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 …

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 …

The Impact Of Nicu Death On Bereaved Mothers, Jennie Terranova

University Honors Theses

Infant loss in the United States occurs 5.6 per 1,000 live births. This paper examines risk factors that contribute to neonatal death. Prematurity is a risk factor for NICU admission. A portion of premature babies receiving care in the NICU will die. The stressful nature of the NICU has been studied widely in journals. The impact of NICU death on hospital staff and bereaved parents has been studied less. Mortality studies suggest that bereaved mothers are at a high risk of dying within the first 5 years after their child has died. Despite the frequency of maternal death post-child loss, …

The Intersecting Association Of Speaking A Non-Dominant Language And Lower Healthcare Access On Self-Reported Depression Among U.S. Adults: A Cross Sectional Study Using Nhanes Data (2015-March 2020), Vincenzo J. Cornacchione, Corey Linver

OHSU-PSU School of Public Health Annual Conference

Objective: This analytic study examined the joint and independent associations between language preferences and healthcare access on moderate to severe depression among non-institutionalized adults living in the U.S., using data from the 2015 to March 2020 National Health and Nutrition Examination Survey (NHANES).

Methods: In this cross-sectional study design, we analyzed a nationally representative data set comprised of 11,051 participants. Multivariable logistic regression models were used to estimate the joint and independent associations between our dual exposures and moderate to severe depression, adjusting for key demographic variables based on our theoretical framework. We created categorical measures of preferred language (speaking …

What Are The Psychosocial Effects Of Service Dogs On Handlers With Disabilities, Kylie Kline

University Honors Theses

This study looks to explore the psychosocial effects that service dogs have on handlers with disabilities. A cross-sectional survey designed to gather information about this directly from service dog handlers was administered to a sample of 20 participants. Then, a qualitative analysis was conducted on data from the survey using an inductive coding scheme that identified themes in the data as key terms and ideas emerged.

Results revealed many nuances surrounding service dogs' effects on handlers' psychosocial health. Notable results include: 20 of 20 participants (100%) reporting their service dogs have had positive impacts on their quality of life; 19 …

Biophilic Design Strategies In Healthcare: Using Nature To Promote Wellness In Small-Scale Mental And Behavioral Health Facilities, Skyler Peckham

University Honors Theses

Designing spaces that promote the health and well-being of the general public has been a highly debated topic for several centuries within the disciplines of architecture, urban planning, and other similar fields. As more research has been done throughout the years, the notion of utilizing nature to promote wellness has become a prominent design strategy. Through the examination of a wide range of scholarship regarding the benefits that nature has for human health and connecting this research to the biophilic evidence-based design strategies of healthcare facilities, I aim to highlight what design aspects truly promote wellness for patients in small-scale …

Classifying Severe And Enduring Anorexia Nervosa: A Literature Review, Phoenix Black

University Honors Theses

Little focus is placed on the subsection of the eating disorder patient population who struggle chronically with their illness. This review synthesizes research on the topic to identify gaps in knowledge and reflect on implications for diagnosis and classification of severe and enduring anorexia nervosa. There was some variability between both clinicians and researchers who focused on this patient population, which is discussed based on different classifying criteria used to include or exclude an individual into the study. This review considers traditional methods used for classifying psychiatric diagnoses in relation to this disorder.

An Investigation Into The Relationship Between Obstetric Racism And Postpartum Depression In Black Women, Miguel A. Claxton Iii

University Honors Theses

Postpartum depression is the most common postpartum mood disorder, with 13% of new mothers reporting symptoms within the first year. Adverse birth outcomes, such as low birth weight and preterm birth co-index with the development of postpartum depression. This correlation is particularly alarming considering that Black women have about a 60% higher rate of preterm birth and an 88% higher rate of low birth weight infants than Caucasian women. By utilizing theories of stratified reproduction, necropolitics, and obstetric racism, this paper aims to situate postpartum depression in Black women as a psychological response to systems of medicolegal control and domination. …

Addressing And Supporting Mental Health Today: Society-Wide And In Hospital Emergency Departments, Kira La Sage

University Honors Theses

Mental health has become one of the most pressing public health issues of the 21st Century. Westernized societies offer much of their attention to childhood obesity, to COVID-19, to undiagnosed and diagnosed Americans living with diabetes. America even sees extended U.S. Senate hearings focusing on opioid use and abuse. Each of these concerns legitimately commands public health official attention, but what the world does not see is any level of sustainable attention given to emotional and mental health crises affecting tens of millions in Westernized countries. Suicide, the most serious of mental health crises, has become the second leading cause …

The Effects Of Mental Illness On Capital Sentencing In The State Of Oregon, Mirtill E. Csikos

University Honors Theses

There is emerging awareness on the potential arbitrariness and unconstitutionality of executing persons with mental illness. Most states with current death penalty laws have little to no protection for severely mentally ill defendants during capital trials. The present paper looked at the effectiveness of sentencing statutes serving the purpose of protecting defendants with severe mental illness in the state of Oregon. Through a careful meta-analysis this research focused on determining how mental illness plays into death penalty decisions and if Oregon’s Guilty Except for Insanity defense provides sufficient protection. Furthermore, the question of mental illness as a mitigating factor was …

Adverse Childhood Experiences, Adult Depression, And Suicidal Ideation In Rural Uganda: A Cross-Sectional, Population-Based Study, Emily N. Satinsky, Bernard Kakuhikire, Charles Baguma, Justin D. Rasmussen, Scholastic Ashaba, Christine E. Cooper-Vince, Jessica M. Perkins, Allen Kiconco, Elizabeth B. Namara, David R. Bangsberg, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Depression is recognized globally as a leading cause of disability. Early-life adverse childhood experiences (ACEs) have been shown to have robust associations with poor mental health during adulthood. These effects may be cumulative, whereby a greater number of ACEs are progressively associated with worse outcomes. This study aimed to estimate the associations between ACEs and adult depression and suicidal ideation in a cross-sectional, population-based study of adults in Uganda. Methods and findings: Between 2016 and 2018, research assistants visited the homes of 1,626 adult residents of Nyakabare Parish, a rural area in southwestern Uganda. ACEs were assessed using a …

Predicting The Efficacy Of Psilocybin In Treating Mental Health And Addiction, Courtney Ledford

altREU Projects

Machine Learning is used to predict the efficacy of psilocybin in treating mental health and addiction by using a random forest algorithm. Psilocybin is a chemical compound found in fungi. Following ingestion, it is converted to psilocin which acts as a serotonin agonist, producing altered states of consciousness and hallucinations. Research suggests the use of psilocybin as a potential treatment for mental health disorders and addiction. An analysis of thirty-one experiments from the Altered States Database was inputted into the model. Past meta-analysis performed on this experimental data focuses on healthy participants rather than participants diagnosed with a mental illness. …

Forests And Mental Health In South Africa: Panel Data Evidence, Dambala Gelo

Forest Collaborative Research

Slides from a presentation that examines the linkages between the green environment (urban forests, green open urban space) and mental health in South Africa. The author used representative panel data from the National Income Dynamics Survey, including the Center for Epidemiological Studies Short Depression Scale, to uncover these links.

Depiction And Function Of Madness In Elizabethan And Jacobean Literature, Yeiji Seo

Young Historians Conference

Since the ancient times of Israel, Greece, and Rome, people with mental illnesses have been regarded as different from others in society. This paper aims to analyze the motives of authors of medical and dramatic texts of Elizabethan and Jacobean literature in regards to mental illness by specifically observing William Shakespeare’s King Lear and Robert Burton’s The Anatomy of Melancholy. This paper also considers the views of other scholars of the field to compose a complete insight on Shakespeare and Burton’s goals in depicting mental illness and finally advocates further research and understanding to positively contribute towards disability reform today.

Take Control: A Proposed Mental Health Treatment Program To Be Implemented In Youth Correctional Facilities Around Oregon Based On The Evidence-Based Target Program, Zoey S. Rochefort

OHSU-PSU School of Public Health Annual Conference

70% of youth in state and local juvenile justice systems exhibit symptoms of one or more mental health disorders and are not receiving adequate treatment. Currently, in Oregon, there is no mental health-screening requirement for youth admitted into detention centers or correctional facilities. Though this doesn’t mean kids never get diagnosed, it does mean there is a large delay in time before treatment begins where they could be receiving care. The Take Control program is working to mitigate wasted time and improve mental health treatment for youth inmates through a seven-step treatment program that provides youth with steps and strategies …

Internet Addiction, Smartphone Addiction, And Hikikomori Trait In Japanese Young Adult: Social Isolation And Social Network, Masaru Tateno, Alan R. Teo, Wataru Ukai, Junichiro Kanazawa, Ryoko Katsuki, Hiroaki Kubo, Takahiro A. Kato

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: As the number of internet users increases, problems related to internet overuse are becoming more and more serious. Adolescents and youth may be particularly attracted to and preoccupied with various online activities. In this study, we investigated the relationship of internet addiction, smartphone addiction, and the risk of hikikomori, severe social withdrawal, in Japanese young adult.

Methods: The subjects were 478 college/university students in Japan. They were requested to complete the study questionnaire, which consisted of questions about demographics, internet use, the Internet Addiction Test (IAT), the Smartphone Addiction Scale (SAS)–Short Version (SV), the 25-item Hikikomori Questionnaire …

Emerging Strategies For Engaging Young People In Systems Of Care, Research And Training Center For Pathways To Positive Futures, Portland State University

School of Social Work Faculty Publications and Presentations

Systems of care are increasingly serving older youth and young adults up to age 24, and in our research and training work with providers, we hear about the challenges of engaging young people in typical services. Many providers are responding to the unique developmental needs of this population by adapting the design and delivery of their services to better engage and retain young people in system of care supports. Overall, strategies include expansion of drop-in center programming, adaptations to practice models like Wraparound, and new outreach efforts using social media and other technologies. Our purpose here is to share some …

Reaching Those At Risk For Psychiatric Disorders And Suicidal Ideation: Facebook Advertisements To Recruit Military Veterans, Alan R. Teo, Samuel B.L. Liebow, Benjamin Chan, Steven K. Dobscha, Amanda L. Graham

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Younger military veterans are at high risk for psychiatric disorders and suicide. Reaching and engaging veterans in mental health care and research is challenging. Social media platforms may be an effective channel to connect with veterans.

Objective: This study tested the effectiveness of Facebook advertisements in reaching and recruiting Iraq and Afghanistan-era military veterans in a research study focused on mental health.

Methods: Facebook ads requesting participation in an online health survey ran for six weeks in 2017. Ads varied imagery and headlines. Validated instruments were used to screen for psychiatric disorders and suicidality. Outcomes included impressions, click-through rate, …

Social Network Correlates Of Ipv Acceptance In Rural Honduras And Rural Uganda, Holly B. Shakya, Jessica M. Perkins, Margaret Traeger, Alexander C. Tsai, David Bangsberg, Bernard Kakuhikire, Nicholas A. Christakis

OHSU-PSU School of Public Health Faculty Publications and Presentations

We investigated the household-level social network correlates of acceptance of intimate partner violence (IPV) in rural, agrarian settings of Honduras and Uganda, two low-income countries with unequal access to resources based upon gender. We collected complete social network data in each location (Honduras in 2014 and Uganda in 2012), across a diverse range of relationships, and then created a measure of household cohesion by calculating the degree to which members of a household nominated each other as important social connections. Our measure of IPV acceptance was based on 4 questions from the Demographic Health Survey to assess the conditions under …

Mitigating Early Loss Of Community Participation In Early Psychosis Services: State Of The Science, Tamara G. Sale, Dora M. Raymaker, Mariam Rija, Veronica Gould, Christina Wall, Ryan P. Melton

School of Social Work Faculty Publications and Presentations

In the early stages of treatment for psychosis, community engagement and social networks are threatened through a combination of symptomology and negative messages and reactions from the environment which may result in internalized stigma, disempowerment, and prolonged isolation. While treatment programs attempt to mitigate these factors, ambivalence toward treatment and the basic concept of psychosis, along with difficulty engaging in conversation, make initial engagement more difficult. Self-determination theory and growing recovery literature point to the importance of maintaining a sense of community relatedness and connection, and developing a sense of agency and competence as important to active recovery and retention …

Foundational Knowledge And Other Predictors Of Commitment To Trauma-Informed Care, Stephanie Anne Sundborg

Dissertations and Theses

Trauma-informed care (TIC) is an approach to service delivery based on the understanding of the prevalence of psychological trauma among service users, knowledge about the impact trauma has on engagement to services, and recognition that service settings can be re-traumatizing. For more than a decade, momentum has been building on this topic. Practitioners are pursuing the knowledge and skills needed to implement trauma-informed service delivery, while organizations are building infrastructure and processes aimed at supporting this approach. Disciplines across many human service sectors are eager to incorporate TIC into policy and practice. Despite this enthusiasm, implementation efforts are slow. Acquiring …

Mindfulness Meditation As A Stress Reactivity Intervention: An Event-Related Potential Study, Jessica L. Trottier, Barry S. Oken

Student Research Symposium

The biological and neural mechanisms of stress have been extensively studied and supported, but are still unclear. Event-related potentials (ERP’s) emitted by neurons in the brain are a useful tool in measuring stress because they reflect neural response in real-time, to the millisecond, versus typical biological markers, which are typically evaluated before and after a stress test. The neurobiological relationship between ERP’s and stress originates in the anterior cingulate cortex, which in turn activates the hypothalamic–pituitary–adrenal axis; the main physiological cascade fueling the stress response and its chronically harmful symptoms. Malfunctions in the stress response, as in the cases of …

Social Support And Depression Symptomatology Post Injury In Division 1 Athletes, Alyssa Catherine Tiedens

Dissertations and Theses

The way in which an athlete responds to the injury--emotionally, behaviorally, and cognitively--can significantly affect the athlete's mental health in a negative way if not handled appropriately. There are different forms of social support that are known to be helpful with coping during specific stages of injury. The purpose of this study was to examine the relationship between perceived levels of social support and depression symptomatology post injury in Division 1 collegiate athletes at Portland State University (PSU).

Participants were PSU student athletes (n=115). Variables: social support amount (SSQN), social support satisfaction (SSQS), and depression symptomatology (CESD-R) score. Selected injured …

Transgender Patients' Experiences Of Discrimination At Mental Health Clinics, Corrine Ann Stocking

Dissertations and Theses

The transgender population is makes up about 0.3% of the U.S. population (Gates 2011). The term transgender is both an identity and an umbrella term used to describe people who do not adhere to traditional gender norms (Institute of Medicine 2011). Transgender people experience many barriers to services, negative health outcomes, and discrimination (Fredrikson-Goldsen et al. 2013; Institute of Medicine 2011; Eliason et al. 2009; Hendricks & Testa 2012). Mental health clinics are an important site for understanding transgender peoples' experiences due to being a gatekeeper for other medical services and their role in helping transpeople with issues surrounding coming …

Family Aided Community Treatment For The Treatment Of Early Psychosis: A Proof Of Concept Study, Ryan P. Melton, Cass Dykeman

Regional Research Institute for Human Services

Major psychotic disorders are one of the leading causes of disability worldwide. If these conditions are identified early and treatment promptly implemented, the prognosis is improved. This study examined the impact of a yearlong family aided community treatment (FACT) intervention upon psychiatric symptoms. Psychiatric symptom scores improved with the FACT intervention. Improved training on early recognition for mental health clinicians, implementation of a specific treatment model in community settings and policy around treatment funding allocation are implications of this study.

Brief Gatekeeper Training For Suicide Prevention In An Ethnic Minority Population: A Controlled Intervention, Alan R. Teo, Sarah B. Andrea, Rae Sakakibara, Satoko Motohara, Monica M. Matthieu, Michael D. Fetters

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Suicide is a critical public health problem around the globe. Asian populations are characterized by elevated suicide rates and a tendency to seek social support from family and friends over mental health professionals. Gatekeeper training programs have been developed to train frontline individuals in behaviors that assist at-risk individuals in obtaining mental health treatment. The purpose of this study is to assess the efficacy of a brief, multi-component gatekeeper intervention in promoting suicide prevention in a high-risk Asian community in the United States.

Methods: We adapted an evidence-based gatekeeper training into a two-hour, multi-modal and interactive event for Japanese-Americans …

Concussion Guidelines Step 1: Systematic Review Of Prevalent Indicators, Nancy Carney, Jamshid Ghajar, Andy Jagoda, Steven Bedrick, Cynthia Davis-O'Reilly, Hugo Du Coudray, Dallas Hack, Nora Helfand, Amy Huddleston, Tracie Nettleton, Riggio Silvana

Psychology Faculty Publications and Presentations

BACKGROUND: Currently, there is no evidence-based definition for concussion that is being uniformly applied in clinical and research settings.

OBJECTIVE: To conduct a systematic review of the highest-quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion. The goal was to establish an evidence-based foundation from which to derive, in future work, a definition, diagnostic criteria, and prognostic indicators for concussion.

METHODS: Key questions were developed, and an electronic literature search from 1980 to 2012 was conducted to acquire evidence about the prevalence of and associations among signs, symptoms, and neurologic and …

A Community-Based Wellness Program To Reduce Depression In African Americans: Results From A Pilot Intervention, Christina Nicolaidis, Corliss Mckeever, Sandra Meucci

School of Social Work Faculty Publications and Presentations

Background

African-Americans are less likely than non-Hispanic Whites to find antidepressants acceptable or seek care for depression.

Objective

To develop and pilot-test a culturally-tailored, community-based, psycho-educational wellness and exercise promotion program to reduce depressive symptoms in African-Americans.

Methods

Participants were African-Americans with moderate depressive symptoms, who were interested in exercise, but were not exercising regularly. They attended a 6-week psycho-educational group program during which they set personal activity goals and learned depression self-management skills. We conducted pre- and post-intervention surveys and post-intervention feedback sessions.

Results

21 African-Americans participated in the intervention. The program had excellent attendance and satisfaction. We found …

Healing Pathways: A Program For Women With Physical Disabilities And Depression, Dena Hassouneh, Thuan Nguyen, Zunqiu Chen, Elizabeth Mcneff

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective. The objective of this study was to test the efficacy of the Healing Pathways (HP) program in reducing clinically significantly depressive symptoms in women with physical disabilities (WPD). Healing Pathways is a peer-implemented group mental health treatment program targeting WPD who have clinically significant cooccurring depressive symptoms. Participants. Eighty women were randomized in this trial. Design. This study used a community-based participatory intervention research design. Using community-based recruiting methods, participants were recruited from Centers for Independent Living, local disability service organizations, via Craig's list as well as other community locations such as grocery stores and bus …

Insights And Blind Spots: A Qualitative Analysis Of Risk In Psychiatric Security Review Board Hearings, Abby Kealani Balfour

Dissertations and Theses

The prevalence and consequences of the insanity plea, titled "guilty except for insanity" in the State of Oregon, are fraught with misconceptions. The use of the plea requires a complex set of interactions between the mental health and criminal justice systems, and comes with severe costs for people who use it. Most of the research on the psychological aspects of the insanity plea emphasizes empirical validity in the form of risk assessment instruments and/or the biomedical model with its focus on disease and illness. This thesis analyzes from community psychology and critical theory perspectives the decision process of hearings held …