Mental and Social Health Commons^™

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 …

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

Antioch University Dissertations & Theses

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

The Use Of Mindfulness In Empirically Supported Treatments In Psychology, Timothy Stewart

Antioch University Dissertations & Theses

After gaining popularity in the United States of America (USA) in the 1960s and 1970s, Buddhist mindfulness was introduced to clinical psychology and investigated for its potential psychological healing effects. In the years since, mindfulness has been widely used in empirically supported treatments (ESTs) in clinical psychology in the USA to treat a wide variety of psychological conditions and disorders. This dissertation examines and compares conceptualizations and implicit understandings of mindfulness in early (Theravāda) Buddhism and in ESTs in clinical psychology in the USA. Through textual narrative analysis of two Buddhist sutta and 10 clinical psychology journal articles, this study …

Maternal Child Maltreatment And Intimate Partner Violence: Effects On Perceptions Of Infant Temperment And The Mediating Role Of Emotion Regulation And Responsiveness, Jewelian N. Fairchild, G. Anne Bogat, Amy K. Nuttall, Alytia A. Levendosky, Joseph S. Lonstein, Maria Muzik

Psychology Faculty Publications

Purpose

Maternal adverse experiences, such as maltreatment in childhood and later intimate partner violence (IPV) during pregnancy, can disrupt the mother-child relationship and influence maternal perceptions of infant temperament. The present study explored how these adversities influence mothers’ views of their infants’ temperaments and examined the role of maternal emotion regulation and responsiveness to their infants as mediators of these relationships.

Methods

Using data from a longitudinal study of highly stressed, vulnerable women, 355 mothers retrospectively reported on their own childhood maltreatment, as well as their experiences of IPV and emotion regulation during pregnancy. Maternal responsiveness was coded using mother-infant …

Advancing Models Of Ptsd-Aud Comorbidity: Protocol For A Multimethod Framework Using Genetics And Ecological Momentary Assessment, Elizabeth A. Stinson, Samhita Lellapalli, Sage E. Hawn, Natalie Merrill, Lance M. Rappaport, Christina M. Sheerin, Vasiliki Michopoulos, Silviu-Alin Bacanu, Roseann E. Peterson, Abigail Powers, Ananda B. Amstadter

Psychology Faculty Publications

Background: Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD), which are moderately heritable, frequently co-occur and contribute to significant public health burdens, particularly among economically disadvantaged urban communities. There are noted sex differences in PTSD and AUD outcomes, with evidence suggesting women have heightened susceptibility to stress-related alcohol use. Preliminary PTSD-AUD ecological momentary assessment (EMA) findings support bidirectional associations across clinical outcomes. However, no studies to date have used PTSD-AUD comorbidity models as organizing frameworks to examine the temporal ordering and stability of within-person symptom dynamics underlying the maintenance or exacerbation of PTSD and AUD symptoms, including bidirectional and …

Cross-National Longitudinal Insights Into College Alcohol Beliefs And Consequences: The Role Of Food And Alcohol Disturbance, Javiera A. Hernandez Puelma, Katherine A. Berry, Luke Herchenroeder, Alison Looby, Adrian J. Bravo, Christopher C. Conway, Fermín Fernández-Calderón, James M. Henson, Lee Horgarth, Manuel I. Ibáñez, Debra Kaminer, Matthew Keough, Oleg Medvedev, Laura Mezquita, Yanina Michelini, Generós Ortet, Ricardo Pautassi, Matthew R. Pearson, Angelina Pilatti, Mark A. Prince, Jennifer P. Read, Verónica Vidal Arenas, Cross-Cultural Addictions Study Team

Psychology Faculty Publications

The present study examined the mediational role of FAD-intoxication (i.e., restricting calories to increase or quicken alcohol intoxication) in the relationship between college alcohol beliefs (CABs) and negative alcohol-related consequences. A sample of 2543 student drinkers from six countries completed the baseline survey, and 505 drinkers completed at least one follow-up. Two models examined whether frequency of FAD-intoxication mediated the relationship between CABs and alcohol-related problems, and structural invariance testing was conducted across sex and countries. FAD-intoxication was concurrently and prospectively associated with greater endorsement of alcohol-related consequences and significantly mediated the effects of CABs on alcohol-related consequences. The relationship …

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

Nursing Faculty Publications

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

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

Accessing Campus Mental Health Services In A Nigerian Southwestern University: Barriers To Academic Success, Caroline Dada

Electronic Theses and Dissertations

Mental health disorders are a significant health concern among higher education institutions in sub-Saharan Africa, including Nigeria. A substantial treatment gap exists in the Nigerian healthcare system, and this gap is further worsened by cultural and religious barriers, which reinforce stigma that discourages students from seeking professional help. This qualitative narrative inquiry explored the barriers students encountered when accessing mental health services at a university in Southwestern Nigeria, to increase service access. Qualitative semistructured interviews were conducted with seven professional mental health providers at a university counseling center between March and April 2025. Inductive thematic analysis was used to identify …

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 …

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 …

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

Antioch University Dissertations & Theses

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

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

Antioch University Dissertations & Theses

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

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 …

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

Antioch University Dissertations & Theses

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

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

Antioch University Dissertations & Theses

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

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

Antioch University Dissertations & Theses

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

A 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 …

The Lived Experience Of Tenders Of Community Grief Rituals, Margaret Y. Wilson

Antioch University Dissertations & Theses

The purpose of this research study is to gain an understanding of the lived experience of tenders of community grief rituals, and how tenders make meaning of their experiences. This study utilized photo elicitation and a reflexive thematic analysis. Participants (N = 11) provided one to three photographs that captured their experience of grief and/or tending grief rituals. The results identified 10 themes supported by subthemes: (a) Grief Tender Wisdom About the Nature of Grief, (b) Life’s Many Experiences are Sources of Grief, (c) The Multifaceted Impacts of Grief-Body, Anger, Compassion, Empathy, Resilience, Gratitude, Joy, and Love, (d) The Nuances …

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

Antioch University Dissertations & Theses

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

The Lived Experience Of Survivors Of Narcissistic Abuse, Jessica Williams

Antioch University Dissertations & Theses

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

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

Antioch University Dissertations & Theses

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

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

Antioch University Dissertations & Theses

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

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

Antioch University Dissertations & Theses

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

Cross-Domain Identity Development In Bipoc Autistic Adults: A Grounded Theory Study, Ginnylyne Mariano Guisadio

Antioch University Dissertations & Theses

Racial and autistic identity development both involve navigating stigma, seeking community, and contending with dominant frameworks that constrain authentic self-expression, yet existing research has not examined how these processes interact for individuals holding both identities. These interactions unfold within structural conditions such as diagnostic disparities, culturally specific ableism, and racialized consequences of visible autistic expression, which shape how identity development proceeds for BIPOC autistic adults. This study investigated whether and how the core identity processes of exploration and commitment proceeded for this population. Nine BIPOC autistic adults participated in written interviews analyzed through constructivist grounded theory, with identity status theory …

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 …

Improving Continuity Of Care In A Psychiatric Outpatient Clinic: A Quality Improvement Initiative., Irene Maranga

DNP Scholarly Projects

Abstract

Missed appointments, also known as ‘no-shows,’ disrupt continuity of care in psychiatric outpatient settings, leading to treatment delays, symptom exacerbation, and increased risk of hospitalization. This project was implemented at an outpatient psychiatric clinic where approximately 4 of 14 patients missed scheduled appointments daily, with no systematic follow-up protocol. A quality improvement initiative designed to re-engage patients after missed appointments through follow-up phone calls was implemented using the Plan-Do-Study-Act (PDSA) framework over two cycles from August through September 2026. Patients who missed appointments received a follow-up phone call within 24 hours. Cycle 1 included one call attempt per …

Racial Bias In Collateral Report Of Adhd Symptom Endorsement, Teresa Mejia

Electronic Theses & Dissertations (2024 - present)

Attention-Deficit/Hyperactivity Disorder (ADHD) is the most frequently diagnosed mental health condition among children in the United States. However, prevalence rates in the diagnosis and treatment of ADHD are unequal across populations. Specifically, the literature has demonstrated consistent variability in symptom endorsements and diagnosis dependent on a child’s demographic factors (i.e., race, gender, age). A diagnosis of ADHD requires that the diagnostic criteria be met in at least two aspects of a child's life, usually the school and home environments. As such, teacher reports are commonly used in the assessment of ADHD for children and adolescents. Given the challenges in obtaining …

Flourishing In Hong Kong: An Analysis Of Wellbeing-Related Outcomes In The Global Flourishing Study, Lanxi Huang, Xu, Maggie Yue Zhao, Hanchao Hou, Aaron Jarden, Tim Lomas, Brendan Case, R. Noah Padgett, Ying Chen, Richard G. Cowden, Byron R. Johnson, Tyler J. Vanderweele

Research outputs 2022 to 2026

Using population-based data from Hong Kong (N = 3,012) drawn from Wave 1 of the Global Flourishing Study, this study examines the distribution of multidimensional flourishing and explores sociodemographic variation across psychological, social, physical, and economic domains. Overall, respondents reported relatively strong happiness and life satisfaction and financial wellbeing, alongside less favourable social connectedness. Patterns of flourishing varied across age, gender, education, employment, and religious affiliation, highlighting meaningful heterogeneity within the population. Early older adults tended to show more favourable wellbeing profiles, whereas younger adults and nonreligious individuals displayed comparatively lower scores across several domains. Educational attainment and employment status …

Determining The Mental Wellbeing Of Family Day Care Educators In Australia, Theresa Rayfield, Ruth Wallace, Karen Lombardi, Eben Afrifa-Yamoah, Brennen Mills

Research outputs 2022 to 2026

Family Day Care (FDC) is an essential service supporting Australian families requiring convenient, versatile, and quality education and care for their children. FDC educators’ mental wellbeing (MWB), often overlooked, is vital to ensure optimal education and care. This study aimed to gauge Australian FDC educators’ MWB and identify factors positively or negatively affecting MWB. A cross-sectional questionnaire measuring MWB, and eight predictor variables influencing MWB, was completed by Australian FDC educators. Structural equation modelling was utilised to ascertain relationships of the predictor variables on MWB. This study established MWB was lower than population norms (N = 292) and provided a …

Student And Faculty Perspectives On Perceived Stress, Coping, And Educational Practice In A Community College Occupational Therapy Assistant Program, Kristen Morgus, Tiffany Karalis Noel, Christopher Stavisky

Journal of Occupational Therapy Education

This mixed methods study examined occupational therapy assistant (OTA) students' and faculty members' perceptions of supports and challenges influencing perceived stress, with the aim of generating actionable recommendations for OTA education. While existing literature offered information regarding stressors and coping mechanisms for occupational therapy and non-traditional students, the confluence of these two identities in this OTA student population, as well as faculty perspectives, presented an underexplored area of inquiry. Specifically, this study examined how the intersection of OTA student identity and non-traditional student status influenced perceived stress, an underrepresented focus in the existing occupational therapy education literature. Data were collected …