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 …

The Resilient Mother: Exploring Factors That Buffer The Influence Of Early Childhood Trauma On Maternal Self-Efficacy, Brigid Magdamo

Electronic Theses and Dissertations

Childhood maltreatment and toxic stress pose significant risks to both individuals and communities, yielding negative outcomes that can perpetuate across generations— a phenomenon known as intergenerational trauma. Early intervention is imperative to disrupt this cycle of adversity and promote positive outcomes. One promising approach involves leveraging protective and promotive factors that cultivate resilience. Individuals with higher levels of benevolent childhood experiences (BCEs) and greater social support tend to exhibit enhanced self-efficacy, thereby potentially buffering the detrimental effects of childhood trauma. Furthermore, the perinatal period presents a critical juncture where maternal well-being significantly impacts both mother and child. The current study …

Examining The Effects Of Perceived Need, Suicidal Ideation, And Interpersonal Shame On Help-Seeking Attitudes In Asian Pacific Islander Desi Americans, Kristen Jiin Park

Electronic Theses and Dissertations

This study examined relationships among suicidal ideation, perceived need for mental health services, interpersonal shame, and help-seeking attitudes in a sample of APIDA adults (N = 175). Guided by Andersen's Socio-behavioral Model of Help- Seeking Behaviors (1968) and the Interpersonal Shame Inventory framework (Wong et al., 2014), the study investigated whether interpersonal shame moderated the relationships between suicidal ideation and help-seeking attitudes, and between perceived need and help-seeking attitudes. Participants completed an online survey assessing demographic and study variables. Results indicated that perceived need and gender were associated with more favorable mental health help-seeking attitudes among APIDA adults. These findings …

Kindergarten Teachers’ Perceptions, Experiences, And Challenges Using Visual Supports For Children With Autism, Jasmine M. Mcnair

Electronic Theses and Dissertations

This qualitative case study examined kindergarten teachers’ perceptions, experiences, and challenges related to the use of visual supports for students with autism spectrum disorder in East Texas. Grounded in cognitive load theory, the study explored whether visual supports enhance learning outcomes by reducing cognitive overload. Four research questions addressed teachers’ perceptions of effectiveness, implementation challenges, the influence of teacher attitudes, and differences based on teaching experience. The researcher collected data through semistructured interviews with 10 kindergarten inclusion teachers and supplemented by classroom observations. Thematic analysis revealed five primary themes: emotional impact and student growth, visual supports as essential instructional tools, …

Predictors Of Elevated Borderline Personality Disorder And Pai-Bor Scores: The Role Of Psychological, Trauma, And Treatment Factors, Isabel Avendano Gil

Electronic Theses and Dissertations

Borderline Personality Disorder (BPD) is a complex and multifaceted mental health condition that significantly affects individuals' emotional, cognitive, and interpersonal functioning. BPD is characterized by impulsivity, emotional dysregulation, unstable relationships, and self-destructive behaviors, and often results in significant impairment across multiple life domains. Previous research has consistently identified Adverse Childhood Experiences (ACEs), particularly sexual abuse (SA), as key contributors to the development of BPD. These early traumas are closely associated with core features of the disorder, including affective instability, identity disturbance, impulsivity, and maladaptive interpersonal patterns.

Psychotherapeutic interventions, such as Dialectical Behavior Therapy (DBT) and Cognitive Behavioral Therapy (CBT), have …

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 …

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 …

“My Body Was Never Mine”: An Arts-Based Phenomenological Analysis Of Queer And Trans Adolescent Involuntary Psychiatric Hospitalization Experiences, Megan Doyle

Electronic Theses and Dissertations

Involuntary psychiatric hospitalization has life-saving and crisis-stabilizing intentions for queer and trans adolescents experiencing mental health crises; however, there are significant concerns about the adverse effects of this practice. This study employed two interwoven qualitative methods, interpretative phenomenological analysis and arts-based research, to gain a deeper understanding of queer and trans individuals’ adolescent experiences of involuntary psychiatric hospitalization. The theory of abolition was applied to examine the carcerality and identity-based oppression embedded within this procedure. Participant narratives and artwork revealed how involuntary psychiatric hospitalization is non-affirming for queer and trans young people in crisis, and the impacts of experiencing coercion, …

Exploration Of The Cultural Beliefs, Values, And Practices Of African American/Black Women Or Birthing Persons Regarding Postpartum Depression: A Focused Ethnography, Stephanie Jacobs

Electronic Theses and Dissertations

Introduction: Postpartum depression (PPD) is the most prevalent perinatal mental health illness in women, affecting approximately 10% to 20% of all women in the United States, and a disproportionately higher number of African American women. The aim of this study was to explore the cultural beliefs, values, and practices of African American/Black women or birthing persons regarding postpartum depression.

Research Question: What are the cultural beliefs, values, and practices of African American/Black women or birthing persons regarding postpartum depression?

Methodology: A focused ethnography was chosen for this study and consisted of semi-structured interviews. Data was transcribed and analyzed …

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 …

The Ethics Of Involuntary Psychiatric Hospitalization: A Comprehensive Analysis Of Policies, Practice, And Ethical Oversight, Mariah Chobany

Electronic Theses and Dissertations

As a specialized field of medicine, psychiatry presents unique ethical challenges and dilemmas distinct from other medical disciplines. A particularly complex aspect of psychiatric care involves the involuntary treatment of patients who may be unable to make informed decisions about their care or participation in research due to the debilitating effects of their psychiatric condition. This presents a significant challenge for providers and researchers, particularly concerning capacity issues and the informed consent process. Despite the intricacies and complexities of ethical dilemmas in psychiatric treatment and research, there is a notable lack of comprehensive guidance in policies and practices on addressing …

Poly (Adp-Ribose) Polymerase-1 (Parp1) Expression In The Frontal Cortex And Hippocampus In Major Depressive Disorder (Mdd) And Suicide, Ramona Faith Fulkerson

Electronic Theses and Dissertations

Major Depressive Disorder (MDD) is a prevalent psychiatric disorder that has a complex pathophysiology. In this study we evaluate the expression of PARP1 and the downstream alarmin protein high mobility group box 1 (HMGB1) in two brain areas that have demonstrated pathology in MDD. MDD donors were compared to controls. MDD subgroups that died by suicide were also compared to those that did not die by suicide. Immunoblotting to determine PARP1 and HMGB1 protein expression was performed in white and grey matter from the frontal cortex and the hippocampus. In BA10 white and grey matter, PARP1 protein expression was significantly …

Exploring The Lived Experience Of Self-Care In Young Adults With Type 2 Diabetes, Holly Berry-Price

Electronic Theses and Dissertations

Introduction

The prevalence of prediabetes in adults aged 18 or older was as high as 38% between 2017-2020. Youth-onset T2DM is a more aggressive phenotype than T2DM that occurs later in life. Young adults with T2DM have poorer health outcomes, lose an average of 15 years of life, all resulting in significant economic burden impacting the person. Current self-management interventions do not improve health outcomes in young adults with T2DM.

Purpose

The purpose of this research was to explore the self-care experiences of young adults living with T2DM.

Methods

Existential hermeneutic phenomenology informed the research. Inclusion criteria as follows: adults …

Validation Of A Novel Heritable Rodent Model Of Drug Abuse Vulnerability In Psychosis And Investigation Of Therapeutic Targets, Loren D. Peeters

Electronic Theses and Dissertations

Schizophrenia is a severe neuropsychiatric disorder of largely unknown etiology that is often accompanied by high rates of cigarette smoking, reduced quit success, and high relapse rates. Dysregulated dopamine signaling and aberrant synaptic plasticity in the mesocorticolimbic pathway are implicated in the pathophysiology of schizophrenia and conferred substance abuse disorder and relapse vulnerability. Genetic factors are presumed to play a significant role in the development of schizophrenia, with a 40-50% concordance rate for monozygotic twins, although genetic markers are inconsistent. As such, epigenetic factors have instead been implicated. Specifically, there is strong evidence to suggest DNA methylation at several candidate …

The Correlation Between Transformational Leadership And Mental Health Clinician Burnout, Rebekah E. Shutter

Electronic Theses and Dissertations

Mental health clinicians working in a hospital setting are at a high risk of experiencing burnout due to the stressful demands of their caseloads, compassion fatigue, limited resources, and unsupportive leadership. While there is ample research regarding the cause and effect of burnout on clinicians there is a gap in the literature when it comes to the impact leadership has on mental heath clinician burnout. The purpose of this quantitative, correlational study is to determine if and to what extent there is a correlation between Transformational Leadership and mental health clinician burnout. Participants for this study consisted of 200 mental …

Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz

Electronic Theses and Dissertations

Purpose: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of young adults who identify as LGBTQ+ and sought emergency care for suicidality when they were adolescents.

Methods: Heideggerian hermeneutics phenomenology is the research method used in this study. Youth, ages 18-25 years, who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents (13-17 years) were recruited to participate;fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described …

The Effect Of Postpartum Depression Screening Education For Postpartum Nurses, Shecarra S. Cook

Electronic Theses and Dissertations

Depression affects about 13% of pregnant women and about 10% of women after childbirth. Some cases are so severe, the mother may even commit suicide. If left untreated, postpartum depression (PPD) affects both the mother’s and the infant’s health as well as their quality of life. The gap in clinical practice is that currently, patients only complete a postpartum depression screening tool during their 6-week follow-up appointment with their OB/GYN, leaving a gap in PPD detection and care during the immediate postpartum period. Postpartum nurses are not usually given specialized training in postpartum depression. The purpose of this study was …

The Efficacy Of Neurofeedback In The Treatment Of Individuals With Anxiety-Spectrum Disorders: A Meta-Analysis, Gordon Michael Russo

Electronic Theses and Dissertations

A number of authors have published articles that assert the efficacy of neurofeedback (NFB) in the treatment of people with anxious symptomatology. Despite this, many insurance companies identify NFB as experimental, which prohibits individuals from utilizing benefits to obtain this therapeutic treatment. In order to examine these discrepancies, the present meta-analyses were conducted and guided by research questions designed to examine the overall effectiveness of NFB, the impact of participant characteristics, and identify the if there is a significant difference in anxiety-spectrum outcomes. Twenty-six trials were divided based on design (14 single group [SG]; 12 between group [BG]) and analyzed …

Group Sandtray Therapy With Adult Survivors Of Childhood Sexual Assault: A Single-Case Research Design, Jana Elaine Scott

Electronic Theses and Dissertations

Childhood sexual assault (CSA) is a growing problem in our society. A child who experiences a sexual assault not only deals with the immediate trauma surrounding this event, but also the aftermath of this event as they progress into adulthood. Trauma and sexual trauma is an umbrella term that incorporates all of the various implications of experiencing a negative event. In the instance of trauma, neurobiological implications have been well researched and established. This knowledge highlights the need for counseling techniques to be developed and studied that target those who have experienced CSA. The aim of this single-case research design …

Determining The Effectiveness Of A Peer Support Person In Individuals With Depression Symptoms, Donna K. Reeves

Electronic Theses and Dissertations

Abstract

This study’s aim was to evaluate the effectiveness of an existing peer support program as an adjunct treatment for patients with depression. This retrospective evaluation analyzed the total scores of 110 patients with depression on the PHQ-9 questionnaire at the initial assessment (Time 1), at 6-weeks (Time 2), and then at 12-weeks (Time 3). The participants were divided into two groups, those who enrolled in a peer support program (n = 55) and those without peer support (n = 55). PHQ-9 total scores for each time interval were compared for the two groups utilizing independent sample t-tests …

Serious Mental Illness And Rural Primary Care: Provider Training, Attitudes, And Opinions, Lydia Eisenbrandt

Electronic Theses and Dissertations

Healthcare resources are especially limited in rural regions of the US. The lack of Primary Care Providers (PCPs) and mental/behavioral health services is problematic, as there are high rates of behavioral and medical concerns within rural populations. Special populations, such as rural persons with Serious Mental Illness (SMI), are medically complex and represent a vulnerable and underserved population. Healthcare outcomes for persons with SMI are poor compared to the general population and commonly lead to premature death. Various barriers prevent this population from accessing optimal healthcare, especially in rural areas, due to negative perceptions/stigma, a lack of understanding from PCPs, …

Impact Of Adverse Childhood Experiences On Mental Health Outcomes And Related Prescription Practices In A Psychiatric Inpatient Sample, Carrie Lemay

Electronic Theses and Dissertations

A definitive association between adverse childhood experiences (ACEs) and negative physical and mental health outcomes has been established. There is evidence that individuals in forensic psychiatric facilities are disproportionately exposed to ACEs, which may impact severity, prognosis, and age of onset of psychiatric symptoms, including behavioral concerns of institutional aggression, self-harm behaviors, and suicide attempts. Such psychiatric and behavioral concerns are often managed through multiple psychotropic prescriptions, leading to psychotropic polypharmacy. This study evaluated the relationship between ACEs, mental health and behavioral concerns, and psychotropic polypharmacy through analysis of archival data from a forensic inpatient psychiatric facility. A total of …

A Deep Learning Approach To Diagnosing Schizophrenia, Justin Barry

Electronic Theses and Dissertations

In this article, the investigators present a new method using a deep learning approach to diagnose schizophrenia. In the experiment presented, the investigators have used a secondary dataset provided by National Institutes of Health. The aforementioned experimentation involves analyzing this dataset for existence of schizophrenia using traditional machine learning approaches such as logistic regression, support vector machine, and random forest. This is followed by application of deep learning techniques using three hidden layers in the model. The results obtained indicate that deep learning provides state-of-the-art accuracy in diagnosing schizophrenia. Based on these observations, there is a possibility that deep learning …

When Process Becomes Processing: Managing Instructor Response To Student Disclosure Of Trauma In The Composition Classroom, Kelci Barton

Electronic Theses and Dissertations

In first-year composition courses, there are three aspects of teaching that are researched well so far: disclosure of trauma in student writing, instructor feedback, and emotional labor. The disclosure of trauma is almost completely unavoidable in first-year composition. We encounter an issue with instructor feedback; how do we provide feedback to student writing, like grammar and mechanics, when the student has disclosed trauma in the writing? Additionally, we can build off this with emotional labor, which already occurs consistently in teaching but is heightened in this instance. When providing feedback to a student who has disclosed trauma, this can be …

Validation Of A Brief Screening Instrument For Psychopathology In Adults, Adam Sattler

Electronic Theses and Dissertations

Structured diagnostic interviews are generally considered to be the gold standard method of assessing mental health conditions; however clinicians rarely use such techniques in clinical practice. A major factor contributing to the infrequent use of structured interviews is the amount of time required for administration and interpretation. As such there is a need to develop assessment instruments that balance the objectivity and structure of evidence-based assessment techniques against personnel time and cost. To address this need the current study sought to validate a brief screening instrument for assessing 9 commental health conditions using a well-researched structured clinical interview to establish …

Sensory-Based Programming In Mental Health: Sense Of Self, Nikki Yeckel

Electronic Theses and Dissertations

The doctoral experiential component (DEC) for this Capstone was completed at the Veterans Affairs Healthcare System (VA) in Pittsburgh, Pennsylvania. The program, called Sense of Self, was implemented with the Veteran mental health (MH) population in an inpatient psychiatric rehabilitation unit at the VA. Sense of Self was a three-day educational program that educated Veterans on the sensory systems and sensory processing, provided calming or alerting strategies with use of sensory materials, and assisted the Veterans in creating sensory home programs based on personal goals. The goals of this Capstone were to inform the staff of the Veteran demographic population …

Do Healthcare Students Endorsing Stigma Of Mental Illness Screen For Suicidal Ideation? An Evaluation Of Knowledge, Attitudes, And Behaviors, Dannel K. Petgrave

Electronic Theses and Dissertations

The stigma of mental illness endorsed by healthcare professionals has been linked to adverse outcomes. This issue underscores the need for early anti-stigma interventions in the context of professional training. The present study measured stigma change and suicide screening behaviors among medical, nursing, and pharmacy students enrolled in an interprofessional Communication Skills for Healthcare Professionals course. The Mental Health Knowledge Schedule (MAKS; Evans-Lacko et al., 2010), Opening Minds Scale for Health Care Providers (OMS-HC; Modgill, Patten, Knaak, Kassam, & Szeto, 2014), and the Marlowe-Crowne Social Desirability Scale Form C (M-C SDS Form C; Reynolds, 1982) was administered at baseline (T …

The Association Between Medication Adherence In Mental Illness And Substance Use Disorder Relapse In Patients With Dual Diagnosis, Tyler Dunn

Electronic Theses and Dissertations

Objectives: The aims of the study were to (1) identify personal, social, and clinical history for patients with substance use disorder (SUD) and mental illness, (2) measure agreeance between patient self-report versus facility record history for mental illness, substance abuse, and psychotropic medication, (3) investigate the specific role of medication adherence and barriers to use for psychotropic medications upon SUD relapse, and (4) assess follow-up changes in mental illness severity and medication adherence in dual diagnosis patients enrolled in a substance abuse rehabilitation program.

Methods: The pilot study utilized a mixed methodology. Inclusion criteria included male patients at least 18 …

Academic Advisors' Attitudes Toward Students Experiencing Mental Health Issues, Danielle Aming

Electronic Theses and Dissertations

As students continue to pursue higher education, the potential for them to experience mental health issues will exist (National Alliance on Mental Illness, 2011; Center for Collegiate Mental Health, 2012; Gruttadaro & Crudo, 2012; Salzer, 2012; Center for Collegiate Mental Health, 2013). When entering a new environment, students will look to make connections with the institution; one of these connections can be with an academic advisor (Harper & Peterson, 2005; Harper & Wilson, 2010; Kuh, 2011; Pearson, 2012). It is important for individuals experiencing mental health issues to make connections to the institution so that they are more likely to …

Exploring A Multifactorial, Clinical Model Of Thought Disorder : Application Of A Dimensional, Transdiagnostic Approach., Mara Ann Hart

Electronic Theses and Dissertations

Background: Bleuler saw thought disorder as the core defining feature of psychotic phenomena, reflective of the “splitting of the psychic functions” that occurred when, in the process of thinking, one’s ideas and feelings disconnect, becoming fragmented and competing functions. Unfortunately, interest in thought disorder as the conceptual core of psychosis was lost with rise of the modern DSM system, paralleling the shift towards a more simplistic, categorical way of defining psychiatric disorders. Aims: This study examined thought disorder from a dimensional perspective, with the aim of disentangling qualitative heterogeneity and diverse sources of influence. Analyses were based on …