Mental and Social Health Commons^™

Defining Treatment-Resistant Bipolar Depression: Recommendations From The Isbd Task Force, Eduard Vieta, Roger S Mcintyre, Trisha Suppes, Tamsyn E Van Rheenen, Balwinder Singh, Kamilla Woznica Miskowiak, Allan H Young, Lakshmi N Yatham, Kyooseob Ha, Michael Berk, Holly A Swartz, Chantal Henry, Maja Pantovic Stefanovic, Gerard Anmella Diaz, Aysegul Ozerdem, Wiesław J Cubała, Diego Hidalgo-Mazzei, Mauricio Tohen, Isabella Pacchiarotti, Paula Villela Nunes, Carlos Lopez-Jaramillo, Ana Gonzalez-Pinto, Paolo Brambilla, Robert Post, Jair C Soares, Michael Bauer, Ana C Andreazza, Xavier Justes Fradera, Montserrat Cosials-Lopez, Giovanna Fico

Faculty, Staff and Student Publications

Objective: Despite the availability of approved treatments, a substantial proportion of patients with bipolar disorder experience treatment-resistant bipolar depression (TRBD), characterized by persistent depressive symptoms unresponsive to standard therapies. However, a universally accepted definition of TRBD is lacking. This consensus document, developed by the International Society for Bipolar Disorders (ISBD) Task Force on TRBD, aims to provide a standardized definition of TRBD to facilitate clinical trials, research, and treatment strategies.

Methods: The Task Force employed a literature review, clinical trials analysis, and expert consensus meetings to define TRBD.

Results: TRBD was defined as the failure to achieve a significant and …

Defining Treatment-Resistant Bipolar Depression: Recommendations From The Isbd Task Force, Eduard Vieta, Roger S Mcintyre, Trisha Suppes, Tamsyn E Van Rheenen, Balwinder Singh, Kamilla Woznica Miskowiak, Allan H Young, Lakshmi N Yatham, Kyooseob Ha, Michael Berk, Holly A Swartz, Chantal Henry, Maja Pantovic Stefanovic, Gerard Anmella Diaz, Aysegul Ozerdem, Wiesław J Cubała, Diego Hidalgo-Mazzei, Mauricio Tohen, Isabella Pacchiarotti, Paula Villela Nunes, Carlos Lopez-Jaramillo, Ana Gonzalez-Pinto, Paolo Brambilla, Robert Post, Jair C Soares, Michael Bauer, Ana C Andreazza, Xavier Justes Fradera, Montserrat Cosials-Lopez, Giovanna Fico

Faculty, Staff and Student Publications

Objective: Despite the availability of approved treatments, a substantial proportion of patients with bipolar disorder experience treatment-resistant bipolar depression (TRBD), characterized by persistent depressive symptoms unresponsive to standard therapies. However, a universally accepted definition of TRBD is lacking. This consensus document, developed by the International Society for Bipolar Disorders (ISBD) Task Force on TRBD, aims to provide a standardized definition of TRBD to facilitate clinical trials, research, and treatment strategies.

Methods: The Task Force employed a literature review, clinical trials analysis, and expert consensus meetings to define TRBD.

Results: TRBD was defined as the failure to achieve a significant and …

Factors That Contribute To Occupational Burnout Among Occupational Therapists And Certified Occupational Therapy Assistants: A Qualitative Design, M'Kayla Davis, Kim Broussard, Mary Jan Greer

Summer 2025 OTD Capstone Symposium

This capstone project investigates the prevalence, contributing factors, and impact of occupational burnout and compassion fatigue among occupational therapists (OTs) and certified occupational therapy assistants (COTAs) in inpatient rehabilitation facilities. Using a qualitative research design, structured interviews and thematic analysis, the study identifies heavy workloads, staffing limitations, emotional demands, and sleep deprivation as primary contributors to burnout. The research employs occupational adaptation theory to explore adaptive strategies practitioners utilize, such as boundary setting and seeking professional or interrelationship support, to mitigate these effects. Findings highlight the pervasive nature of burnout among participants on professional performance and personal well-being, and the …

Addressing Psychosocial Barriers To Participation In People Experiencing Homelessness: An Occupational Therapy Workshop, Preston Bender, Steven M. Gerardi, Lacey Spark

Summer 2025 OTD Capstone Symposium

Despite the occupational therapy (OT) profession's emphasis on holistic, person-centered care, many OT practitioners and students report feeling a lack of self-efficacy and preparedness to navigate the complex psychological, social, and systemic barriers that hinder occupational participation in people experiencing homelessness (PEH). This capstone project aimed to address the perceived unpreparedness among clinicians through the creation of an 8-hour interactive educational workshop aligned with Experiential Learning Theory. The content is grounded in the Model of Human Occupation (MOHO) and informed by the Bridging the Transition from Homelessness: A Social Justice Framework (BTTF), trauma-informed care (TIC), harm reduction, and diversity, equity, …

Mental Health And Substance Use Interventions Within Muslim Community Spaces: A Community Based-Participatory Research Proposal, Halah Mansour Alayleh

Master's Projects and Capstones

Background. Muslim Americans face significant mental health and substance use challenges compounded by Islamophobic discrimination, cultural stigma, and barriers to accessing culturally competent services. They also significantly underuse professional mental health services. Purpose. This study aims to collaborate with Muslim communities within the San Francisco Bay Area to develop a replicable intervention framework for addressing mental health and substance use stigma within mosques and other Muslim community spaces. Methods. The proposal uses a community-based participatory research (CBPR) methodology while integrating the theory of planned behavior (TPB) and stigma theory in the framework. This proposal outlines the four phases of intervention …

Advancing Mental Health Awareness Among Persons Of Color: An Occupational Therapy Perspective, Irene Rattitham, Cassandra Nelson

Summer 2025 OTD Capstone Symposium

This capstone project aimed to advance mental health awareness among persons of color (POC) residing in a skilled nursing facility by developing and implementing a culturally responsive psychoeducational program. Informed by the Person-Environment-Occupation (PEO) model, trauma-informed care, and mindfulness-based practices, the program addressed barriers such as stigma, limited awareness, and cultural perceptions of mental health. A needs assessment guided the creation of an 8-module curriculum covering topics like emotional regulation, family involvement, and accessing support. Educational materials were translated into Spanish, Korean, Japanese, and Vietnamese to enhance accessibility. The program was delivered through group and individual sessions, in-service presentations, and …

Improving Collaboration With Hospital Security And Nursing Staff, When Treating Patients In Acute Crisis, By Implementing A Modified Sbar Card., Yuna Choi

Doctor of Nursing Practice Papers

Inpatient psychiatric units provide assistance to patients experiencing acute mental health crises such as psychosis or suicidal ideation. Patients experiencing acute mental health crises can sometimes become agitated or aggressive towards staff, themselves, or other patients, which can pose a significant risk to everyone’s safety. The purpose of the project is to improve staff satisfaction and collaboration by standardizing the interdisciplinary communication between hospital security and nursing staff. Over a period of two weeks, the facilitator educated security and unit staff on a SBAR card during shift huddle to implement on the unit in the event of an acute mental …

Seeking Existential Meaning In The “Sea Of Trees:” A Qualitative Exploration In The Depths Of Japan’S Aokigahara “Suicide” Forest, Sophia Bates

Masters Theses, 2020-current

This thesis explores the intercultural perceptions of suicidality and the role that these perceptions have on meaning of life in Japanese culture through an exploratory, autoethnographic analysis of my journey walking through Japan’s Aokigahara “suicide” Forest. In June 2024, I traveled to Fujikawaguchiko, Japan to conduct an autoethnographic analysis of my experiences walking through Aokigahara Forest using shinrin-yoku and mindful walking (Jung, 2014) as supplemental research methodologies to make empirical observations and take notes on my journey walking through suicide forest as an embodied sensory experience. Drawing upon the research and ideas of cultural anthropologist and existential philosopher Ernest Becker, …

Bridging Psychiatry And Rare Genetic Diseases: A Scoping Review Of Therapeutic Strategies And Diagnostic Delay Paired With Healthcare Economic Burden Analysis, Sheldon R Garrison, Isaac J Siegel, Christopher R Takala, Sarah L Vaithilingam, Gene W Yang, Anthony W Zoghbi, Madeline M Hartig, Sreya Vadapalli, Margaret E Anderson

Duncan NRI Faculty and Staff Publications

Rare genetic diseases (RDs) with primary neuropsychiatric symptoms pose unique challenges for diagnosis and management. While the majority of these RDs have neuropsychiatric symptoms that are secondary to the RD, a subset presents with primary neuropsychiatric symptoms directly linked to their underlying pathophysiology. This subset has significant unmet medical need with delayed diagnoses leading to prolonged delays in treatment optimization and the trialing of medications that fail to target the underlying pathophysiology. This comprehensive review identifies 108 RDs with central neuropsychiatric symptoms that have a 7.7-year average diagnostic delay. Optimal management strategies for these RDs typically includes non-psychotropic medications, dietary …

Implementation Of Artificial Intelligence For Scribing In An Outpatient Mental Health Clinic, Elissa A. Moore

Student Scholarly Projects

Practice Problem: Traditional documentation practices place a significant burden on psychiatric mental health nurse practitioners (PMHNP) in outpatient mental health clinics (MHC), contributing to provider burnout and negatively impacting the patient-provider relationship. Preserving practicing PMHNPs is essential across the United States, but imperative in medically underserved areas where mental health services are limited.

PICOT: In PMHNPs (Population), does the use of AI scribing software (Intervention) compared to traditional documentation methods (Comparison) reduce documentation time and increase provider satisfaction (Outcome) over a ten-week period (Time)?

Evidence: This Doctor of Nursing Practice (DNP) scholarly project was informed by evidence obtained from 15 …

Feasibility Of A Peer-Facilitated Video-Based Mental Health And Substance Use Service-Learning Program, Mara Carmina A. Tamayo, King Filart, Maria Regina Hechanova

Journal of Community Engagement and Higher Education

This study examined the feasibility of implementing a peer-facilitated mental health and substance use video-based program delivered by psychology students as part of service learning. The program was delivered on-site and online. Findings reveal improvements in knowledge, attitudes, refusal self-efficacy, and adaptive coping among on-site participants. However, there was no effect on online participants given many implementation challenges. Recommendations include delivering the program on-site, strengthening training for facilitators, increasing program duration, and shortening the videos.

Author Reply, Cyprian Mostert

Population Health, East Africa

No abstract provided.

The Role Of Neuroscience In Mental Health Management Within The Adhd Population, Kadi Rae Smith

University Honors Theses

Neuroscience-based educational interventions play a role in the management of Attention Deficit Hyperactive Disorder (ADHD), including the regulation of ADHD-correlated depression and anxiety. Existing research shows that elevated rates of depression correspond to anxiety within the ADHD community; approximately 8.83% of the global population. Social ostracization and isolation are established contributors to depression and anxiety which are commonly comorbid with ADHD. The need exists for further investigation of the beneficial impact that an accurate, biological understanding of how the brain works has on the mental health of the ADHD population, and by extension their families, education systems, and medical industries. …

Enhancing Mental Health Through Mind-Body Exercises In Sedentary Students: A Systematic Review With An Indonesian Perspective, Izmi Alya Khairunnisa, Aditya Denny Pratama

Jurnal Sosial Humaniora Terapan

Sedentary Behavior (SB) among students is associated with increased risks of depression, anxiety, stress, and weakened immune function. According to the WHO, SB contributes to approximately two million deaths each year. This systematic literature review aims to evaluate the effectiveness of mind-body exercises in improving mental health outcomes—specifically stress reduction, anxiety management, and emotional regulation—among students with sedentary lifestyles. Using the PRISMA framework, 2,201 articles were identified from databases including Scopus, PubMed, and ProQuest, with six studies meeting the inclusion criteria. The review found that mind-body exercises such as yoga, tai chi, and pilates significantly reduce stress and anxiety, enhance …

Exploring The Connection Between Mental Health Stigma, Social-Emotional Risk, And Help-Seeking Behaviors Among High School Students, Dorie Ross

USF Tampa Graduate Theses and Dissertations

Throughout the United States, the rate of adolescents experiencing mental health-related challenges continues to rise, impacting their social-emotional well-being. Despite increasing concerns, the majority of adolescents do not seek treatment for mental health problems. One barrier contributing to a lack of help-seeking behaviors is mental health stigma. Furthermore, for students who have sought help for such concerns, there is a lack of consensus on whom high school students turn to for support when seeking help. The current study utilized quantitative methodology in the form of Structural Equation Modeling to examine the complex relationship between social-emotional risk, perceptions of mental health …

Residential Factors Associated With Mental Health In United States Veterans, Air Force Military, And Air Force Employees, Andrew J. Hoisington, Christopher A. Stamper, Molly Penzenik, Meredith Reitter, Elizabeth J. Kovacs, Nazanin H. Bahraini, Lisa A. Brenner

Faculty Publications

Individuals in Westernized countries spend most of their time indoors. However, exploration of residential building factors that may influence occupants’ mental health is limited in scientific literature. The purpose of this study was to explore investigator's perceived areas of importance in residences to mental health via survey methods. To that end, we administered the Housing, Occupancy, Materials, and Environment (HOME) survey to assess factors that may influence mental health to those working in the United States (US) Air Force (n = 230) or past military members, US Veterans (n = 180). Self-reported mental health surveys were also administered to the …

Development Of An Age-Appropriate Household Dysfunction Measure And Its Concurrent Validity With Multiple Outcomes Among Middle School Adolescents In Southeast Texas, Sumaita Choudhury, Timothy J Walker, Emily T Hébert, Christine M Markham, Ross Shegog, Robert C Addy, Melissa F Peskin

Faculty, Staff and Student Publications

Existing adverse childhood experience (ACE) measures include a limited number of household dysfunction (HD) items and the use of adult-oriented language that is not always appropriate for middle schoolers. We developed an age-appropriate 10-item HD measure informed by previously validated ACE measures and tested its concurrent validity with dating violence (DV) perpetration, lifetime substance use, and mental health outcomes among middle schoolers in Southeast Texas. This cross-sectional study used the baseline data from a DV prevention intervention program for sixth graders (N = 126), Me & You Tech. Baseline data were collected from March 2023 to April 2023. To …

Optimizing Psychiatric Care Through Pharmacogenomics: An Evidence-Based Program To Increase Multi-Gene Pharmacogenomic Testing And Provider Competence In Mental Health Settings, Marc Boulanger

Doctor of Nursing Practice Final Manuscripts

Objective: This scholarly project aimed to enhance psychiatric providers' competency, confidence, and knowledge in the PHASER pharmacogenomic (PGx) testing program at the VA San Diego Healthcare System.

Background: PGx testing enhances psychiatric care by enabling precise medication management tailored to a patient’s genetic profile, improving treatment effectiveness and reducing adverse drug reactions. Despite demonstrated clinical utility, adoption of PGx remains limited due to provider knowledge gaps. This project addresses these gaps through targeted education.

Methods: Two educational modules, developed with input from the PHASER site-lead, aimed to enhance provider knowledge and confidence in PGx. Module one introduced the PHASER program …

The Cost Of Accommodative Burdens: Prevalence & Impact On Deaf And Hard Of Hearing Individuals, Lorelei Becktel

Undergraduate University Honors Capstones

This exploratory qualitative study (n=8) investigated the mental health effects of lack of reciprocity in accommodation and the resulting accommodative burden on deaf and hard of hearing individuals. Lack of reciprocity occurs when the split of the burden for communication accommodations falls significantly more on the deaf or hard of hearing individual. The resulting accommodative burden occurs when deaf and hard of hearing individuals adapt to make communication easier for hearing people at a level that is uncomfortable, unwanted, and/or detrimental to their needs. Effects, determined by participant responses, were examined via semi-structured interviews and analyzed via thematic analysis. Relationships …

Evaluating Scheduling Tool To Improve Behavioral Health Counseling Scheduling Rates On Same Day Of Referral, Edward Delesky, Md, Oluwatoni Okuboyejo, Md, Elizabeth Franko, Md, Nwamaka Amobi, Md, Ronak Ahir, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

• Studies suggest 1 in 5 adults in the US suffer from mental illness, with up to 46% of Philadelphia residents reporting poor mental health.
• Care integration beginning with primary care physician evaluation and management is becoming more common.
• Behavioral health counseling (BHC), provided by a primary physician and trained psychologist, is vital in management of mental health conditions.
• Studies suggest same-day scheduling of follow up appointments improves treatment adherence.
• Goal: improve BHC scheduling rates on same-day of initial referral across two practice teams

Burnout And Self-Efficacy: Exploring The Rewards And Challenges Faced By Crisis Counselors Working In Emergency Department Settings, Ellen Dotas

Dissertations, 2020-current

This dissertation explores burnout and self-efficacy in counselors who work with clients in crisis in emergency department settings. Mental health and emergency departments are two areas that tend to report higher levels of burnout than are reported in other occupational fields. While much research has been done on the topics of burnout and self-efficacy, limited information is available about counselors who work in these crisis roles. This dissertation follows a three-manuscript format and includes a conceptual, qualitative, and quantitative manuscript. The conceptual manuscript explores the nature of the crisis assessment itself, focusing on the area of risk assessment. The qualitative …

Exploring The Relationship Between Diet And Mental Health, Emory Layne

Honors Theses

Dietary patterns in Western societies have shifted over the past century due to the rise of food manufacturing and technological advancements. Ultra-processed foods now account for approximately half of the daily energy intake in high-income countries. Similarly, the national mental health crisis emerged in the 21st century and worsened after the COVID-19 pandemic. The changes in diet have impacted the gut microbiome, which interacts with the brain through the bidirectional gut-brain axis. Research suggests the concept of the gut-brain axis is a principal indicator of diet’s impact on mental health. However, this area of research is still emerging and requires …

Exploring The Relationship Between Disability And Stress: A Preliminary Study, Katie Mcclyman

Undergraduate University Honors Capstones

Mental health issues can become disabling, and living with a disability in an ableist world can cause mental health struggles. This project explores what aspects of living with a disability generate stress. This project is a survey that gathered data through a two-questionnaire survey of disabled college-aged students. The need for a project like this came from the fact that there is not substantial research from the field of psychology done on disabled people and the relationship between disability and stress. The results of this study found that the more disability impact increases, so does disability related stress. This means …

Lawyers, Trauma, And Professional Well-Being: How The Legal Community Takes Back Its Mental Health, Brenda D. Gibson

Arkansas Law Review

Accompanying a notable shift in the legal academy to being more attentive to our students’ mental health, there must be an equal (or even greater) shift to focusing on trauma, mental health, and well-being in the broader profession. Significantly, trauma and its effects are compounded when combined with the challenges faced by underrepresented populations within the profession. To date, these challenges have been greeted by an ad hoc, piecemeal reaction to stress and trauma,10 which only inhibits wellness in the profession. Part I explores the current literature in both the humanities and the legal profession, beginning with a brief discussion …

Eos Wellness Center: Rethinking Inpatient Mental Health Facility Design, Emily Simms

Bachelor of Architecture Theses - 5th Year

The design of mental health facilities significantly impacts patient outcomes, especially for individuals with depression. Environmental factors such as lighting, thermal comfort, and access to nature influence mental health. This research explores how architectural design can reduce self-harm incidents and enhance recovery outcomes for patients with depression. The project hypothesizes that synchronizing light patterns and thermal comfort with patients’ circadian rhythms will reduce self-harm incidents and improve recovery. The problem established in the research is that disruptions to circadian rhythms increase the risk of depression, PTSD, and anxiety by 30% (Burns et al., 2022). Suicide is also the second leading …

An Educational Intervention: Knowledge Acquisition Of Perimenopausal Mental Health Symptoms And Treatment Options For Women Aged 35 Years Plus, Allison M. Hopps

Doctor of Nursing Practice Scholarly Projects

Perimenopause is a span of four to six years preceding menopause when estrogen levels decline. Up to 40% of women experience depression during the perimenopause transition. Hormone replacement therapy (HRT) can be an effective treatment for depressive symptoms during perimenopause, but many healthcare practitioners prescribe antidepressants instead of HRT for the management of mood-related symptoms. Perimenopausal depression is associated with the progression of chronic conditions such as cardiovascular disease, diabetes, and dyslipidemia. The general population, including women and healthcare providers, lacks the education and awareness surrounding perimenopause symptoms and treatment. This project educated women between ages 35 to 55 on …

One Can Only Dream, Sophia V. Yacca

Theses and Dissertations

One Can Only Dream is an interactive installation in which players are invited to navigate a liminal, dream-like game, engage with a branching series of questions, and introspect upon the relationships between unconscious expression, conscious self-perception, and the inherent difficulty of depicting, sharing, and understanding subconscious thought.

Rooted in both my personal experience with a rare neurophysiological condition and in my desire to create, this project examines dreams not only as a medical and cultural phenomenon, but also as a means to form identity, reflect trauma, and inspire creativity. Drawing from modern interactive storytelling and my lived experiences, this work …

Finding Freedom In Appalachia: Evaluating A Mental Health Intervention In West Virginia, Elizabeth A. Claydon, Karen Haring, Jessica Haring, Kelsey Riggi, Beth Currence

Journal of Appalachian Health

Introduction: Rural areas have limited capacity to provide comprehensive mental health treatment and resources. This creates the need for interventions to ensure individuals with mental health concerns have access to resources to improve their mental health.

Purpose: The purpose of this mixed-methods evaluation was to assess the effectiveness and impact of Libera, a mental health program tailored for girls and women within the Appalachian region.

Methods: Quantitative surveys, including validated measures for depression, anxiety, and eating disorder symptoms, and life satisfaction, were collected pre- and post-Libera intervention for participants. Simultaneously, annual surveys were sent to Listeners in addition to qualitative …

Affordable Architecture: Promoting Mental Health Through Cost-Effective Design In Underfunded High Schools In Dallas-Fort Worth, Raphaella Malicay

2025 Spring Honors Capstone Projects - Archive

Mental health awareness has increased over the years as well as numerous strategies to support mental health. Some of these strategies include addressing the built environment. This paper explores the intersection between mental health and the built environment through the lens of affordable architectural methods that would be effective in underfunded secondary schools. This study examines how architecture influences students’ well-being and how certain design strategies can be implemented even in schools that lack the financial resources for adequate infrastructure. Here the focus is on investigating affordable solutions such as improving ventilation, optimizing natural light, having flexible learning spaces, and …

Investigating Mental Health Outcomes Of National Collegiate Athletic Association (Ncaa) Division I Student-Athletes At The University Of Louisville, 2019-2023., Paul Harvey

Electronic Theses and Dissertations

Mental health outcomes among collegiate student-athletes, has become a broader concern in the 21^st century. This study examines prevalence and incidence of anxiety and depression amongst student-athletes at the University of Louisville from 2019-2023 across different Sports Groups. The prevalence of anxiety was found to be 20.22% and risk of anxiety was 15.65%. The prevalence of depression was found to be 13.11% and risk of depression was 18.75%. Logistic regression was used to estimate the association between sports groups and anxiety/depression. There was a borderline association between sports groups and prevalence of anxiety after confounder adjustment (OR=1.86, 95% CI: …