestations of COVID- 19. The SARS-CoV-2 Spike Protein S1 subunit (S1SP) can independently trigger robust inflammatory and vascular injury responses in the lung, and our prior work demonstrated that chronic alcohol consumption markedly intensifies these effects in mice. PTP4A3 phosphatase is a key regulator of inflammation and endothelial barrier function. In this study, we investigated whether the PTP4A3 inhibitor KVX-053 can counteract alcohol-enhanced S1SP-induced lung injury in K18-hACE2 mice.

Methods: Animals were maintained …

Aging With Mercy, Thriving In Place, Emma Layne Katzman, Karen Weis, Jennifer Rugletic Washko

Entry Level Occupational Therapy Doctoral Capstone Projects Class of 2026

Occupational engagement, spirituality, and quality of life are recognized as important dimensions of aging, however, these factors remain underexplored among older adults residing within faith-based communal living environments. This doctoral capstone experience, Aging with Mercy, Thriving in Place, consisted of two distinct but complementary components: an Institutional Review Board (IRB)-approved mixed methods research study and a quality improvement initiative. The purpose of the research study was to explore occupational engagement, occupational role transitions, spirituality, identity, and perceived quality of life among older adults residing within a faith-based communal living environment. Quantitative data were collected using the World Health Organization Quality …

Factors Associated With Opioid-Involved Overdose: Descriptive Data From A Randomized Controlled Trial Evaluating Extended-Release Buprenorphine For Perinatal Opioid Use Disorder, Sara M. Witcraft, Leah Holcomb, Yingjia Wei, Gerald Cochran, John T. Winhusen, Michelle R. Lofwall, Peter R. Martin, Jessica L. Young, Jessica Spinali, Constance Guille

Center on Drug and Alcohol Research Faculty Publications

Background: Opioid use disorder (OUD) during pregnancy is a leading contributor to peripartum morbidity and mortality, with overdose deaths rising significantly in recent years. Despite the identification of various factors associated with overdose events, including social, demographic, psychiatric, and neonatal outcomes, the relative contributions of these factors to peripartum overdose history (or lack thereof) remain unclear. Thus, this study aims to characterize factors associated with lifetime opioid-involved overdose events among currently pregnant individuals receiving buprenorphine (BUP) treatment for OUD.   Methods: Treatment-seeking pregnant individuals with an estimated gestational age of 6 to 30 weeks were enrolled in a large multisite randomized …

Correlates Of Recovery Capital Among Women In Jails: Leveraging A Dimensional Recovery Framework, Amanda Fallin-Bennett, Martha Tillson, Jaxin Annett, Hartley Feld, Michele Staton

Nursing Faculty Publications

Background: Recovery capital encompasses internal and external factors that support recovery from substance use disorder, such as employment, social support, and physical and mental health. There is a need for more research on recovery capital among women who are incarcerated, who often face complex barriers to recovery, such as poverty, unemployment, and histories of trauma.

Methods: Women (N ¼ 900) were recruited from Kentucky jails as part of the broader NIDA-funded Kentucky Justice Community Opioid Innovation Network (JCOIN) cooperative project. Measures from baseline interviews (during incarceration) were selected in alignment with the Substance Abuse Mental Health Service Administration (SAMHSA)’s four …