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The Relationship Between Parental Trauma History And Perceptions Regarding Their Child’S Healthcare And Utilization Of Healthcare Services, Krishna Patel

Theses and Dissertations

Abstract

TITLE: The Relationship Between Parental Trauma History and Perceptions Regarding Their Child’s Healthcare and Utilization of Healthcare Services

Adverse child events (ACEs) have been associated with a number of physical and mental health problems and have also been linked to increased health care utilization. While parents who have an ACE history may tend to seek healthcare services for themselves, limited studies have examined the impact of their trauma history on seeking healthcare services for their child. Healthcare utilization may also depend on the parents’ level of health anxiety, as well as their anxiety about their child’s health status. This …

Predictors And Moderators Of Treatment Outcomes For Anxious Children Randomized To Computer-Assisted Cognitive Behavioral Therapy Or Standard Community Care, Orri Smárason, Andrew G Guzick, Wayne K Goodman, Alison Salloum, Eric A Storch

Faculty, Staff and Students Publications

Introduction:

Computer-assisted cognitive behavioral therapy (CCBT) for childhood anxiety disorders may aid the dissemination of CBT, while maintaining treatment fidelity. Although CCBT is an effective intervention, not everyone benefits equally from treatment. Identifying patient characteristics that predict who will benefit from treatment and to what extent can help with matching patients to suitable interventions, and allow researchers and clinicians to modify, and individualize, their treatment formats more effectively. Such predictors and moderators have not yet been examined for CCBT outcomes in anxious children and studies of more traditional treatment formats have yielded inconsistent results.

Methods:

Using data from a randomized …

Safety And Efficacy Of Long-Term Deutetrabenazine Use In Children And Adolescents With Tics Associated With Tourette Syndrome: An Open-Label Extension Study, Joseph Jankovic, Barbara Coffey, Daniel O Claassen, Joohi Jimenez-Shahed, Barry J Gertz, Elizabeth A Garofalo, David A Stamler, Maria Wieman, Juha-Matti Savola, Eran Harary, Jessica Alexander, Hadas Barkay, Mark Forrest Gordon

Faculty, Staff and Students Publications

BACKGROUND: Tourette syndrome (TS) is a neurodevelopmental disorder characterized by motor and phonic tics.

OBJECTIVE: To assess the safety and efficacy of deutetrabenazine (Teva Neuroscience, Inc, Parsippany, NJ), a vesicular monoamine transporter 2 inhibitor, in children and adolescents with TS.

METHODS: Alternatives for Reducing Tics in TS (ARTISTS) open-label extension (OLE) (NCT03567291) was a 54-week, global, phase 3, open-label extension study of deutetrabenazine (6-48 mg daily) conducted May 28, 2018 to April 3, 2020 with a 2-week randomized withdrawal period. Participants (6-16 years of age) had TS and active tics causing distress or impairment. Safety (primary outcome) was assessed by …

Closing The Gap For Children With Ocd: A Staged-Care Model Of Cognitive Behavioural Therapy With Exposure And Response Prevention, Lara J Farrell, Allison M Waters, Eric A Storch, Gabrielle Simcock, Iain E Perkes, Jessica R Grisham, Katelyn M Dyason, Thomas H Ollendick

Center for Medical Ethics and Health Policy Staff Publications

Childhood obsessive-compulsive disorder (OCD) is among the most prevalent and disabling mental health conditions affecting children and adolescents. Although the distress and burden associated with childhood OCD are well documented and empirically supported treatments are available, there remains an unacceptable "treatment gap" and "quality gap" in the provision of services for youth suffering from OCD. The treatment gap represents the large number of children who never receive mental health services for OCD, while the quality gap refers to the children and young people who do access services, but do not receive evidence-based, cognitive behavioural therapy with exposure and response prevention …

Obsessive-Compulsive Disorder In Youth And Young Adults With Depression: Clinical Characteristics Of Comorbid Presentations, David B Riddle, Andrew Guzick, Abu Minhajuddin, Orri Smárason, Gabrielle M Armstrong, Holli Slater, Taryn L Mayes, Lynnel C Goodman, Denise L Baughn, Sarah L Martin, Sarah M Wakefield, Joseph Blader, Ryan Brown, Wayne K Goodman, Madhukar H Trivedi, Eric A Storch

Faculty, Staff and Students Publications

Obsessive-compulsive disorder (OCD), anxiety disorders, and depressive disorders are highly comorbid, and each contribute to significant functional impairment for affected youth. Comorbid anxiety disorders in depressed youth have been associated with greater depressive symptom severity and impairment, but the impact of comorbid OCD in this population remains unclear. Accordingly, the present study examined the differential clinical characteristics of youth with depression and comorbid OCD relative to age/gender matched depressed youth with no such comorbidity and to those with depression and a comorbid (non-OCD) anxiety disorder. A sample of 797 youth and young adults ages 8-20 years who met diagnostic criteria …

Promoting Ocd Wellness And Resilience (Power) Study: Rationale, Design, And Methods, Jessica D Leuchter, Minjee Kook, Daniel A Geller, Alyssa G Hertz, Jessica Garcia, Erika S Trent, Tracey Dibbs, Ogechi Onyeka, Wayne K Goodman, Andrew G Guzick, Andrew D Wiese, Amanda D Palo, Brent J Small, H Blair Simpson, Lauren K Havel, Sohail A Nibras, Kirti Saxena, Eric A Storch

Faculty, Staff and Students Publications

Obsessive-compulsive disorder (OCD) affects 1-2% of children and is associated with functional impairment and diminished quality of life. Several treatments are efficacious: cognitive behavioral therapy (CBT) with exposure and response prevention, serotonin reuptake inhibitor (SRI) monotherapy, and combined treatment (SRI + CBT). Expert clinician-informed practice parameters suggest that youth with mild to moderate OCD should be treated initially with CBT yet SRIs are frequently employed as the first-line intervention or in combination with psychotherapy in applied practice. Empirical data to guide SRI discontinuation in pediatric OCD are very limited. This study, Promoting OCD Wellness and Resiliency (POWER), aims to address …

Promoting Ocd Wellness And Resilience (Power) Study: Rationale, Design, And Methods, Jessica D Leuchter, Minjee Kook, Daniel A Geller, Alyssa G Hertz, Jessica Garcia, Erika S Trent, Tracey Dibbs, Ogechi Onyeka, Wayne K Goodman, Andrew G Guzick, Andrew D Wiese, Amanda D Palo, Brent J Small, H Blair Simpson, Lauren K Havel, Sohail A Nibras, Kirti Saxena, Eric A Storch

Faculty, Staff and Students Publications

Obsessive-compulsive disorder (OCD) affects 1-2% of children and is associated with functional impairment and diminished quality of life. Several treatments are efficacious: cognitive behavioral therapy (CBT) with exposure and response prevention, serotonin reuptake inhibitor (SRI) monotherapy, and combined treatment (SRI + CBT). Expert clinician-informed practice parameters suggest that youth with mild to moderate OCD should be treated initially with CBT yet SRIs are frequently employed as the first-line intervention or in combination with psychotherapy in applied practice. Empirical data to guide SRI discontinuation in pediatric OCD are very limited. This study, Promoting OCD Wellness and Resiliency (POWER), aims to address …

Growing In Grief: A Meaning-Making Expressive Arts Therapy Method Developed For Bereaved Youth, Jessica Wilson

Expressive Therapies Capstone Theses

Approximately 5.3 million youth in the United States have experienced the death of a sibling or parent. They face challenges such as an increased risk of depression, anxiety, substance use, and other detrimental effects on adjustment. A small subset of this population experiences significant emotional and behavioral difficulties, characterized by an inability to function in major life roles, a preoccupation with the loss, and separation distress. Modern grief literature describes meaning-making as an adaptive coping process contributing to a sense of renewed hope and self-efficacy and a reduction in distressing grief symptomology. Expressive arts therapy is an effective way to …

Covid, Creativity, And Connecting Through Change: Reviewing The Literature On How Art Therapy Can Help Children And Adolescents Cope With Pandemic-Related Grief, Lydia Speicher

Expressive Therapies Capstone Theses

The COVID-19 pandemic has been one of the most significant global events in the past century, both resulting in massive casualties and significant mental health outcomes across the world. Some of the most impacted populations are children and adolescents whose lives have been interrupted during their formative years. The purpose of this literature review is to explore how art therapy has been used during the COVID-19 pandemic to address the grief experienced by children and adolescents through their losses of stability and peer support surrounded by uncertainty. This literature review seeks to understand exactly how the pandemic has affected the …

Effortful Control Moderates The Relation Between Negative Emotionality And Child Anxiety And Depressive Symptom Severity In Children With Anxiety Disorders, Elizabeth M Raines, Andres G Viana, Erika S Trent, Haley E Conroy, Karina Silva, Michael J Zvolensky, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

The present study investigated the interactive effect of reactive (negative emotionality) and regulatory (effortful control) aspects of temperament in the prediction of child anxiety and depressive symptoms. Clinically anxious children and their mothers completed a battery of questionnaires that included self- and mother-ratings of child effortful control, negative emotionality, anxiety, and depressive symptoms. Multiple regression analyses were conducted to examine the moderating effect of effortful control on the relation between negative emotionality and child anxiety and depressive symptom severity. The interaction between negative emotionality and effortful control was statistically significant and simple slopes revealed that as effortful control increased, the …

Disrupted White Matter Microstructure Correlates With Impulsivity In Children And Adolescents With Bipolar Disorder, Tianjia Zhu, Alessio Simonetti, Minhui Ouyang, Sherin Kurian, Johanna Saxena, Jair C Soares, Kirti Saxena, Hao Huang

Faculty, Staff and Student Publications

Altered white matter (WM) microstructure likely occurs in children with bipolar disorder (BD) with impulsivity representing one of the core features. However, altered WM microstructures and their age-related trendlines in children with BD and those at high-risk of developing BD, as well as correlations of WM microstructures with impulsivity, have been poorly investigated. In this study, diffusion MRI, cognitive, and impulsivity assessments were obtained from children/adolescents diagnosed with BD, offspring of individuals with BD (high-risk BD) and age-matched healthy controls. A novel atlas-based WM skeleton measurement approach was used to quantify WM microstructural integrity with all diffusion-tensor-imaging (DTI) metrics including …

The Role Of Parental Military Status And Educational Attainment On Mental Health Service Usage Among Children And Adolescents, Cierra Jones Williams

Walden Dissertations and Doctoral Studies

A lack of mental health services for children and adolescents has been linked to significant health problems in adulthood. Researchers have investigated factors that influence usage of mental health services among children and adolescence, but significant gaps persist regarding use of mental health service among military-connected youth. This quantitative study was conducted to examine if parental military status and parental education affected the usage of mental health services among children and adolescents ages 3–17 in the United States. Multivariable logistic regression was used to analyze secondary data from the combined 2019–2020 National Survey of Children’s Health. After adjusting for income, …

Evaluating The Impact Of Mental Health Needs And Services Disruption: Covid-19 & Wisconsin Children’S Welfare Services, Gavin Rienne

Theses and Dissertations--Epidemiology and Biostatistics

Children’s traumatic experiences have lifelong impacts on their mental health and quality of life, therefore mental health services are a critical part of necessary community resources. The increased frequency and severity of natural disasters such as hurricanes, tornadoes, and pandemics reinforces the need to examine and understand the importance of mental health and child services in response to disaster events. This research assesses the relationship between disasters and subsequent health service utilization amongst children and adolescents. We investigated current research on the relationship between children’s mental health and community mental health resource efficacy and accessibility after a major disaster by …

Effect Of Family Engagement On The Behavioral Health Of Mentally Ill Offenders, Jessica Rae Horn

Walden Dissertations and Doctoral Studies

In the United States, 40% of incarcerated individuals have been diagnosed with a mental health disorder, but they often lack the support system needed to navigate their incarceration. This study addressed ways to understand how family engagement opportunities can improve the behavioral health of mentally ill offenders. Specifically, five research questions were used to explore the degree to which the practice of family engagement was understood as a method for providing support to mentally ill incarcerated individuals. The study followed the Baldrige Framework of Excellence to identify current organizational leadership and management issues that can help reach its goals, improve …

Use Of Lithium In Pediatric Bipolar Disorders And Externalizing Childhood- Related Disorders: A Systematic Review Of Randomized Controlled Trials, Delfina Janiri, Lorenzo Moccia, Silvia Montanari, Valentina Zani, Claudia Prinari, Laura Monti, Daniela Chieffo, Marianna Mazza, Alessio Simonetti, Georgios D Kotzalidis, Luigi Janiri

Faculty, Staff and Students Publications

Background: Lithium is the standard treatment for bipolar disorders (BD) in adults. There is a dearth of data on its use in the pediatric age. This review aimed to investigate the use of lithium in pediatric bipolar disorder (BD) and other externalizing childhood-related disorders.

Methods: We applied the Preferred Reporting Items for Systematic Reviews and Meta-analyses criteria (PRISMA) to identify randomized controlled trials evaluating the use of lithium in pediatric (BD), conduct disorder (CD), attention deficit hyperactivity disorder, oppositional defiant disorder, and disruptive mood dysregulation disorder. The primary outcome of our study was to evaluate the efficacy of lithium compared …

Deep Brain Stimulation For Pediatric Dystonia: Clinicians' Perspectives On The Most Pressing Ethical Challenges, Kristin M Kostick-Quenet, Lavina Kalwani, Laura N Torgerson, Katrina Munoz, Clarissa Sanchez, Eric A Storch, J S Blumenthal-Barby, Gabriel Lazáro-Muñoz

Center for Medical Ethics and Health Policy Staff Publications

Introduction: Pediatric deep brain stimulation (pDBS) is commonly used to manage treatment-resistant primary dystonias with favorable results and more frequently used for secondary dystonia to improve quality of life. There has been little systematic empirical neuroethics research to identify ethical challenges and potential solutions to ensure responsible use of DBS in pediatric populations.

Methods: Clinicians (n = 29) who care for minors with treatment-resistant dystonia were interviewed for their perspectives on the most pressing ethical issues in pDBS.

Results: Using thematic content analysis to explore salient themes, clinicians identified four pressing concerns: (1) uncertainty about risks and benefits of pDBS …

Analysis Of The Efficacy Of Autologous Peripheral Blood Stem Cell Transplantation In High-Risk Neuroblastoma, Jin Yan, Li Jie, Yang Jiaxing, Cao Yanna, Li Zhanglin, Li Zhongyuan, Wang Daowei, Zhao Guangzong, Zhong Benfu, Yan Jie, Zhao Qiang

Faculty, Staff and Student Publications

Objective: This study aimed to analyze the efficacy of autologous peripheral blood stem cell transplantation for high-risk neuroblastoma in China.

Methods: The data of 90 high-risk neuroblastoma patients treated with the CCCG-NB 2015 regimen were reviewed. The baseline clinicopathological characteristics and prognosis were analyzed and compared. In addition, the prognoses of tandem autologous stem cell transplantation and single autologous stem cell transplantation groups were compared.

Results: The results of survival analysis showed that autologous peripheral blood stem cell transplantation based on this pretreatment regimen significantly improved the prognosis of children in the high-risk group. The 3-year event-free survival (EFS) and …

Early Intervention In Autism Spectrum Disorder: The Need For An International Approach, Amina Abubakar, Patricia Kipkemoi

Institute for Human Development, East Africa

Globally, autism spectrum disorder (ASD) affects approximately 1 in 100 children. Ideally, a diagnosis is made with the onset of symptoms before 3 years of age; however, a diagnosis may sometimes be delayed until 6 years or later. There has been an increase in ASD research over the last few decades, with many systematic reviews and meta-analyses synthesizing research evidence for ASD interventions in children. Evidence tends to support the notion that intervention for ASD must occur as early as possible, close to the critical periods when early social and communication skills are developing. Therefore, early screening and intervention could …

Clinicians' Perspectives On The Effectiveness Of Trauma - Focused Cognitive Behavioral Therapy With African American Children: A Qualitative Study, Jada Carter

Doctoral Dissertations

Literature exploring clinicians' perspectives on the effectiveness of trauma-focused cognitive behavioral therapy with African American children who suffer from trauma-related disorders is very limited. The current study examined clinicians' perspectives on the TF-CBT model when utilized with this population, including their experiences working with African American children and families with observable types of trauma-related disorders. This research study also explored the various facets of trauma that African Americans encounter in childhood and the barriers that prevent them from receiving adequate mental health care. Thematic analysis was utilized to explore themes that emerged when treating African American children with TF-CBT. Five …

Community-Based Asthma Assessment In Young Children: Adaptations For A Multicentre Longitudinal Study In South Asia, Mohammad Shahidul Islam, Samin Huq, Steven Cunningham, Jurgen Schwarze, Asmd Ashraful Islam, Mashal Amin, Farrukh Raza, Benazir Baloch, Muhammad Imran Nisar, Sajid Bashir Soofi

Department of Paediatrics and Child Health

Background: Systematic assessment of childhood asthma is challenging in low- and middle-income country (LMIC) settings due to the lack of standardised and validated methodologies. We describe the contextual challenges and adaptation strategies in the implementation of a community-based asthma assessment in four resource-constrained settings in Bangladesh, India, and Pakistan.
Method: We followed a group of children of age 6-8 years for 12 months to record their respiratory health outcomes. The study participants were enrolled at four study sites of the 'Aetiology of Neonatal Infection in South Asia (ANISA)' study. We standardised the research methods for the sites, trained field staff …

All You Knead Is Love, Donna Madoff

Expressive Therapies Capstone Theses

This thesis explores the development of a method to gain a deeper understanding of the process of making bread’s potential as art therapy. The Expressive Therapies Continuum (ETC), mindfulness arts-based research, and neurobiological research provide the foundation for understanding the method. Lusebrink and Hinz's schematic framework, the ETC provides a therapeutic model for the applications of media in art therapy. Research posits that the three levels of the ETC, Kinesthetic/Sensory, Perceptual/Affective, and Cognitive/Symbolic reflect different functions and structures in the brain that process visual and affective information (Lusebrink, 2004). In addition, the application of new techniques in brain imaging has …

Pre-Migration To Post-Migration – Mental Health Problems In Unaccompanied Migrant Children From The Northern Triangle Of Central America, Paola Zuniga

Electronic Theses, Projects, and Dissertations

Background - The number of unaccompanied migrant children arriving at the U.S. southern border has significantly increased. Each year, children are forced to flee from their native countries of Guatemala, Honduras, and El Salvador. These countries form the Northern Triangle region of Central America, which is recognized as “one of the most dangerous places on earth” according to the United Nations High Commissioner for Refugees (UNHCR). Children from this region, experience significant trauma during their pre-migration, in-transit, and post-migration journey. This raises significant concerns about potential mental health problems. For this reason, access to mental health services for UMCs is …

Bullied Because Of Their Teeth: Evidence From A Longitudinal Study On The Impact Of Oral Health On Bullying Victimization Among Australian Indigenous Children, Md Irteja Islam, Verity Chadwick, Tuguy Esgin, Alexandra Martiniuk

Research outputs 2022 to 2026

Making life better for Indigenous peoples is a global priority. Although bullying and oral health have always been a topic of concern, there is limited information regarding the impact of this problem on the general population, with no evidence in this regard among the Australian Indigenous population. Thus, we aimed to quantify the relationship between bullying victimization and oral health problems by remoteness among 766 Australian Indigenous children aged between 10–15-years using data from the LSIC study. Bivariate and multilevel mixed-effect logistic regression analyses were employed. Findings indicated children self-reported bullying more than parents reported their children were being bullied …

Occupational Therapists’ Clinical Reasoning In Aat With Dogs In Pediatric Therapy, Catherine C. Goodman

Occupational Therapy Doctorate Capstone Projects

Purpose: The purpose of the study was to understand the clinical reasoning used by occupational therapists to select animal assisted therapy with a dog to be included in a treatment plan for their pediatric occupational therapy clients

Theoretical Framework. The Ecology of Human Performance model supports the study purpose and emphasizes the effect of a person’s context and environment on their ability to function and perform tasks.

Methods. The descriptive qualitative study used interviews of seven occupational therapy practitioners who have included dogs in therapy sessions with children. Interactive coding and theme development was employed with member checking applied to …

Therapists’ And Teachers’ Experiences Of Children With Aggression: A Children’S Partial Hospitalization Program, Kimberlee Joy Dunlap

Walden Dissertations and Doctoral Studies

Aggression is an indicator of future criminal behavior. It can be a result of trauma, substance-abusing parents, or executive functioning. Research has shown that aggression in childhood often creates criminal behavior later in life, thus researchers suggest that more studies are conducted on programs that help children with aggression. The purpose of this qualitative study was to examine the experiences of therapists who work with aggressive children in a children’s partial hospitalization program, and those teachers who have had these children in class before entering the program and upon discharge from the program. The qualitative study was done using semi-structured …

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 …

“I Want Justice From People Who Did Bad Things To Children”: Experiences Of Justice For Sex Trafficking Survivors, John G. Morrissey, James Havey, Glenn M. Miles, Nhanh Channtha, Lim Vanntheary

Dignity: A Journal of Analysis of Exploitation and Violence

This research from the Butterfly Longitudinal Research Project focused on understanding the experiences and perceptions of justice and the justice system for 93 Cambodia participants (including 88 survivors of sex trafficking) as they navigated the legal system. Thirty-two of these survivors had experiences in court and provided details into their courtroom experiences, predominantly within Cambodia but also in the United States. The survivors’ experiences were diverse; however, the prevailing themes were: fear throughout their legal journeys; a low level of awareness and understanding of their legal experiences; and that NGO support was essential for these survivors to engage in the …

Designing A Virtual Reality Experience To Reduce Anxiety Of Children With Chd During The Perioperative Period, Yang Zhang

Theses - ALL

Children with congenital heart disease (CHD) often need to bear great anxiety related to various invasive surgeries and medical procedures. In a study of virtual reality technology in the medical industry, I found that it has great development potential in reducing children's anxiety. Therefore, the goals of this thesis project were to use virtual reality technology to reduce anxiety for children with CHD. Using previous research of anxiety in children with CHD and the solutions to children's anxiety in various hospitals, this thesis summarizes the design directions. Then, through interviews with pediatric cardiologists, child development experts, and children with coronary …

Mental Health And The Impact Of Friendship, Ian Adkins

WRIT: Journal of First-Year Writing

Mental health issues are a very large problem in the United States today. For a long time, mental health issues were ignored and not even seen as something worth looking into or studying, let alone being a real medical condition. When they finally started to come to light, they were only associated with adults. In the United States, children’s mental health issues were largely ignored. It has only been recently that mental health in adolescents is being addressed, and phycologist and scientists are finding important information about how friendships can impact the way these at-risk adolescents deal with mental health …

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 …