Mental and Social Health Commons^™

Implementing An Anxiety Management Bundle In Long-Term Nursing Facilities, Sundan G. Bryson

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

There is currently a gap in accurate screening and treatment of anxiety in Long-Term Care (LTC) nursing facilities. The question for this quality improvement project was: Will implementing interventions for long-term care residents aged 65 and older improve anxiety screening, non-pharmacological interventions, and mental health referrals by 10% compared to current practices? Interventions to enhance anxiety screening included the Geriatric Anxiety Scale-Long Term Care (GAS-LTC) tool to assess and score anxiety. In addition, a Non-Pharmacological Intervention (Non-PI) tool was created to evaluate interventions performed by facility staff. Referrals to the mental health care provider were submitted if a resident scored …

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.

Reverse Koebner Phenomenon In Linear Scalp Morphea Following Punch Biopsy: A Rare Therapeutic Response, Suhas C. Gowda, Akshay Samagani, Shreyas C. Gowda

Digital Journal of Clinical Medicine

Morphea is a chronic immune-mediated fibrosing disorder characterized by excessive collagen deposition in the skin. Linear morphea of the scalp (en coup de sabre) commonly demonstrates the Koebner phenomenon, wherein lesions develop at sites of trauma; however, the reverse Koebner phenomenon—trauma-induced regression—is exceptionally rare. We report an unusual case of linear scalp morphea showing early regression following a diagnostic punch biopsy. A 71-year-old male presented with an asymptomatic, indurated linear plaque on the scalp of two months’ duration. Histopathology from a 3.5-mm punch biopsy confirmed morphea, demonstrating dense collagen bundles with lymphoplasmacytic infiltrate. At follow-up eight days after …

Atypical Antipsychotic-Induced Weight Gain Preventive Bundle: A Quality Improvement Project, Jocelyn Urbano

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Antipsychotic-induced weight gain (AIWG) is a common, clinically significant adverse effect associated with second-generation antipsychotic medications and contributes to increased cardiometabolic risk among individuals with serious mental illness (SMI; Carolan et al., 2025; Hegde et al., 2024). Individuals experiencing homelessness or social instability often encounter additional barriers to maintaining healthy lifestyle behaviors and consistent engagement in healthcare, further increasing metabolic risks and treatment issues (Hamel et al., 2024; Kelly et al., 2025). This preventive care bundle, designed to reduce the risk of AIWG, was implemented in an outpatient behavioral health clinic serving an underserved urban Texas population.

As metformin may …

Post-Stroke Depression (Psd) And Occupational Therapy (Ot) Intensity: A Retrospective Medicare Claims Analysis, Lauren H. Allen

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Purpose: Post stroke depression (PSD) is the most frequent and burdensome mental health complication following a stroke, affecting approximately one third of survivors. Examining how PSD relates to outpatient occupational therapy (OT) utilization may help identify gaps in post-stroke mental health care and reveal whether current billing practices adequately capture OT services.

Project Goals: This project aimed to determine whether an early PSD diagnosis predicts outpatient OT treatment intensity and describe patterns of OT billing related to mental health, including mental health current procedural terminology (CPT) code use and CPT code distributions.

Site: This project was conducted in collaboration …

Burnout And Workforce Outcomes Among Registered Nurses, Madeline Willcoxen

Theses, Dissertations and Capstones

Purpose: The purpose of this study was to examine the relationship between staffing and organizational support interventions and workforce outcomes among registered nurses providing direct patient care in hospital settings. The study focused on three measurable outcomes: emotional exhaustion, absenteeism, and annual nurse turnover. The population included hospital-based registered nurses, and the comparison involved standard staffing and support conditions.

Methods: A systematic literature review was conducted following PRISMA 2020 guidelines. Studies published between 2015 and 2026 were identified using PubMed, CINAHL, Scopus, and PsycINFO databases. Inclusion criteria required quantitative studies examining staffing or organizational support interventions among registered nurses in …

“Kuchoka”: Investigation Of Research Fatigue In Mosoriot, Kenya, Felishana Cherop, Violet Naanyu, Juddy Wachira, Lukoye Atwoli

Internal Medicine, East Africa

Background: Health research is key to the promotion of population and community health, however, conducting many research studies in a community can cause research fatigue.

Purpose: We determined the prevalence of research fatigue and associated factors in Mosoriot, Kenya.

Methods: We conducted a cross-sectional study in the Mosoriot community from Wednesday 28, May 2014, to Thursday 30, April 2015, involving (n = 327) community members who were randomly sampled to respond to self-administered and/or guided questionnaires. We analyzed descriptive statistics to summarise the data and used the Pearson Chi-Square test to assess the bivariate associations between the …

The Psychiatric Burden Of Hidradenitis Suppurativa: A Trinetx Analysis Of Sex-Specific Disparities In Mental Health And Medication Use, Emily Sheetz, Julia Feord, Collette Sholi, Parker Adams, Tamas Gal, Susan G. Kornstein, Arturo Saavedra

Department of Medicine Faculty Publications

Background:

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition associated with physical and psychological burden. Prior research has shown increased rates of depression and anxiety among individuals with HS; however, sex-based disparities in the prevalence of these mental health conditions in patients with HS remain underexplored.

Objective:

To evaluate sex-based differences in the prevalence of major depressive disorder (MDD), generalized anxiety disorder (GAD), and the prescribing of antidepressants and anxiolytics among patients with HS.

Methods:

Using the TriNetX database, we identified patients over the age of 18 who had a recorded diagnosis of HS. Propensity score matching based on …

Examining The Physiological Stress-Reducing Effects Of Virtual Nature Exposure And Slow Breathing, Jesse Benefiel

Cal Poly Humboldt theses and projects

In a time of excess stress, it is essential to examine accessible stress-reduction methods. Research has demonstrated that virtual nature exposure and slow breathing can independently reduce stress, but the literature is lacking with regard to their combined effects. The present study aimed to replicate independent effects of breathing and nature on stress and to test for potential effects, including whether their combination would produce an interaction effect. Using a 2 Environment (Natural v. Control) by 2 Breathing (Slow v. Normal) between-subjects design, 63 participants completed a modified color-word Stroop task to induce stress and were then exposed to either …

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 …

Anchoring Roots And Spreading Branches: The Growth And Regulation Of Art Therapy In Singapore, Christine Phang

Art Therapy | Doctoral Dissertations

The development of art therapy in Singapore has advanced rapidly over the last two decades. Yet, to date, there has not been a comprehensive overview of art therapy in Singapore. Additionally, more research is needed to understand how the complex component of regulation can benefit the profession of art therapy. This study therefore set out to paint a picture of art therapy in Singapore, capture the art therapy community’s thoughts and opinions concerning regulation, and identify actionable ways to advance the profession. A mixed method design was employed which utilized a survey and interviews to gather quantitative, qualitative, and arts-informed …

Creativity In A Flash: Exploring The Perceived Therapeutic Effects Of Combining Creative Arts Therapies And Flash Technique, Celia J. Gagnon

Art Therapy | Doctoral Dissertations

Since the onset of the COVID-19 pandemic, research has revealed a significant strain on mental healthcare systems and healthcare professionals. Concurrently, there has been a rapid escalation in the prevalence of anxiety, depression, loneliness, and adolescent suicide rates, all of which have reached critical levels (World Health Organization, 2025; World Health Organization, 2022; Institute for Health Metrics and Evaluation, 2025; American Psychiatric Association, 2024). Post-pandemic, these statistics continue to rise across all nations and socioeconomic groups (WHO, 2025). Consequently, there is an urgent need to intensify research that supports the enhancement of mental health services globally (Institute for Health Metrics …

Enhancing Self-Acceptance And Reducing Anxiety Through Tree Ring Self-Portraits In Art Therapy: A Mixed-Methods Study, Stacey Kamp

Art Therapy | Doctoral Dissertations

This mixed-methods dissertation examined the therapeutic potential of the Tree Ring Self-Portrait, a novel art therapy intervention designed to enhance self-acceptance and reduce anxiety through symbol-based, life-phase self-portraiture grounded in narrative meaning-making and image-based processing (White & Epston, 1990; Moon, 2010; Hinz, 2020). Adults who self-identified with anxiety-related concerns were recruited through community and clinical referral sources and completed a standardized three-session intervention involving reflective mapping of life phases, a watercolor-based concentric-ring self-portrait process, and a guided review of the completed artwork with semi-structured interviews. The final sample (n = 20; ages 22–74) included participants with varied engagement in psychotherapy …

“Why Can’T I Do My Homework Without Crying?” Neurodivergence And The Gendered Expectations Of Functioning, Alia Wang

Pitzer Senior Theses

The purpose of this qualitative interview study was to examine the experiences of neurodivergent women and gender-diverse individuals regarding productivity. Neurodivergence is often understood in biological and medical terms; far less attention has been given to how neurodivergent individuals experience and navigate everyday life. Meanwhile, productivity is often framed as a neutral measure of efficiency, but in practice, it is shaped by social norms that shape particular ways of thinking, working, and behaving.

Particularly for women and gender diverse people, these expectations are compounded not only by cognitive differences but also by gendered norms around behavior. This creates a mismatch …

Enhancing Nursing Education To Improve Care For Women Experiencing A Substance Use Disorder During Pregnancy, Sadie Caddell

Honors Theses and Capstones

Introduction: Nursing education prepares students to care for patient populations by enhancing knowledge of clinical pathophysiology and applying foundational nursing skills to tailor to the unique care requirements of each patient. When analyzing the nursing course curriculums as guides for what is included in nursing education, it is essential to consider relevant patient populations to ensure adequate representation in lectures. Inclusivity of relevant patient populations within curriculums equips students to encounter a variety of patients in a clinical setting. Perinatal substance use has prevalence in the local community of this university, with 6% of all births in New Hampshire in …

Stress And Reward Interactions In Substance Use Disorder: An Evolutionary Mismatch Framework, Nicholas L. Castrucci

Honors Theses and Capstones

Substance use disorder (SUD) is a major public health concern characterized by compulsive substance use despite adverse consequences. While contemporary models emphasize biological, psychological, and environmental contributors, stress- and reward-related systems are often examined in isolation. This review integrates these systems within an evolutionary mismatch framework to examine how chronic stress exposure and repeated substance use increase vulnerability to addiction. Stress and reward systems are evolutionarily conserved but may become chronically dysregulated under modern conditions characterized by persistent psychosocial stressors and highly potent rewarding stimuli. This is associated with converging neuroadaptations across stress and reward circuitry, resulting in altered affective …

Feeding Missoula: Food Insecurity In Rural Children And Youth, Chani Brammer, Braelee Cheeks, Jordin Holland, Rayne Mccollough, Laurel Palmer, Therese Solomon

Undergraduate Theses, Professional Papers, and Capstone Artifacts

In Montana, approximately one in seven children live in a food-insecure household, with rural Montanans in particular facing significant barriers. Existing needs-based food assistance programs, such as SNAP and WIC, have structural weaknesses: SNAP benefits are often not sufficient to last through the month, and those eligible for these programs face a confusing application process, shame and stigma, and logistical hurdles, such as limited transportation.

“Feeding Missoula” began with an evaluation of how current food assistance programs met or failed to meet the needs of rural youth. Our methodology integrated a comprehensive review of existing literature and structured interviews with …

Nicotine Self-Administration And The Impacts On Medial Habenula And Interpeduncular Nucleus Neurophysiology, Nathan Alexander Olszewski

Theses, Dissertations and Capstones

Nicotine use is a tremendous public health issue in the United States, with over 23 million people being dependent on the substance. Low cessation rates associated with nicotine use are largely attributed to the withdrawal and craving symptoms that occur after abstinence of use from nicotine. The medial habenula (MHb) and interpeduncular nucleus (IPN) are two brain regions heavily associated and linked with nicotine withdrawal. Here, I sought to understand how these brain regions are altered in their physiology during nicotine intake. Utilizing E-Vape self-administration, mice were first taught to selfadminister nicotine of various, clinically relevant, dosages which correlate to …

Collaboration In Acute Care: Enhancing Occupational Therapy Outcomes Through Canine Therapy Integration​, Deanna Hamke

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

The utilization of animal-assisted therapy has the potential to increase patient participation, motivation, and help simulate real-life experiences to promote a successful discharge from therapy services. The purpose of this doctoral capstone project was to: 1) expand collaboration between occupational therapists & canine therapy handlers through use of a communication platform and 2) to create a resource outlining in-session responsibilities to facilitate partnership between occupational therapists and canine therapy handlers. Occupational therapy treatment sessions were completed using canine therapy interventions targeting mobility, engagement, and emotional regulation. The final deliverables included multiple educational resources and a platform for communication. These deliverables …

Investigating The Relationship Between Drug Overdose Deaths, Excessive Alcohol Drinking, And Adult Smoking In Urban And Rural Ohio Counties In 2025, Sumin Byoun, Anne Griffin

Scholarship in Medicine - All Papers

Deaths from drug overdoses have been increasing each year. Ohio ranks among states with the highest number of drug overdose deaths per year. There is a gap in the literature regarding discussions of how excessive alcohol drinking and cigarette smoking rates may predict drug overdose death rates in a community. First, this study investigates differences in excessive drinking, adult smoking, and drug overdose deaths between urban and rural counties in Ohio. Second, this study explores whether excessive drinking and smoking behaviors can predict drug overdose death rates in urban and rural Ohio counties. Data exclusive to Ohio counties was obtained …

Bringing Awareness And Education To Rural Areas About The Role Occupational Therapy (Ot) Has In Infant Care, Makenzi Richwald

Occupational Therapy Doctorate Capstone Posters

This capstone project focused on education and advocacy. The aim of my capstone project was to provide education to parents of eastern Kentucky (KY) about what Occupational Therapy (OT) can address with infants aged 0-18 months. I saw a gap in knowledge in the eastern KY community about what OT could do for infants and wanted to address this. Through my research, consultation with my mentors, and collaboration with the occupational therapists at my site (BPT) I discerned 14 areas of development and/or common reasons of needed referral for OT services by this age group. These educational materials aimed to …

The Restorative Effects Of Virtual Reality Nature Simulations: An Empirical Investigation, Isabel T. Folger, Yichen Zhang, Kenneth B. Abrams

Psychology Faculty Work

Although extensive research demonstrates that nature films can facilitate recovery from stress and cognitive overload, it remains unclear whether more immersive media, such as virtual reality (VR), are more effective than similar two-dimensional films. The present study examined the effects of immersiveness on affective, cognitive, and physiological restoration. Three levels of immersiveness for film viewing were employed: 2D (computer monitor), standard VR (visual and auditory input), and enhanced VR (standard VR plus olfactory and haptic input). All participants were exposed to parallel versions of a six-minute nature film. We hypothesized that greater immersiveness would produce stronger restorative effects. All versions …

Cocaine Upregulates Microglial Lipid Droplet Formation Through Increasing Lipid Synthesis Activity In Vitro And In Vivo, Yan Cheng, Brooke Russell, Liam Liyang Guo, Aryan Patel, Yan Y. Sanders, Ming-Lei Guo

Department of Biomedical and Translational Sciences Faculty Publications

A novel subtype of microglia, lipid droplet accumulation microglia (LDAMs), has been identified in the aged brain, which is characterized by sustained inflammation and senescent-like phenotypes. LDAMs are deeply involved in promoting brain aging as well as the pathogenesis of multiple neurodegenerative diseases. Cocaine can alter brain lipidomic profiles, induce microglial activation, and accelerate brain aging. This suggests that cocaine might affect microglial lipid metabolism, which ultimately aggravates aging-related neurological disorders in people with addictions. In this study, we explored the effects of cocaine on microglial lipid metabolism. Our results showed that chronic cocaine administration altered brain lipid profiles and …

Hepatitis C Virus Transmission Among People Who Inject Drugs In Rural United States: Mathematical Modeling Study Using Stochastic Agent-Based Network Simulation, Lin Zhu, Jennifer R. Havens, Abby E. Rudolph, April M. Young, Golnaz Eftekhari Yazdi, William W. Thompson, Liesl M. Hagan, Liisa M. Randall, Jianing Wang, Rebecca Earnest, Shayla Nolen, Benjamin P. Linas, Joshua A. Salomon

Center on Drug and Alcohol Research Faculty Publications

People who inject drugs (PWID) account for the majority of hepatitis C virus (HCV) infections in the United States. The injection-equipment-sharing network likely plays an important role in shaping the dynamics of HCV transmission. Recognizing the emerging HCV epidemic in rural communities, we developed an agent-based network simulation model of HCV transmission via injection equipment sharing and used data on rural PWID networks to inform model parameterization and calibration. We then simulated an array of networks that varied key network properties to understand their impact on the magnitude and distribution of HCV incidence. The results show substantial heterogeneity in HCV …

Alcohol Awareness, Prevention, And Education In Greek Life, Vivian J. Mcmechen, Kara Ann Lasater, Page Dobbs

2026 Honors Symposium

Background: Alcohol consumption is normalized in Greek Life culture, and this social standard can lead to risky health behaviors and overconsumption. At the University of Arkansas, approximately one-third of students are members of Greek Life; there is a need for prevention methods that understand students’ lived experiences. Purpose: The purpose of this study is to examine students’ experiences with alcohol prevention, awareness, and education as current members of Greek Life at the University of Arkansas. Through student interviews and surveys, this project aims to inform and provide recommendations for relatable and student-centered alcohol prevention and education efforts. Methodology: This study …

From Mandate To Meaning: Designing Implementation Supports For Organizational Readiness In Behavioral Health Service Planning, Lauren K. Mergen

Theses and Dissertations--Education Sciences

Behavioral health agencies often struggle to translate the Transformational Collaborative Outcomes Management (TCOM) framework into practice when implementation is externally mandated. This study examined how educational leaders can support meaningful use of TCOM tools under a Midwestern state’s October 2024 requirement that behavioral health providers use the state Child and Adolescent Needs and Strengths assessment in service planning.

Using a Mixed Methods Action Research design, the study progressed through six phases: Diagnosis, Reconnaissance, Planning, Acting, Evaluation, and Monitoring. The Diagnosis Phase identified a knowledge-to-practice gap and weaknesses in implementation support infrastructure. Practitioner surveys administered immediately after training and six months …

The Caregiving Experience: Comparing Stress And Quality Of Life Among Caregivers Of Children With And Without Autism Spectrum Disorder, Mona Khayal

Antioch University Dissertations & Theses

This comparative cross-sectional study investigated caregiving burden, quality of life, and anxiety among primary caregivers of children with autism spectrum disorder compared to caregivers of typically developing children. Using Bronfenbrenner’s Ecological Systems Theory, 66 caregivers (31 autism, 35 comparison) of children aged 6-18 completed the Zarit Burden Interview-12, WHO Quality of Life-BREF, and GAD-7. According to the results, autism caregivers reported substantially higher burden (M = 31.26 vs. 13.23, d = 2.42) and anxiety (M = 9.13 vs. 4.63, d = 1.04), with 90% exceeding clinical burden thresholds compared to 26% of comparison caregivers. Quality of life was lower across …

Understanding The Underutilization Of The Campus Recreation Facility: A Mixed-Methods Examination Of Basic Psychological Need Satisfaction, Social Physique Anxiety, Sense Of Community, And Physical Environment Barriers, Caden M. Pfingsten

Master's Theses or Doctor of Nursing Practice

Campus recreation facilities have been identified as important contributors to student well-being, academic persistence, and institutional belonging. Despite these documented benefits, a persistent gap exists between available services and actual student utilization at many institutions. This study examined the psychological, social, and environmental factors associated with students' underutilization of the Campus Recreation Facility (CRF) at a mid-sized Midwestern public university in favor of paid off-campus commercial gym memberships.

Using a cross-sectional survey design, 169 students completed a battery of validated and researcher-adapted instruments assessing basic psychological need satisfaction (autonomy, competence, and relatedness), Sense of Community, and social physique anxiety across …