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 Development And Piloting Of A Novel Client-Rated Trans And Gender Expansive Clinical Competence Scale For Mental Health Providers, Karen Abraham

Dissertations, Theses, and Capstone Projects

Transgender and gender expansive individuals (TGEI) are people who encompass a broad and comprehensive set of experiences of gender diverse individuals and identities that exist both within and beyond a binary framework. In the United States, the Williams Institute identified a proportion of 0.5% of American adults identifying as transgender (Herman et al., 2022). TGE samples report poorer physical and mental health than their cisgender counterparts across the lifespan (Rastogi et al., 2025; Reisner et al., 2015; Reisner, Poteat, et al., 2016). Health disparities of TGEI relative to their non-TGE counterparts can be seen in the prevalence of mood disorders …

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, …

Understanding Familicide: Psychosocial, Behavioral, And Mental Health Risk Factors And Implications For Forensic Behavioral Health Professionals, Molly M. Vogl

Master of Arts in Human Services

Familicide is a rare but devastating form of family violence involving the killing of multiple family members by another family member. Although research examining domestic violence, homicide, and homicide-suicide has expanded, familicide remains less understood due to its low occurrence and complex nature. This capstone examined the psychosocial, behavioral, and mental health risk factors commonly associated with familicide perpetrators and explored how forensic behavioral health professionals may use this information to improve violence risk assessment, prevention, and intervention efforts. A review of peer-reviewed research from academic databases and scholarly search engines identified common themes associated with familicide, including relationship conflict, …

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 …

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 …

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, …

Exploring The Experiences Of Women In Mental Health Therapy After The Occurrence Of Perinatal Loss, Courtney Allison Nishnick

Counseling & Human Services Theses & Dissertations

Perinatal loss encompasses losses of pregnancies at any gestational age, as well as deaths occurring within one year post-birth. In the United States, around 40 thousand stillbirths and infant deaths occur every year (Ely & Driscoll, 2025; Gregory et al., 2025), with about 23 million miscarriages also occurring annually worldwide (Quenby et al., 2021). Perinatal loss experiences lead to distressing mental health symptoms not limited to anxiety, depression, posttraumatic stress, and grief (Crockett et al., 2019; Wamser & Ferro, 2025). While there is extensive research on perinatal loss as it pertains to medical context, there is minimal research relating to …

Association Between Stress Mindset, Psychological Symptoms, And Psychosocial Risk In Liver Transplant Patients, Sarah Kay Brill

Dissertations

Psychosocial functioning is a central component of liver transplant evaluation, yet less is known about how cognitive factors, such as stress mindset, relate to transplant readiness. The present study examined the association between stress mindset and psychosocial risk, as well as its relationship with depressive symptoms, anxiety, and perceived stress among patients undergoing liver transplant evaluation. Patients included 62 adults completing standard pre-transplant assessment measures, including the Stress Mindset Measure–Specific (SMM-S), Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Perceived Stress Scale (PSS). Hierarchical logistic regression analyses indicated that stress mindset was …

The Primary Care Brief Intervention Competency Assessment Tool (Bi-Cat): Examining Reliability And Validity, Arielle Guillod

Dissertations

Within primary care, the Primary Care Behavioral Health (PCBH) model integrates behavioral health services into medical settings through brief, population‑based interventions delivered by behavioral health consultants (BHCs). Although effective performance in this role requires competencies distinct from traditional mental health practice, few psychometrically sound tools exist to assess clinical skills in primary care. The Brief Intervention Competency Assessment Tool (BICAT) is commonly used for this purpose but lacks published evidence supporting its reliability and validity. This dissertation examined the psychometric properties of the BICAT across two studies. Study 1 evaluated factor structure, internal consistency, and construct validity in a heterogeneous …

Aligning Perspectives: Exploring Parent-Youth Agreement On Well-Being And The Impact Of Positive Psychology On Communication & Relationship Habits, Daijah N. Hines

USF Tampa Graduate Theses and Dissertations

As research calls for best practices in assessment of psychological constructs from multiple informants, more information is needed for secondary reports of subjective experiences such as perceptions of life satisfaction. Adolescence is a vital period for intervention and assessment supports to promote well-being, yet there is a gap in the research on how to interpret multi-informant data for mental health constructs such as subjective well-being especially within this population. Research has shown support for and validated the use of parents/caregivers as secondary informants (Dew & Huebner, 1994; Hines et al., 2023; Shoshani & Slone, 2017) yet there is still vague …

Can Hope Be Changed In 30 Minutes? The Development, Refinement, And Pilot Evaluation Of A Hope-Based Single-Session Intervention, Aileen Kangavary

USF Tampa Graduate Theses and Dissertations

Background: Although mental health problems are on the rise among youth, nearly 80% do not access treatment. Schools serve as key settings to address adolescent mental health and wellness needs given the substantial barriers that limit access to community-based mental health services. Despite this potential, schools often face implementation challenges. Therefore, scalable and accessible approaches are needed to meet the growing demand for adolescent mental health support. Single-Session Interventions (SSIs) represent a promising, cost-effective, and digital avenue for providing timely mental health support to youth. Increasingly, research conceptualizes mental health through a two-dimensional framework that includes the presence of well-being …

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 …

Evaluation Of Neuroplastic Changes In Psychological Intervention And Contemporary Treatments Of Depression, Taylor Severance

Dissertations

Major depressive disorder is one of the most prevalent mental health disorders worldwide. There is a vast range of treatment options for depression, with varying levels of effectiveness. Recent treatments for depression have expanded, increasing alternative treatments, and it is unknown which treatments have the largest impact on depression. This research was designed to examine the treatments of depression, with a focus on psychotherapy and contemporary treatments such as ketamine, psilocybin, and transcranial magnetic stimulation. A literature review was conducted to assess treatment outcomes and neuroplastic changes in these interventions, as well as combinations of the interventions. Data were evaluated …

Addressing Mental Health Issues And The Effectiveness Of Cognitive Behavioral Therapy And Mindfulness-Based Interventions Among Athletes, Shelby Jones-Stachnik

Dissertations

This literature review identifies mental health concerns among competitive athletes and evaluates psychological interventions to address these challenges. Specifically, the review explores the mental health concerns experienced by athletes engaged in high-level sport. It examines whether cognitive behavioral therapy and mindfulness-based interventions are effective approaches for improving psychological outcomes in this population. A systematic review of peer-reviewed research was conducted, and findings were synthesized to evaluate the effectiveness of cognitive behavioral therapy and mindfulness-based interventions. The review included randomized controlled trials, quasi-experimental studies, and meta-analyses examining psychological interventions in athletic populations. Findings across the literature indicate that both cognitive behavioral …

Diverse Families Navigating Mental Health At The Pediatrician’S Office: A Mixed Methods Exploration Of The Interplay Of Stress, Culture, And Child Mental Health In The Primary Care Setting, Sara B. Budowsky

Dissertations

Low-income and ethnic minority youth experience high psychiatric need but persistently low participation in traditional mental health care. General pediatricians are often the first and only healthcare providers with whom many families engage around their child’s emotional and behavioral development. Using both quantitative analysis of retrospective secondary data and Interpretative Phenomenological Analysis (IPA) of in-depth interviews with diverse caregivers, this project explored influencers of child mental health and family utilization of pediatric primary-care-based mental health services in the context of a uniquely multicultural clinic serving a predominantly Medicaid population. Three key findings include: 1) Caregiver Stress was a highly significant, …

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 …

Empowering Healing And Recovery: Adverse Childhood Experiences Screening In A Cognitive Behavioral Therapy Intensive Outpatient Program, Serena C. Lee

Doctor of Nursing Practice Final Manuscripts

Purpose: This evidence-based practice project implemented Adverse Childhood Experiences (ACEs) screening in an adult Cognitive Behavioral Therapy Intensive Outpatient Program (COG IOP) at San Diego's largest behavioral health hospital to identify ACE exposure, deliver supportive interventions, and enhance clinician competency in trauma-informed care.

Background: ACEs are potentially traumatic experiences occurring before age 18 that are associated with toxic stress and worsening health outcomes. Despite evidence linking ACEs to adverse outcomes and substantial healthcare costs, routine ACE screening is not standardized in behavioral health settings.

Methods: Guided by the San Diego 8A's Evidence-Based Practice model, eligible patients were offered ACEs screening …

Enhancing Tardive Dyskinesia Screening In An Outpatient Psychiatry Training Clinic: A Quality Improvement Initiative, Ariel Davalos

Doctor of Nursing Practice Final Manuscripts

Background: Tardive Dyskinesia (TD) is a debilitating, often irreversible movement disorder caused by prolonged exposure to dopamine receptor-blocking agents, affecting 15-30% of patients on long-term antipsychotic therapy. Despite endorsement of the Abnormal Involuntary Movement Scale (AIMS) as the gold standard for TD screening, the condition remains significantly under-diagnosed. Purpose: This quality improvement project evaluated whether a 45-minute educational intervention could improve PMHNP trainees’ confidence and competence in TD recognition and AIMS administration. Methods: Guided by the Iowa Model of Evidence-Based Practice, the project used a pre-post survey design with a planned one-month follow-up across two clinical training sessions. Ten PMHNP …

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 …

Mediating Effects Of Fear Of Failure And Depressive Symptoms On The Relationship Between Perfectionism And Academic Procrastination Among Postgraduate Students At Public Universities In Klang Valley, Wang Li

Student Works (2020-2029)

This study addresses the issue of low timely completion rates among postgraduates in Malaysia. Based on this problem, this study aims to investigate the relationships between perfectionism, fear of failure, depressive symptoms, and academic procrastination. A total of 511 postgraduate students from public research universities in Klang Valley participated in the study. Preliminary analyses revealed moderate overall levels of perfectionism, fear of failure, and procrastination, alongside a comparatively higher level of depressive symptoms. Spearman’s rank-order correlations confirmed significant bivariate relationships among all key variables. Subsequent Partial Least Squares Structural Equation Modeling (PLS-SEM) demonstrated that fear of failure and depressive symptoms …

Empowering Recovery: Implementing Ace Screenings To Enhance Care For Patients With Substance Use Disorders, Joshua Wolf

Doctor of Nursing Practice Final Manuscripts

Objective: This evidence-based practice project evaluated the impact of implementing adverse childhood experience (ACE) screenings for patients with substance use disorders (SUDs) in an outpatient community behavioral health clinic.

Background: ACEs are strongly associated with an increased risk of developing SUDs, chronic medical comorbidities, and negative treatment outcomes. Despite consistent evidence supporting the need for identification of ACEs and implementing trauma-informed care, standardized ACE screening is not routinely incorporated into outpatient SUD treatment, potentially limiting the identification of the need for education and referrals.

Methods: The ACE Questionnaire for Adults was implemented during routine psychiatric visits for patients diagnosed with …

Thoughts From The Pit: Can Raving Change The World? A Literature Review Exploring Rave Culture As Expressive Arts Healing, Marissa Rose Renella

Expressive Therapies Theses

This literature review examines the structural and philosophical commonalities between expressive arts therapy (EXA) and rave culture. Drawing on scholarship from anthropology, cultural studies, health sciences, transpersonal psychology, neuroscience, and expressive arts therapy, this review identifies five core principles shared between the two fields: transformational experiences, multimodality, entrainment and flow, containment and ritual, and community and social action values. Across each principle, the literature reveals not surface-level similarity but deep convergence — two fields that have, independently and through different lineages, arrived at the same understanding of what human beings need in order to heal, grow, and connect. To the …

Re-Painting Motherhood: A Community-Based Expressive Arts Project Exploring Motherhood’S Myths, Realities, And Hopes Through A Narrative Therapy Lens, Lauren Grignaffini-Morris

Expressive Therapies Theses

This thesis examines how socially constructed ideals of motherhood shape maternal identity, distress, and isolation, and explores the potential of addressing these experiences through a community-based expressive arts project. Drawing on motherhood studies, expressive arts therapy, and narrative therapy, the project highlights the potential benefits of utilizing expressive arts in a community setting to ease the tension between romanticized cultural narratives and the lived realities of mothers. Conducted with a support group for mothers in rural Vermont, the project used visual art, movement, creative writing, and collaborative mixed-media painting to examine problem-saturated motherhood stories, connect through embodied experience, and explore …

Brain-Based Mechanisms Of Behavioral Impairment In Fetal Alcohol Spectrum Disorder (Fasd): The Neuroimaging Biomarkers Of Inhibitory Control, Zinia Pervin

Biomedical Engineering ETDs

The developing brain is highly susceptible to alcohol-induced toxicity, often resulting in long-term deficits in executive function and behavioral regulation. Inhibitory control impairments are among the most prominent deficits observed in Fetal Alcohol Spectrum Disorder (FASD). This study investigated the neural mechanisms of inhibitory dysfunction using a multimodal MEG–DTI approach in 67 children aged 6–8 years (34 with FASD, 33 controls) who performed a Go/No-Go task. Source-level MEG analyses revealed reduced stimulus-locked cortical activation in the anterior cingulate cortex and significant group-by-hemisphere interactions in the superior parietal cortex and cuneus. Time–frequency analyses showed diminished response-locked beta power in the sensory-motor …

Application Of Occupational Therapy Task-Oriented For Chronic Post-Stroke Rehabilitation: A Case Study, Gia Nghi Vu

UNLV Theses, Dissertations, Professional Papers, and Capstones

Stroke remains the leading cause of long-term disability, with persistent upper extremity (UE) impairment limiting engagement in daily tasks, reducing quality of life and contributing to learned non-use in the chronic stage among stroke survivors. The Occupational Therapy Task Oriented (OTTO) approach is proposed to optimize occupational performance through the use of meaningful, functional and highly individualized tasks that enable clients to fulfill their valued roles and participate in desired daily activities. The purpose of this capstone project was to advance clinical skills by applying the OTTO approach to examine its effect on occupational performance and UE motor function in …

Exploring The Impact Of University-Recognized Spaces On Racial Battle Fatigue Among Black Faculty & Staff At Historically White Institutions, Tiffany M. Courseault

LSU New Orleans Theses and Dissertations

Black Faculty and Staff (BFS) at Historically White Institutions (HWIs) navigate environments shaped by racial microaggressions, systemic inequities, and institutional marginalization. These conditions contribute to Racial Battle Fatigue (RBF), a psychological, behavioral, and physiological response to sustained exposure to racialized stress. While institutional Diversity, Equity, and Inclusion (DEI) initiatives are often positioned as mechanisms for improving campus climate, existing research suggests they frequently fail to address the lived realities of BFS. This study examined how university-recognized communal spaces function as critical sites of support, resistance, and mitigation within these environments.

Using a narrative inquiry methodology, this study explored the lived …

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 …