Psychiatric and Mental Health Commons^™

An Assessment Of Accessibility And Affordability Of Inpatient Psychiatric Care In Tennessee, Kailee Havrda

Electronic Theses and Dissertations

Introduction: Access to mental health has seen changes over the past decade, but little research and attention have been given to access to inpatient psychiatric facilities. Inpatient psychiatric care is crucial for patients experiencing mental health emergencies who need immediate access to care. Gaps in spatial accessibility, affordability, and the access and assessment process were identified due to a lack of available information in the field.

Methods: Secondary data from the Tennessee Department of Health were used to assess financial accessibility through payer source charges and patient encounters, as well as through mapping of inpatient psychiatric facilities and conducting drive …

Breaking The Cycle: From Victimization To Offending Through The Lens Of Human Services, Colette R. Penalosa

Master of Arts in Human Services

The victim-offender overlap challenges the common view that victims and offenders are separately labeled by recognizing that both groups have experienced significant childhood trauma, physical, emotional, and psychological abuse, neglect, and other adverse childhood experiences (ACEs). Current research implies these experiences can increase the risk of offending as they all influence cognitive and behavioral development while leaving criminal behavior undetermined. The purpose of this capstone is to analyze the relationship between childhood victimization and offending from a human service perspective; analyzing the pathways a victim takes on the road to offending. Research conducted will focus on exploring the victim-offender overlap, …

Integrating Matrescence Into Birth Worker Practice: A Practice Improvement Project, Kelsey B. Green

Doctor of Nursing Practice (DNP) Projects

Background: Perinatal mood and anxiety disorders (PMADs) affect 20–25% of mothers worldwide and are a leading cause of maternal complications. Stigma, fragmented care, and limited provider training leave families vulnerable, while birth workers offer trusted, continuous support.

Problem: Birth workers' maternal mental health (MMH) training is minimal and often excludes matrescence, the developmental transition to motherhood, limiting their ability to distinguish normal adjustment from clinical PMADs and delaying intervention.

Methods: A single-group, pre-/post-test design evaluated a matrescence-informed workshop at Roots Community Health's 2nd Annual Symposium. Anonymous surveys measured knowledge, attitudes, and confidence, analyzed with Mann–Whitney U, Wilcoxon signed-rank tests, and …

Loss Of Pleasure (Anhedonia): A Sex-Dependent, Cross-Species Consequence Of Unpredictable Signals To The Perinatal Brain, Anna M. Zhou, Madison R. Tetzlaff, Laura M. Glynn, Curt A. Sandman, Hal S. Stern, Tallie Z. Baram, Elysia Poggi Davis

Psychology Faculty Articles and Research

Reward seeking is an essential component of human behavior. Anhedonia (reduced motivation for and pleasure in reward) is a core feature of several mental illnesses. Early life adversity associates with later impairments in reward behaviors and related psychopathology; however, specific aspects of early adversity that lead to disrupted reward behaviors are unknown. Capitalizing on evidence that unpredictable signals to the developing brain constitute adversity and influence neurodevelopment, we examined whether exposure to perinatal unpredictable maternal signals associated with diminished reward responsivity, and probed causality using experiments in mice. We analyzed a longitudinal human study (N=158 mother/child dyads) and a …

Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef

Theses and Dissertations

Corporal punishment (CP) and severe physical punishment (SPP) remain a major public health, child rights, and child protection policy concern. In Egypt, despite legislative reforms, survey-weighted analysis of the 2021 Egypt Family Health Survey (EFHS) 2021 (CAPMAS, 2022) reveals prevalence rates of 60.5% for CP and 27.4% for SPP among children aged 1–14 (author’s calculations using EFHS-2021, n=7623), yet evidence distinguishing the determinants of routine corporal punishment from escalation to severe physical punishment remains limited in low- and middle-income contexts. Guided by Bronfenbrenner’s ecological framework, this mixed-methods study identifies key drivers of CP and its escalation to SPP among Egyptian …

A Predictive Coding Account Of Spatial Working Memory Following Prophylactic Levetiracetam Administration Prior To Traumatic Brain Injury, Omeima Mutwali

Dissertations, Theses, and Capstone Projects

Traumatic brain injury (TBI) symptom prevention and remediation is an important area of research that would benefit vulnerable groups, including active-duty and veteran soldiers. These patients can sustain penetrative forces in fields of combat or in training, which result in focal lesions that trigger inflammatory and degenerative processes in the brain. Both primary and secondary injuries are associated with changes to cognition, behavior and affective state. This disease poses increased risk of epileptogenesis, as well. Given these outcomes, prior research has evaluated levetiracetam (LEV) as a prophylactic treatment for seizures, cognitive deficits and negative emotionality. LEV acts as a presynaptic …

Trends Of Pediatric Psychotropic Polypharmacy In Massachusetts Before And During The Covid-19 Pandemic, Gianna D'Ambrozio

Graduate Doctoral Dissertations

Youth in the U.S. and internationally are increasingly being diagnosed with depression and related psychiatric conditions (Murthy, 2021) many of whom are being subjected to non-evidence-based, or what has been termed irrational, psychotropic polypharmacy (Barnett & Concepcion Zayas, 2019). Psychotropic polypharmacy can be defined as “the use of 2 or more psychiatric medications in the same patient,” (Zito et al., 2021) though definitions can vary. Using data from the Center for Health Information Analysis’ Massachusetts All-Payer Claims Database, this study examined the sociodemographic factors associated with high rates of polypharmacy, a hypothesized increase in pediatric psychotropic polypharmacy rates in Massachusetts …

Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard

Doctoral Dissertations

Background – Obstetric fistula is a childbirth injury caused by prolonged labor that leads to stillbirth and incontinence, spurring social exclusion and isolation. These layers of trauma put women with fistula at great risk for psychological suffering, which has profound negative socioeconomic impacts on them, their families, and communities. This study captured treatment as usual at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), the country’s largest provider of fistula care.

Method – Improving holistic fistula treatment requires engaging the clinicians who care for women with fistula. This study aimed to investigate the training, beliefs, and treatment approaches of nurses and …

Feasibility Of Assessing Dietary Patterns And Anxiety In College Students: A Pilot Study Using Nutrition Questionnaires, Gad-7, And Asq, Kylie Ford

Electronic Theses and Dissertations

Anxiety is highly prevalent among college students representing a significant public health concern. Research indicates that dietary patterns may influence mental health outcomes; however, the practicality of collecting comprehensive dietary and psychological data in college populations remains unclear. This pilot study assessed the feasibility of evaluating dietary patterns and anxiety using self-report instruments. Participants completed the Nutrition and Eating Habit questionnaire, the Generalized Anxiety Disorder-7 (GAD-7), and the Anxiety Sensitivity Questionnaire (ASQ). Although twenty-one students were recruited, survey completion rates were low, with only seven participants completing the nutrition questionnaire necessary to calculate the Dietary Inflammatory Index (DII). Descriptive analyses …

Social Correlates Of Trauma And Posttraumatic Stress Disorder: The Importance Of Context, Lukoye Atwoli, Linnet Ongeri

Internal Medicine, East Africa

Understanding trauma and posttraumatic stress disorder (PTSD) requires a contextual perspective that considers historical legacies, social environments, and cultural realities. This paper draws on empirical evidence from Kenya and Uganda to demonstrate the limitations of applying trauma frameworks developed in high-income countries to African contexts. Findings from the Orphaned and Separated Children’s Assessment Related to Their Health and Well-Being (OSCAR) study challenge assumptions about care environments. The study reveals higher PTSD rates among orphans in family-based settings compared to institutional care, and highlights the protective roles of religion and social support. The Neuropsychiatric Genetics of African Populations-Psychosis (NeuroGAP-Psychosis) study provides …

Questionnaire For Eudaimonic Well-Being: Psychometric Validation Among Malaysian Youth, Mohd Ahsani A. Malek, Nurulwahida Saad, Suzana Mohd. Hoesni, Muhamad Ariff Ibrahim, Nurul Shafira Adi, Mohd Nazir Mohd Nazori

Makara Journal of Health Research

Background: The rising prevalence of mental illness underscores the need to understand how individuals can live and flourish under such conditions. In Malaysia, research has largely emphasized diagnosis and treatment, with limited focus on positive psychology and few validated instruments. This study aimed to translate and validate the questionnaire for eudaimonic well-being (QEWB) among Malaysian youth.

Methods: The QEWB was translated into Malay using back-to-back translation and administered to undergraduates from four public universities through a cross-sectional survey design. Convenience quota sampling was used, resulting in 229 respondents completing the online form to measure sociodemographic characteristics, eudaimonic well-being, …

Starting With Story, Not Symptom: Narrative Collapse And Cultural Repair In Appalachia, Wayne Coombs Ph.D.

Journal of Appalachian Health

Appalachia’s opioid crisis reflects uneven burdens, especially in distressed coalfield counties, and it cannot be solved by symptom tracking alone. This commentary argues for a narrative shift, starting with story and cultural repair alongside clinical care. Narrative collapse is defined here as the loss of shared, dependable public meaning across groups, not the absence of storytelling in families, churches, and recovery circles. Trauma science suggests that chronic threat reshapes nervous systems across generations, making safety a prerequisite for renewed trust. Drawing on narrative identity research, the piece proposes peer story work as infrastructure that can reduce shame, support treatment engagement, …

Health Data And Policy Related To Methamphetamine-Use Suicide In Mississippi, Mary C. Drane

Honors Theses

The purpose of this research is to investigate how methamphetamine use in Mississippi, especially in its rural areas, intersects with public health, policy, and suicide outcomes in the state. Mississippi's methamphetamine crisis has evolved significantly, shifting from locally produced drugs to cartel-supplied crystal methamphetamine, while state and federal policies have struggled to keep pace with the scale and complexity of the problem. Using a convergent parallel mixed-methods design, this research analyzed CDC Wonder multiple causes of death data and SAMHSA Treatment Episode Data Set Admissions (TEDS-A) data from 2018 to 2024 alongside four qualitative key informant interviews with stakeholders across …

Can The Implementation Of The Pause Decrease Death Anxiety And Poor Mental Health In Practicing Nurses?, Lilli Meyer

Undergraduate Theses

Practicing nurses are frequently exposed to patient death, placing them at increased risk for death anxiety and compromised mental health. Despite this, there remains a lack of structured, in-the-moment interventions to support emotional processing within clinical settings. This study evaluates whether the implementation of “The Pause,” a brief moment of silence following a patient’s death, may reduce death anxiety and improve mental health outcomes among practicing nurses. A quantitative survey consisting of eight questions was distributed to nurses in the Louisville, Kentucky area over a three-month period, yielding 26 responses. Findings indicated that 80.8% of participants reported no improvement or …

Eating Disorder Prevention And Early Intervention In U.S. Higher Education – A Comparative Benchmarking Study, Jake R. Arcement

Senior Theses

Eating disorders (EDs), including anorexia nervosa, have the highest mortality rate of any psychiatric illness, yet remain underrecognized relative to their severity and treatment burden. Because the period of peak onset aligns with the college years, institutions of higher education are uniquely positioned to play an important role in prevention, early identification, and referral to specialized care. However, limited research has examined how colleges and universities structure ED prevention and treatment resources. This thesis applies a comparative benchmarking framework to assess current institutional practices across U.S. colleges and universities. A national survey of student health and counseling centers examined staffing, …

Mom Is Developing Too: Preliminary Evidence For The Reciprocal Effects Of Infant Sensory Reactivity And Maternal Behavior, Emily C. Sweiss, Vincent Berardi, Elysia Poggi Davis, Curt A. Sandman, Laura M. Glynn

Psychology Faculty Articles and Research

Caregiver sensitivity to infant cues is well-established as a predictor of child development. Infants also actively influence their social environment, especially their caregivers, even from their earliest days. Sensory reactivity, characterized as hypo- (under) and hyper- (over) responding to environmental stimuli, is one domain of development that is likely to influence caregiver-infant interaction, due to its role in regulating emotions and responses to both physical and social stimuli. Although sensory reactivity could be an important target for improving caregiver-child interaction, the longitudinal, reciprocal relations between infant sensory reactivity and caregiver behaviors are currently unknown. In the present proof-of-concept study, we …

Feasibility, Acceptability And Initial Efficacy Of A Community-Based Mental Health Literacy Program Delivered By Civil Society Organizations Among Adults In Kenya: A Quasi-Experimental Study, Patrick Mwangala, Venoranda Rebecca Kuboka, Nimo Sharif, Ann Karendi, Gideon Mbithi, Amina Abubakar

Institute for Human Development, East Africa

Mental health literacy (MHL) strategies are crucial for mental health promotion and prevention. This study aimed to determine the acceptability, feasibility, appropriateness and initial efficacy of an adapted MHL program in a community sample of adults in Kenya. This was a quasi-experimental pre-post study conducted from July 2023 through July 2024. The MHL program contained nine modules delivered over 3 days. Participants were assessed at baseline and immediately after the program. The primary outcomes were mental health knowledge and participants’ attitudes on mental health/illness. Secondary outcomes included depressive symptoms, anxiety symptoms, self-perceived social support, self-perceived wellbeing, MHL program acceptability, feasibility …

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.

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 …

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 Role Of Resistance Training In Managing Menopause-Related Changes, Alyson K. Strauss

Honors Undergraduate Theses

Resistance training serves as a critical non-pharmacological strategy for mitigating the physiological and psychological declines associated with the menopausal transition. This natural biological phase, marked by declining estrogen levels, typically leads to accelerated bone mineral density loss, sarcopenia, metabolic regulation disturbance, and heightened mood disturbances. To evaluate the efficacy of targeted exercise interventions, a systematic review was conducted following PRISMA guidelines. From an initial pool of 60 relevant articles, 13 studies met the specific inclusion criteria, focusing on structured resistance training protocols for perimenopausal, menopausal, and postmenopausal cohorts.

The synthesis of these studies indicates that resistance training is a highly …

The Knowledge, Experiences, And Attitudes Of Nurses Regarding Trauma-Informed Care For Sexually Abused Intrapartum Patients, Kayleigh Mcgraw

Honors Undergraduate Theses

Labor and delivery nurses care for women from diverse backgrounds who are preparing for a life-changing event, often marked by fear, excitement, sadness, and joy. However, 1 in 5 women in the United States have experienced rape or attempted rape, and for these survivors, labor can become re-traumatizing. Many report flashbacks, dissociation, and a sense of “being back in the rape” during childbirth. Research further links prior sexual assault to unplanned cesareans, traumatic births, and childbirth-related PTSD. Trauma-informed care (TIC) provides a framework to reduce these risks by encouraging providers to understand trauma, recognize signs of distress, and act to …

“In A Relationship”: Can Ai Take The Place Of A Human Relationship?, Hannah Smith

Student Scholar Symposium

This research explores the impact of AI on adolescent development, specifically focusing on how large-language models (LLMs) influence the way adolescents approach and value human connections. While AI can offer some benefits, it cannot fully replace the essential elements of human relationships, such as empathy, creativity, and emotional understanding, which are fundamental to a fulfilled life.

Behind The Badge: Effects Of Stress And Trauma In Policing -- Understanding The Importance Of Evidence-Based Prevention, Early Intervention, And Wellness Programs, Jessica Rolshouse

Master of Arts in Human Services

Law enforcement officers are exposed to occupational stress and trauma routinely and at rates that far exceed the general population. This chronic exposure places them at risk for physical and psychological injury and negative outcomes to include mental health disorders including burnout, anxiety, depression, and PTSD. Prolonged exposure to occupational stress and trauma also increases the risk of suicidal ideation and dying by suicide, the most tragic outcome of the stress law enforcement officers face. This literature review focuses on individual risk factors, occupational stress, and trauma, and the development of mental health disorders in law enforcement officers. It also …

A Quantitative Exploration Of Risk And Protective Factors Affecting The Mental Health Of Chitimacha Tribal Youth, Daphnie Vilcan-Tanner

LSU New Orleans Theses and Dissertations

This study examines the relationships between demographics, risk factors, and protective factors with mental distress among Chitimacha Tribal adolescents aged 12 to 18. Using a Positive Youth Development framework, the research aimed to identify the prevalence of mental distress, trauma, discrimination, and protective factors, as well as their collective and individual impacts on mental health. Data were collected through online surveys completed by 73 participants residing on or near the Chitimacha Tribal Reservation. Descriptive statistics and multiple linear regression analyses were conducted to analyze the data. Results revealed that while trauma and discrimination collectively predicted mental distress, family and community …

Barriers To Mental Health Access Among Immigrant Populations In The U.S., Cecilia Menzinger

Capstones

No abstract provided.

Evaluation And Identification Of Risk Factors For Stress Among Maquiladora Workers Based On The Mexican Official Standard 035 Survey Tool, Andrea Baca Melendez

Open Access Theses & Dissertations

Background and significance: Occupational psychosocial risk factors are workplace conditions that can trigger physiological, emotional, cognitive, and behavioral changes. They are strongly associated with mental health issues such as anxiety and depression, as well as non-mental health conditions like myocardial infarction, stroke, and occupational injuries. Analyzing these risks from a sociodemographic perspective provides valuable insights for improving work environments and workers’ well-being. Purpose: This study aimed to identify and determine the levels of occupational psychosocial risk factors among workers in a manufacturing company in Cd. Juárez, Chihuahua, and to examine their relationship with sociodemographic variables to inform future interventions in …

Exploring Intersectional Risks Of Substance Use Disorder, Mental Health, Hiv/Aids, And Hepatitis C Among Hispanic Adults On The Tx-Mx Border: A Mixed-Methods Study, Md Mohsin

Open Access Theses & Dissertations

Purpose: The purpose of this study was to explore intersectional risks of substance use disorders, mental health, HIV/AIDS, and HCV among Mexican-origin Hispanic adults on the Texas-Mexico border. Methods: The study employed an exploratory sequential mixed-methods approach, which involved collecting and analyzing qualitative data first, followed by quantitative data collection. Selected purposively, 15 in-depth interviews were conducted among the target population. Using convenient sampling, 106 cross-sectional surveys were conducted. Qualitative interview data were analyzed manually using thematic analysis. Quantitative data analyses included univariate descriptive analysis, bivariate, and multivariable penalized logistic regression, negative binomial, and zero-inflated negative binomial regression. Results: The …

Impact Of Covid-19 Pandemic On Quality Of Life, Anxiety, Connections To Friends, And Access To Resources Among People With Hiv: Using The Social Ecological Model, Carol Dawson-Rose, Christine Davey, Emily Huang, Laura Cox, Phillips Craig, Motshedisi Sabone, Lufuno Makhado, Emilia Iwu, Kathleen Fitch, Sheila Shaibu

School of Nursing & Midwifery, East Africa

The purpose of this study was to understand the impact of the coronavirus disease 2019 (COVID-19) pandemic and mitigation efforts on health and social outcomes for people with HIV at the individual, social, and structural levels of the Social Ecological Model. The International Nursing Network for HIV collected data for a cross-sectional survey of people with HIV in Botswana, Canada, Colombia, Hong Kong, Kenya, Nigeria, South Africa, Thailand, and the United States from August 2021 through June 2023. Among 1,400 participants, 47.5% experienced decreased quality of life, 40.9% experienced increased anxiety, 33.0% had reduced connection with friends, and 38.8% had …

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 …