Psychiatric and Mental Health Commons^™

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 …

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 …

Clinical Correlates And Predictors Of Suicide Attempt Severity In Elderly Patients: A Cross-Sectional Study From South India, Rajamani Siddamallappa, Kiran Kumar Kadarappa Dr, Megha C N

Digital Journal of Clinical Medicine

Background: Suicide in late life is a major yet under-recognized public health problem in low- and middle-income countries. Elderly suicidal behaviour reflects interactions between psychiatric morbidity, substance use, psychological distress, intent, and method selection. Indian data examining these factors comprehensively remain limited.

Objectives: To assess psychiatric morbidity, hopelessness, suicide intent, planning patterns, methods, and independent predictors of suicide attempt severity among elderly suicide attempters.

Methods: This cross-sectional study included 75 elderly individuals (≥60 years) admitted following a suicide attempt to a tertiary care hospital in South India. Depression severity, hopelessness, and suicide intent were assessed using Beck’s Depression Inventory-21 (BDI-21), …

Family Mental Health – A Case Report, Vikrant Arora, Medha Kosireddy, Mathumitha Ananth, Kishor M. Manohar Rao

Digital Journal of Clinical Medicine

Psychiatric illness in India is estimated to be 15% as per National Mental Health Survey 2015-16.  Mental health challenges within families, especially depression, anxiety disorders that are not common and when unaddressed exert cascading effects on all members, disrupting emotional cohesion, relational functioning, and socioeconomic stability. There are few case reports on entire family presenting to psychiatry department.

With informed consent a city-based middle-class family of non-consanguineous origin, where the 40-year-old female, presented with intractable limb pains and health anxiety, she had multiple consultation in last few months and her 48-year-old husband also had with episodic pains, irritability and her …

Exploring The Impact Of Inpatient Mental Health Care On Adolescents, Alexandria M. Mckahan

2025 Fall Honors Capstones Projects - Archive

Adolescent psychiatric hospitalizations continue to rise, yet there is limited research on which daily practices inside inpatient units genuinely support engagement and recovery. This project examined how structure, staff tone, and therapeutic programming influence adolescents’ participation and emotional stability within a real inpatient setting. The study focused on three questions: how structured routines affect recovery, what challenges staff face when supporting adolescents with complex needs, and how adolescents’ engagement patterns reflect their perception of care. Using a mixed-methods case study at Mesa Springs Behavioral Health Hospital, I conducted approximately twenty field observations, semi-structured staff interviews, and descriptive engagement tracking across …

Stigma And Barriers To Seeking Mental Health Care Among Emergency Department Providers – A Mixed Methods Study, Shannon C. White, Charlotte H. Harris, Ravindra Gopaul, Joshua M. Smyth

Student Papers, Posters & Projects

High levels of psychological distress and depression are common among clinicians working in US emergency departments [ED], yet treatment-seeking remains rare, contributing to burnout and negative well-being. Reluctance to seek care often reflects concerns about negative consequences (e.g., stigma, negative professional impact). We sought to characterize the availability of mental health resource availability, beliefs about seeking care, and barriers faced by emergency department healthcare providers. A sequential mixed-method design was employed. Phase 1 included a survey of ED physicians, advanced practice providers (APPs; i.e., nurse practitioners and physician assistants) and medical residents at an academic medical center. The survey assessed …

Incorporating Behavioral Health Strategies In Primary Care To Improve Outcomes Of Depressed Patients, Amy L. Brummett

Student Scholarly Projects

Practice Problem: Depression, otherwise known as major depressive disorder, is a mood disorder characterized by persistent feelings of sadness, loss of interest, sleep disturbances, changes to weight (both gain and loss), difficulty concentrating, and in extreme cases, suicidal thoughts, and/or attempts (Mayo Clinic, 2022). An estimated 8.3% or 21.0 million adults in the United States have experienced at least one episode of depression. Primary care clinicians are often the first to recognize the symptoms of depression. Depression was very prevalent in the clinic where this DNP Scholarly project took place. The owner/nurse practitioner found that she was increasingly treating depressed …

The Progression Of Deinstitutionalization And Its Effects On The American South: A Judicial Analysis Of 20th-Century United States Supreme Court Decisions, Eva-Marie V. Jones

Honors College Theses

This thesis explores the effects of four landmark Supreme Court cases on the deinstitutionalization movement in the American south. Previous literature frequently discusses the legislative implications of this era; however, no law is applicable without the interpretation and application of the judiciary, which so often contextualizes the greater public perspective. Rarely has an analysis of judicial decisions involving psychiatric care merged with regional focus, and certainly not in a format accessible to the average individual.

From unmarked graves to abandoned infrastructure, the legacy of historic psychiatric care in the United States has been largely obscured – yet its consequences continue …

Art Therapy In Social Work Practice, Laura Gebur

Journal of Undergraduate Research at Minnesota State University, Mankato

Art therapy is an emerging practice among mental health professionals looking for new ways to engage with their clients and encourage nonverbal communication. Creativity is a means of processing memories, improving relationships, and strengthening the mind-body connection across a variety of age groups and practice settings. The efficacy of art therapy has led to its integration into social work practice, benefitting a diverse range of client populations within the field. While a lack of macro-level research studies has prevented the implementation of standardized art therapy techniques in social work, clinical research trials have examined art therapy across several areas of …

Probiotic Intervention In Managing Chronic Stress, Bianca Opdenbosch

PANDION: The Osprey Journal of Research and Ideas

Chronic stress can induce gut dysbiosis which contributes to the dysregulation of the gut-brain axis and leads to anxiety and depressive-like symptoms. The gut-brain axis relies on nervous, immune, and endocrine interactions. Gut dysbiosis, an imbalance within the gut microbiome, disrupts gut-brain communication, impairing gut barrier integrity, inflammation regulation, and hormonal and neurotransmitter production. These gut changes contribute to mood disorders resulting from stress, and thus it is important to implement dietary interventions, like probiotics, to help mitigate these effects. Research highlights the potential of probiotics to act as an intervention to combat stress-induced gut dysbiosis and replenish beneficial bacteria …

Hungry Minds: Analyzing The Impact Of Food Insecurity And Food Assistance Programs On Neurocognitive Development And Childhood Mental Health, Kayla A. Davenport

Senior Theses

Introduction: Food insecurity affects millions of children in the United States and is increasingly recognized as a significant risk factor for poor nutritional intake and adverse health outcomes. However, less is known about how the experience of food insecurity disrupts healthy development and well-being, particularly among American youth. This thesis had two aims: (1) to examine the relationship between household food insecurity and children’s neurocognitive and mental health outcomes and (2) to evaluate how major food assistance programs address, or fail to address, these developmental risks.

Methods: This thesis uses a mixed-methods approach, integrating a narrative literature review, a cross-sectional …

Faktor-Faktor Yang Berhubungan Dengan Gejala Depresi Pada Pasien Insomnia Usia Lanjut Di Rawat Jalan, Amalia Nur Pratiwi, Edy Rizal Wahyudi, Profitasari Kusumaningrum, Hamzah Shatri, Ikhwan Rinaldi, Rino Alvani Gani, Ika Prasetya Wijaya, Adityo Susilo, Kaka Renaldi

Jurnal Penyakit Dalam Indonesia

Introduction. The elderly population is increasing globally, including in Indonesia, where 10.7% of the population in 2020 were elderly. Insomnia is a common health issue among older adults and has been identified as a predictor of depression. This study aims to identify factors associated with depressive symptoms in elderly outpatients with insomnia.

Methods. This cross-sectional study was conducted in 2024 on patients aged ≥60 years at the outpatient unit of Cipto Mangunkusumo Hospital (RSCM), Jakarta, Indonesia, using consecutive sampling to select participants. Elderly patients were screened using the Pittsburgh sleep quality index (PSQI), and those with a score …

Psychiatric Associations With Barriers To Use Of Mental Health Services In Medical Students, E. Cadence Rarity, Nora Newcomb, Aishwarya Vuppala, Jade Brunicardi, Kim Van, Amelia C. Phillips

Journal of Wellness

Introduction: Medical students experience stress, anxiety, and depression at rates greater than those of the general population. Medical students also underutilize mental health services. There exists a need for a comprehensive, multivariate analysis of the reasons medical students do not pursue mental health services, and the undesirable mental health outcomes that are associated with these barriers. This study associates psychiatric phenomena of stress, anxiety, and depression within the context of barriers to use of mental health services in medical students.

Methods: In this cross-sectional study, medical students (N = 128) from the University of South Florida engaged with …

A Clinical Pathway For Differential Diagnosis Of Adhd Vs Trauma: Early Childhood Recognition And Intervention, Maria Neiers

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Distinguishing Attention-Deficit/Hyperactivity Disorder (ADHD) from Complex Posttraumatic Stress Disorder (C-PTSD) presents significant diagnostic challenges due to overlapping symptom presentations, shared neurobiological impacts, and frequent comorbidities. This paper explores the nuanced clinical differentiation between ADHD and C-PTSD, and other trauma disorders, in pediatric populations, emphasizing the importance of trauma-informed assessment, early identification, and integrative clinical reasoning. The discussion highlights how structured diagnostic reasoning can reduce uncertainty, enhance diagnostic clarity, and support effective treatment planning. As a central contribution, this paper introduces an original clinical reasoning flowchart and a case conceptualization to illustrate its practical application in real-world diagnostic dilemmas. The need …

Reimagining The Counseling Profession: Preparing Counselors For Ai And Digital Health Integration, Carl J. Sheperis, Dusti L. Annan-Coultas, Caronne C. C. Rush

Journal of Counselor Preparation and Supervision

Digital health technologies including artificial intelligence (AI) are transforming mental healthcare delivery, creating new opportunities and challenges for counseling practice. This article examines digital health applications in counseling, including telehealth, mobile apps, digital therapeutics, virtual reality, and AI-powered tools. We explore key implications for practice, including enhanced accessibility, impacts on therapeutic relationships, and ethical considerations. The article presents a six-domain competency framework covering privacy and security, technical proficiency, ethical literacy, clinical integration, therapeutic adaptability, and administrative management. A case study illustrates the practical application of hybrid digital care, while a discussion of counselor education highlights the need for curriculum updates. …

A Religious Etiology Of Genito-Pelvic Pain And Pain With Penetration, Emily L. Carlson

Theses and Graduate Projects

Pelvic pain during penetration (PPDP) has been described using various diagnostic terms, including vaginismus, dyspareunia, and vulvodynia. The most recent and comprehensive classification is Genito-pelvic pain/penetration disorder (GPPPD) which is characterized by psychological distress associated with pain during or in anticipation of vaginal penetration (DSM-5-TR; American Psychiatric Association [APA], 2022). The etiology of PPDP is multifactorial, involving a complex interplay of biological, psychological, and relational factors. Religious and cultural influences may play a significant role in shaping individuals’ experiences of sexual pain. This study investigated the etiology of PPDP in relation to the religious influences among women raised in Judeo-Christian …

Cognitive Impairment In Adult Attention Deficit Hyperactivity Disorder: Clinical Implications And Novel Treatment Strategies, Alexis J. Vega, Gabriel V. Hernandez, Ahmed I. Anwar, Bahareh Sharafi, Rahib K. Islam, Sahar Shekoohi, Alan D. Kaye

School of Medicine Faculty Publications

Attention Deficit Hyperactivity Disorder (ADHD) is a lifelong condition; however, traditional treatment focuses on hyperactivity and inattention, which is largely a manifestation of pediatric ADHD. Studies are limited regarding cognitive difficulties, as seen in adult ADHD, as well as treatment strategies for this population. This review of the literature examines multiple recent studies that discuss various novel treatment strategies for cognitive impairment in adults with ADHD. A targeted literature review was conducted using PubMed to identify recent studies on cognitive dysfunction in adults with ADHD, with an emphasis on emerging treatment strategies. Data collected included sample size, intervention strategies, cognitive …

Ketamine As A Novel Treatment For Bipolar Disorder: Efficacy, Safety, And Future Directions, Sophia M. Valerino

Advances in Clinical Medical Research and Healthcare Delivery

Bipolar disorder is a complex mood disorder characterized by alternating episodes of depression and mania/hypomania, affecting approximately seven million people in the United States. Current pharmacological treatments include lithium, anticonvulsants, and second-generation antipsychotics, but these medications are often associated with significant side effects and poor adherence. Ketamine, a noncompetitive NMDA antagonist, has recently gained attention as a potential treatment for bipolar disorder due to its rapid antidepressant effects, particularly in treatment-resistant mood disorders. This article examines the therapeutic potential of ketamine for bipolar disorder, focusing on its mechanism of action and efficacy. Clinical studies have shown promising results, with ketamine …

Neutrophil-To-Lymphocyte, Monocyte-To-Lymphocyte, And Platelet-To-Lymphocyte Ratio In Acute Hospitalized Patients With Schizophrenia, Apichan Dangrungroj, Mayteewat Chiddaycha

Chulalongkorn Medical Journal

Background: Schizophrenia has been increasingly linked to inflammation. The neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) have emerged as potential indicators of systemic inflammation.

Objectives: The objectives are to compare NLR, MLR, and PLR between patients with schizophrenia and healthy controls, and to investigate the factors associated with NLR. Methods: This retrospective study included 102 sex- and age-matched patients hospitalized with schizophrenia and control subjects. NLR, MLR, and PLR were calculated from the Complete Blood Count (CBC) results and compared between groups. Sociodemographic data and clinical characteristics were analyzed using multiple linear regression to identify …

Improving Anxiety Screening In Active-Duty Military: Policy Recommendation For Implementing Ham-A Alongside Gad-7, Alex Judkins

Student Scholarly Projects

Practice Problem: Military personnel appear to be at increased risk for mood and stress-related conditions, such as anxiety and depression. These are frequently associated with traumatic brain injury (TBI), yet existing policies and practices may not fully capture this symptom complexity.

PICOT: For healthcare policymakers and providers (P), how does a policy review and recommendation for implementing the HAM-A screening tool for anxiety (I), compared to continued reliance on GAD-7 (C), impact the early identification and policy alignment for somatic and psychic anxiety management among active-duty military personnel (O)?

Evidence: Investigating psychological illnesses and their physiological manifestations in isolation fails …

Delusional Parasitosis With Depression, Hypertension And Migraine, Mouli Mandal, M Kishor, Mr Murali

Digital Journal of Clinical Medicine

Delusional Parasitosis (DP) , also known as Ekbom Syndrome, is a psychiatric disorder characterised by the unshakeable belief of infestation by parasites, insects or other organisms, despite the absence of objective medical evidence.
This case report presents a 49 year old female with a history of chronic headaches, progressively worsening insect crawling sensations. She was initiated on treatment and supportive psychotherapy.
This case highlights the importance of a thorough multidisciplinary approach in managing Delusional Parasitosis, emphasising the need to differentiate between primary and secondary forms, address the potential medical and psychiatric comorbidities, and implement appropriate pharmacological and psychotherapeutic interventions.

Use Of Naltrexone For Treating Binge Eating And Food Obsession Related To Trauma: A Case Report And Literature Review, Rebecca K. Hicks, Iram Kingson, Jordan Gaal, Suzanne Holroyd

Marshall Journal of Medicine

Impulse-control disorders, including those related to eating behaviors, are complex conditions with limited pharmacologic treatment options. While naltrexone is primarily used for opioid and alcohol dependence, emerging research suggests it may also be effective in managing a variety of impulse-driven conditions. As a pure opioid antagonist, naltrexone’s mechanism of action involves the inhibition of opioid receptors on dopaminergic neurons involved in the reward pathway of the brain, thereby reducing the reinforcing effects of substances such as alcohol and opioids. Research suggests that through this mechanism of action, naltrexone shows promise in treating impulsive behaviors also driven by the reward pathway, …

A Program Evaluation: Insomnia In Adults With Major Depression Disorder With Cognitive Behavioral Therapy For Insomnia (Cbt-I), Taylor E. Wilson

Dissertations

Abstract

Problem: In 2023, Compass Health Network (CHN) data analysts found that 91% of CHN patients in the United States who have died by suicide reported problems with sleep, which was the highest risk factor for suicide. The objective of this program evaluation project is to evaluate CHN CBT-I effectiveness on patients ‘suicidality by improving their insomnia.

Methods: CHN quality improvement (QI) project used a quantitative method pre/post score design. Quantitative aggregate data was collected on the participants who met the inclusion criteria via retrospective and prospective chart review prior to CHN implementing the intervention. CBT-I clinicians collected PHQ-9, Columbia-Suicide …

Depressive Disorders, Bad Mental Health Days, And Diabetes Management Behaviors Among Non-Hispanic American Indian/Alaska Native Adults: Findings From The Behavioral Risk Factor Surveillance System, Kaipeng Wang, Luohua Jiang, Jie Zhu, Spero M. Manson

Graduate School of Social Work: Faculty Scholarship

Objective

This study examined the association between diagnosis of depressive disorder, the number of bad mental health days per month, and diabetes management behaviors among American Indian/Alaska Native (AI/AN) adults with diabetes.

Research design and methods

Data were drawn from the Behavioral Risk Factor Surveillance System (2018–2021), including 2,272 self-identified non-Hispanic AI/AN adults diagnosed with non-gestational diabetes. Key variables included a self-reported prior diagnosis of depressive disorder and the number of bad mental health days in the past month. Outcome variables were seven diabetes management behaviors, such as taking a diabetes management class and performing daily foot checks. Statistical analyses …

A Systematic Review Of Flotation-Restricted Environmental Stimulation Therapy (Rest), Elnaz Lashgari, Emma Chen, Jackson Gregory, Uri Maoz

Psychology Faculty Articles and Research

Background

Restricted Environmental Stimulation Therapy (REST) is a therapeutic technique that involves immersing an individual in an environment with minimal sensory input or stimulation. The goal of REST is to induce a state of relaxation that is deeper than what can be achieved through other forms of relaxation techniques. Research suggests that REST can help reduce anxiety, alleviate chronic pain, improve sleep, and enhance creativity and cognitive function. Flotation-REST is a popular type of REST that utilizes an enclosed tank filled with buoyant saltwater to facilitate relaxation. This study aimed to synthesize the evidence on studies that investigate the effects …

Evaluating The Predictive Value Of Basc-3 Anxiety Scale And Working Memory Index Scores For Clinically Significant Test Anxiety: A Comprehensive Analysis Of Non-Classifiable Cases, Des'tiana S. Williams

Electronic Theses and Dissertations

This dissertation will explore how test anxiety (TA) affects working memory (WM) and whether certain factors can help predict higher levels of test anxiety. Anxiety has been defined as a common experience that can show up in various forms—like general worry, social fears, panic attacks, and specific phobias (APA, 2022). It was described as often triggering our natural “fight-or-flight” response, which can impact our ability to focus, think clearly, and remember things. For students, test anxiety has been especially challenging, affecting how they perform in high-stakes academic settings. Using data from a university based psychological assessment center, this study will …

Binge Eating Disorder: A Clinical Review, Michell Mcdiffett Mshs, Pa-C

Lynchburg Journal of Medical Science

Binge eating disorder (BED) is the most common eating disorder (ED) in the United States (U.S.) and is characterized by recurrent episodes of eating a larger than normal amount of food in a discrete period of time and includes a sense of loss of control over food intake. BED is often comorbid with serious somatic and psychiatric disorders and is associated with reduced quality of life and excess mortality. Some consider BED a public health concern due to frequent co-occurrence with obesity and worse outcomes in those populations. The diagnosis is often delayed due to shame and underreporting of symptoms …

Overcoming Barriers To Connection Between People With Schizophrenia And Their Caregivers, Sarah G. Fernandez

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

The purpose of this doctoral project is to bring together existing literature on relational barriers between patients and caregivers, and strategies for overcoming them, for one reason: to help clinicians facilitate connection within families and households where one person has schizophrenia. It is therefore comprised of two parts: this paper containing a three-part literature review on barriers to connection including social skill deficits characteristic of the disease of schizophrenia, environmental factors, and caregiver burden and expressed emotion within families, as well as protective factors and strategies for overcoming them. The second component of this project is a psychoeducational module geared …

Revising And Consolidating The Dsm-5 And Icd-11 Post-Traumatic Stress Disorders Into A Dimensional Spectrum-Based Disorder: A Literature Review, Samuel Milton Shatsky

University Honors Theses

This thesis investigates the clinical, cultural, and theoretical implications of replacing the current DSM-5 and ICD-11 categorical diagnoses of posttraumatic stress disorder (PTSD) and complex posttraumatic stress disorder (CPTSD) with a unified dimensional framework: trauma spectrum disorder (TSD). The proposed TSD model addresses ongoing concerns around diagnostic inflation, treatment misalignment, and clinical confusion stemming from binary trauma categorizations. This thesis explores whether adopting a dimensional diagnostic model to replace DSM-5 and ICD-11's current PTSD and CPTSD designations could lead to improved treatment outcomes and diagnostic clarity.

Methodology consisted of an extensive literature review of the field's current research. Using the …

Fda Approves Lecanemab-Irmb Maintenance Dosing For Early Alzheimer’S Disease Treatment, Jordyn Linfield, Giang Nguyen, Ashley Jacob, Andrew Johnson, Maria Nguyen, Sara Ha, Joshua Honaker, Samantha Mccord, Kelly Kroustos

Pharmacy and Wellness Review

Alzheimer’s disease (AD) is the most prevalent neurodegenerative disorder and is associated with progressive and irreversible cognitive decline that begins with memory lapses leading to physical and functional impairment. The conventional therapies that have been used for the treatment from Alzheimer's Disease include acetylcholinesterase inhibitors and memantine, but additional therapy options are being developed. Lecanemab, brand name Lequembi, is currently a Food and Drug Administration (FDA) approved humanized monoclonal antibody for the treatment of Alzheimer’s disease and indicated for mild cognitive impairment (MCI) or mild dementia. While there is impactful aid for treatment, lecanemab has three significant adverse reactions, which …