Mental and Social Health Commons^™

“Medical Cannabis”: Advising Patients While Navigating Medical Ethics And Limited Evidence, Anna-Maria South, Shanna L. Babalonis, Laura C. Fanucchi, Michelle R. Lofwall

Internal Medicine Faculty Publications

Cannabis is increasingly legalized in more areas of the USA and marketed under the misnomer “medical cannabis.” Yet, there are no official dosing guidelines or approved medical uses for plant cannabis by the Food and Drug Administration. Due to significant federal barriers, research on efficacy, safety, and adverse effects of cannabis is limited. Patients are interested in cannabis as potential treatment of medical issues and/or symptoms and clinicians should include a discussion of the risks of cannabis consumption. However, many risks are not yet known, and clinicians might be unaware of the emerging literature. This perspective summarizes the potential harms …

Discrimination Distress And Current Combustible And Non-Combustible Tobacco Product Use Among Us Youth, 2023, Meman Diaby, Osayande Agbonlahor, Maggie K. Richardson, Joy L. Hart, Shyanika W. Rose, Delvon T. Mattingly

Markey Cancer Center Faculty Publications

Introduction: Discrimination is the unfair treatment of people based on their identity. Youth who experience discrimination may cope with associated distress by using tobacco products, with amplified health consequences depending on the type of product.

Methods: We used data from the 2023 National Youth Tobacco Survey (n = 22 069) and derived an overall continuous measure from the 15-item Adolescent Discrimination Distress Index, as well as three continuous discrimination distress sub-indices: educational, institutional, and peer (range for each: 0–5). We defined current tobacco use as two outcomes: any past 30-day use of combustible (cigarettes, cigars, hookah, roll- your-own, pipe, bidis) …

Psilocybin-Assisted Therapy And Alcohol Use Disorder, Zoe R. Evans

Theses, Dissertations and Capstones

This current paper has studied whether the psilocybin-assisted treatment has been linked with meaningful shifts in three clinical outcomes among adults 18 years old and above diagnosed with alcohol use disorder (AUD): percentage of heavy drinking days, abstinence rates, and neural responsiveness to alcohol-related cues. A literature review following a systematic approach was performed using guidelines from PRISMA 2020 based on four databases, namely PubMed and PsycINFO, and Scopus and CINAHL, where peer-reviewed articles published between 2015 and 2026 were included. A semi-structured professional interview with a clinical researcher in the Division of Addiction Sciences of Marshall University was also …

Effectiveness Of Post-Discharge Interventions Following Psychiatric Hospitalization On Readmissions And Suicide Prevention Among Adolescents, Maria Paz Eladia Posadas

Nursing | Senior Theses

Background: Suicide is a pervasive and far-reaching issue. Psychiatric hospitalization is often used as an intervention for individuals, including adolescents, experiencing suicidal ideation and/or behavior. However, post-discharge care may lack structure or clearly defined follow-up services, which can result in rehospitalizations and increased suicidality. Objective: The goal of the proposed research study is to investigate how implementation of peer support groups for adolescents following psychiatric hospitalization can assist in reducing readmissions and mitigating suicide risk. This can also help shape strategies for managing care after discharge. Method: The proposed research study utilizes a quantitative quasi-experimental design to determine the efficacy …

Precision In Practice: Subject Matter Expert Integration To Support Excellence In Population-Specific Documentation, Sara Pump, Mary Hawes, Lauren Spain, Virginia Kasenic, Meagan Talent, Alivia Stewart, Carrin Shaw, Chad Gautreaux, Dori Cousin, Ponesea Allen, Jonathan Rowe

2026

This poster describes a quality improvement initiative that integrated psychiatric resource nurses as subject matter experts (SMEs) into clinical documentation workflows to improve documentation compliance for high-risk behavioral health patients. The intervention resulted in substantial improvements in charting accuracy and compliance, including an increase in emergency department documentation compliance from 28% to 95% over seven months, while enhancing staff education, collaboration, and patient safety.

Chatbot Therapy - Help Or Hindrance, Kadi Rae Smith

Anthós

Introduction

Generative artificial intelligence (Gen-AI) chatbots are complex computer programs designed to mimic human conversations using programming that incorporates large language models (LLM) and natural language models (NLM) to simulate human interactions that are being rapidly integrated into everyday life across an increasing amount of online platforms. This article explores the applications and efficacy of chatbots for mental healthcare, from self-directed chatbot interactions to clinician-supervised implementation of chatbot-based therapeutic tools, weighing the benefits and limitations of this ever-expanding technology.

Methodology/Taxonomy

A literature review was conducted primarily using Web of Science, accessed through Portland State University, and Google Scholar, with specifications …

Art As Medicine: Exploring The Intersection Of African Cultural Practices And Art Therapy To Examine Its Efficacy In Pain Management And Healing Among Black Women With Lupus, Kandace I. Simmons

Art Therapy | Master's Theses

This thesis examined the intersection of chronic illness and systemic inequities faced by Black women living with lupus. These women often encountered unique challenges in managing their health and well-being, exacerbated by both the physical and sociocultural implications of the disease. Through a Black Feminist/Womanist theoretical lens, this research investigated the potential of art therapy to serve as a transformative instrument for pain management and healing when infused with culturally relevant practices. Employing a narrative approach and qualitative methodology, this study explored the lived experiences of African American women with lupus, incorporating their art and personal stories to inform the …

The Use Of Visual Autobiographies In First, Second, And Third-Generation Children Of Immigrants In Navigating Belonging And Identity, Sorprisela Martinez

Art Therapy | Master's Theses

This study explored how autobiographical artmaking supports adolescents of immigrant-origin in understanding identity and sense of belonging through visual and narrative reflection on personal stories. The qualitative research approach was guided by three research questions examining: (1) the ways autobiographical work expresses complexities of immigrant heritage and multiple identities; (2) how narrative lens supports a deeper interpretation of autobiographical expressions; and (3) how adolescents’ understanding of their parents’ migration stories contributes to their own identity formation and self-presentation. Seven adolescents participated in a two-session, arts-based process that included creating autobiographical books, discussion of their images, and reflection on their cultural …

Wise Beyond Our Years: Menopause, Negative Body-Image, And Art As A Catalyst To Self-Acceptance, Nicole Lea

Art Therapy | Master's Theses

This mixed methods study examined the impact of menopause on women’s body image and self-acceptance through an arts-based group intervention. Quantitative data was collected using the Body Image Self-Compassion Scale, and qualitative data was gathered through art-making, group discussion, and individual interviews. Participants were (n=5) menopausal women aged 46-52 from the Bay Area who reported negative body image related to menopause. The intervention consisted of four one-hour open studio workshops with a fifth meeting added in which participants created altered books while engaging in peer support and discussion. Descriptive statistics indicated an increase in mean body image self-compassion scores from …

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 …

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 …

"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 …

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 …

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 …

Cohort Profile: The Resilient Minds National Study Of Mental Health And Cognitive Resilience In Community Dwelling Adults Aged 18 To 93, Kaarin J. Anstey, Brooke Brady, Lidan Zheng, Jana Koch, Md Hamidul Huque, Michelle K. Lupton, Ralph Martins, Daniel Ashworth, Erin Goddard, Nikki Anne Wilson, Claudia M. Hillenbrand, Ralf B. Loeffler, Maria Markoulli, Arun V. Krishnan, Tanya Layton, Ranmalee Eramudugolla

Research outputs 2022 to 2026

Purpose: The Resilient Minds (ReMind) cohort was established to investigate cognitive and mental health resilience across the life course, addressing a gap in longitudinal evidence about resilience. The study collected data on traditional medical and lifestyle risk factors for chronic disease, genetics, and a range of mental health and cognitive outcomes. It also aimed to explore contemporary contextual influences on resilience, including internet use, social engagement, environmental exposures, and life course adversities such as perceived discrimination. Participants: The cohort included 1,640 adults aged 18–93 years, recruited through social media and community groups, to participate in a fully remote, two-year health …

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 …

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 …

Exploring The Impact Of Group Art Therapy On Sense Of Belonging In Early Adolescents: A Mixed Methods Study, Carol Chu

Art Therapy | Master's Theses

During adolescence, peer relationships strongly influence development and emotional well-being. In addition, Adlerian theory emphasizes social interest and the importance of connectedness within the social environment. This mixed methods study explores the impact of a four-session group art therapy intervention in a middle school setting on young adolescents’ sense of belonging. Seven students in the seventh and eighth grade from a public middle school in Sacramento County participated in the study. Quantitative data were collected at two time points in the study, before and after the intervention, using the Sense of Belonging Scale (SBS). All seven participants demonstrated an increase …

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 …

Simulating Social Attitudes With Llms: Accuracy, Demographic Effects, And Refusal Behavior In The Sensitive Domain Of Suicide Prevention, Cristina J. Perez, Michael P. Vasquez Jr., Philippe J. Giabbanelli, Patrick Y. Wu

VMASC Publications

Large language models (LLMs) are increasingly used to simulate public opinion, yet their validity in sensitive policy domains remains underexplored. We evaluate whether LLMs can reproduce attitudes toward suicide prevention policies using 32 questions drawn from seven nationally representative U.S. surveys (2023-2025). We systematically vary demographic conditioning (race/ethnicity, gender, age, education, income, party), prompt framing (direct elicitation, respondent embodiment, specialist embodiment), and model architecture (GPT-5 Nano, DeepSeek V3.2, Meta Llama 3.1 8B, Mistral Small 24B). Across 811,560 prompts, the mean absolute error—the average gap between predicted and human response distributions—is 23 percentage points. We also find that LLM responses to …

Culturally Responsive Dialectical Behavior Therapy With Chinese Sexual And Gender Minority Individuals: A Qualitative Study, Weiyi Liao M.S.

Selected Full Text Dissertations, 2011-

Professional guidelines emphasize the importance of adapting evidence-based treatments to the cultural and contextual needs of minoritized populations. Although substantial research has examined lesbian, gay, bisexual, transgender, and queer (LGBTQ+) mental health, comparatively little is known about the psychotherapy experiences of Chinese sexual and gender minority individuals or how dialectical behavior therapy (DBT) may be delivered responsively with this population. DBT is an evidence-based treatment for emotion dysregulation, self-harm, and suicidal behavior that explicitly addresses the effects of invalidating environments. Because Chinese cultural contexts and LGBTQ-related minority stress may both shape emotional expression, help-seeking, and treatment experiences, this qualitative study …

[Review Of The Book The Prescription-To-Prison Pipeline: The Medicalization And Criminalization Of Pain, By M. Smirnova], Hayley Jackey

Sociology & Criminal Justice Faculty Publications

[Introduction] Smirnova’s The Prescription-to-Prison Pipeline offers a critical examination of the impacts of prescription drugs as well as the over-policing and policies created to push individuals into the carceral system rather than providing other options for assistance. Smirnova further captures the social inequalities of race and class of those encased in this pipeline. Within this understanding of the detriment that the system, medical providers, and society place on those who use substances, Smirnova’s use of interviews allows for a clear understanding of how these systems work in conjunction to uphold the pipeline.

Magnifying Mental Health In The Perinatal Population: A Systematic Review, Kasey E. Arnold, Alyssa M. Maki

Williams Honors College, Honors Research Projects

Pregnant individuals often experience significant anxiety, which can negatively affect both pregnancy and fetal outcomes. This systematic review evaluates the effectiveness of pharmacologic versus non-pharmacologic anxiety-relieving interventions, primarily focusing on the labor period. The PICOT question is: In perinatal patients, do non-pharmacologic anxiety-relieving measures, compared to pharmacologic anxiety-relieving measures, have a greater impact on ease of delivery and overall mental health during pregnancy and the perinatal period? PRISMA (2020) guidelines were used with inclusion criteria of human subjects, English language, and published within the last six years. Databases included PubMed, CINAHL, and Cochrane Library. Twenty-three studies were analyzed to examine …

The Influence Of Familial Substance Use Disorder On Perceptions And Attitudes Towards Substance Use Disorders And Participant Substance Use Behavior Among Emerging Adults, Elijah M. Lefeld, Jennifer Stanley

Williams Honors College, Honors Research Projects

This research project explores how the lived experience of having an immediate family member with a substance use disorder (SUD) influences a person’s perceptions, attitudes, and behaviors related to substance use. Rather than focusing on the individual diagnosed with SUD, the study examines the reciprocal impact on family members within the social subsystem. Using a quasi-experimental design, the project will compare participant responses using with and without a familial connection to SUD. Data will be collected through Qualtrics surveys distributed via SONA. These measures will record demographic information, personal substance use habits, attitudes toward addiction, perception of substance use disorders, …