Psychiatric and Mental Health Commons^™

Wellness Intervention As A Quality Of Life Predictor In Mentally Ill Veterans, Tosha Lashon Ellis

Walden Dissertations and Doctoral Studies

Veterans with serious mental illness (SMI) are at high risk of developing conditions such as insulin resistance, obesity, and smoking, which may lead to chronic medical problems. As a result, the morbidity and mortality of people with SMI are high compared to the general population. It appears that integrated care improves the wellbeing of veterans; however, there is a gap in the literature on wellness-based interventions for veterans with SMI. The purpose of this cross-sectional study was to evaluate the association between a wellness intervention for veterans and their perceived quality of life (QOL). Social cognitive theory was the theoretical …

The Danger Zone: How The Dangerousness Standard In Civil Commitment Proceedings Harms People With Serious Mental Illness, Sara Gordon

Scholarly Works

Almost every American state allows civil commitment upon a finding that a person, as a result of mental illness, is gravely disabled and unable to meet their basic needs for food and shelter. Yet in spite of these statutes, most psychiatrists and courts will not commit an individual until they are found to pose a danger to themselves or others. All people have certain rights to be free from unwanted medical treatment, but for people with serious mental illness, those civil liberties are an abstraction, safeguarded for them by a system that is not otherwise ensuring access to shelter and …

Supervisory Working Alliance And Job Satisfaction In Community Mental Health Settings, Jennifer Weigelt

Walden Dissertations and Doctoral Studies

Researchers have written extensively on many facets of supervision in the counseling profession, including the supervisee benefits associated with a strong supervisory working alliance. While the majority of studies have focused on the working alliance in academic settings with student trainees, there has been a lack of research exploring the role of the supervisory working alliance in workplace settings, where supervision can be different from supervision offered in a university clinic or counseling center. Employee job dissatisfaction has been a problem identified within the mental health workforce. Researchers have identified effective supervision as a mediating factor. The purpose of this …

Barriers To Colorectal Cancer Screening In People Obtaining Care From Community Mental Health Agencies, Kelly L. Gardiner

Walden Dissertations and Doctoral Studies

Barriers to Colorectal Cancer Screening in People Obtaining Care

From Community Mental Health Agencies

by

Kelly Gardiner

MSN, Wayne State University, 1997

BSN, Wayne State University, 1988

Dissertation Submitted in Fulfillment

of the Requirements for the Degree of

Doctor of Philosophy

Public Health

Walden University

August 2016

Despite being highly treatable with early intervention and preventative screenings, the overall mortality rate of colorectal cancer is substantially higher in participants with a preexisting mental disorder. Variables affecting the likelihood of completing screening for those with mental illnesses were unknown in people who obtain services from a Community Mental Health agency. Using …

The Perception Of African American Clergy Regarding Mental Health Services, Tamara White

Walden Dissertations and Doctoral Studies

The rise in diagnosable mental illness disorders in the United States is a major concern. However, researchers indicate that African Americans are far less likely to seek mental health treatment than Caucasian Americans. This qualitative, phenomenological study addressed a research gap regarding the beliefs, perceptions, stigmas, and practices of African American clergy regarding their promotion of mental health services. Two conceptual frameworks consisting of the sociocultural theory and the social learning theory guided the study. There were two research questions used to guide the exploration of the purposive sampling of 6 African American clergy from major African American denominations across …

The Exposure Of Workplace Conflict On Residential Mental Health Clients, Shawna Deann Stoneking

Walden Dissertations and Doctoral Studies

Individuals who receive residential mental health services rely on caregivers for support, supervision, and a safe living environment. Residential clients exposed to workplace conflict among staff may feel insecure and mistrust their caregivers, which in turn could negatively impact quality of life and treatment outcomes. The theory of therapeutic alliance proposed by Zetzel, emphasizing the client's perception of the therapist as a nurturing beneveolent figure, was used as the conceptual framework for this phenomenological study. Semi-structured interviews were conducted with 6 adults, recruited with homogenious sampling, who had experienced conflict among staff members and who had been discharged from residential …

Acculturation, Inflammation, And Depression Among Hispanic Adults In The United States, Kristin Marie Marano

Walden Dissertations and Doctoral Studies

Disparities exist in the recognition and treatment of depression among Hispanics in the United States, creating a social, ethical, economic, and public health burden. This study was designed to generate an improved understanding of the causes of and/or contributors to depression within this population. It was specifically designed to 1) assess the prevalence and severity of depression among Hispanic adults in the United States relative to adults of other race/ethnicities in the United States; 2) clarify the inconsistent results in the literature concerning the relationship between acculturation and depression among Hispanic adults in the United States; and 3) fill a …

Integrated And Reducing Re-Entry Into The Criminal Justice System, Scott Huntington

Walden Dissertations and Doctoral Studies

Numerous studies have focused on the effectiveness of integrated treatment services for people with cooccurring disorders (CODs) within the criminal justice system (CJS). However, there has been a paucity of research on the effectiveness of community-integrated treatment services with CODs and influences on decreasing their interaction within the CJS. This study quantitatively examined the possible relationships between integrated treatment services and CODs and their effect on decreasing interactions within the CJS. The sample (N = 320) consisted of people with CODs from a community-based facility. The statistical analysis was a 2-way (2 x 2) and 3-way (2 x 2 x …

Master's Students' Self-Assessment Of Competency In Grief Education And Training In Cacrep-Accredited Counseling Programs, Jane Earline Wood

Walden Dissertations and Doctoral Studies

Counseling can promote positive outcomes for grieving clients by addressing personal loss and helping the client process their grief. However, a lack of understanding on the part of counselors of how people grieve may result in negative client outcomes such as psychological stress, poor health, or an increased risk of depression. Education and training in grief counseling can improve counselors' problem recognition and skills in treatment planning. The purpose of this study was to examine whether Council for Accreditation of Counseling and Related Educational Programs (CACREP) master's degree counseling students view themselves as having been adequately trained in grief theories …

Clergy Characteristics As Predictors Of Mental Health Literacy, Jodi Vermaas Vermaas

Walden Dissertations and Doctoral Studies

The mental health literacy (MHL) rates of Christian clergy in the United States remains underinvestigated in the current literature. This gap of knowledge is problematic for the large numbers of individuals with mental illness who seek assistance from clergy and may receive inadequate care for their concerns. As theoretically designated by the behavioral models of health care and MHL research, denomination-type, educational variables, and demographic characteristics were investigated as potential predictors of MHL. A sample of 238 Christian clergy from throughout the United States completed the web-based Mental Health Literacy Scale and demographic questionnaire. Results of analysis of variance (ANOVA) …

Behavioral Health Medical Interpreters: Cluster Analysis Of Vicarious Traumatization And Posttraumatic Growth, Pauline N. Stahlbrodt

Walden Dissertations and Doctoral Studies

Medical interpreter services will be essential for developing and implementing culturally relevant interventions and treatment for limited English proficiency (LEP) populations. This study sought to identify the possible risks or protective factors that may be associated with vicarious traumatization (VT) or vicarious posttraumatic growth among medical interpreters in behavioral health settings. A 2-step cluster analysis was conducted yielding 2 distinct groupings of medical interpreters (Subtype 1, n = 73; Subtype 2, n = 101). The most important predictor determining the 2 subtypes was whether the participant had a personal history of trauma. In addition, there were significant differences between the …

African American Clergy's Attitude Toward Professional Mental Health Services, Ebony Gaffney

Walden Dissertations and Doctoral Studies

Evaluating the attitude of African American clergy toward parishioners seeking professional mental health services for mental illness has important treatment implications. Religion and spirituality are equally important determinants of mental health and can affect African American clergy's attitudes toward professional care for mental illness. Utilizing the health belief model (HBM), this quantitative study examined the role of theological beliefs, education, and personal experience with mental illness as they correlated with clergy's attitudes toward seeking professional mental illness services. Approximately 98 African American Protestant Clergy in the states of Georgia and South Carolina participated in this study. Data were collected using …

A Phenomenological Exploration Of Children's Experiences During The Therapeutic Process, Katherine Destefano

Walden Dissertations and Doctoral Studies

Billions of mental health care dollars for millions of children and adolescents in need has garnered significant attention within the behavioral health industry to reduce costs while improving treatment efficacy through the identification and implementation of evidence based practices with youth populations requiring therapeutic services. This hermeneutic phenomenological qualitative research approach in the field of psychology is a consumer driven one in the world of business. Line by line context and discourse analyses, which included both a prior and inductive coding, of the verbiage and phraseology of 10 boys and 10 girls, aged 8-12, actively engaged in outpatient psychotherapy, formed …

Improving Quality Of Life In Older Adults With Depression And Diabetes Through Medication Compliance Education, Valreen Hinds-Beharrie

Walden Dissertations and Doctoral Studies

Improving Quality-of-Life in Older Adults with Depression and Diabetes through Medication Compliance Education

by

Valreen Hinds-Beharrie

MSN, Adelphi University, 1997

BSN, Adelphi University, 1986

Project Submitted in Partial Fulfillment

of the Requirement for the Degree of

Doctor of Nursing Practice

Walden University

March 2016

Diabetes and depression are prevalent diseases that cause morbidity and mortality. Diabetes is a heterogeneous metabolic disease in which hypoglycemia is a central feature. Depression is associated with increased counter-regulatory, hormone release, and alteration in glucose transport function. Depression occurs in some individuals with diabetes and is associated with poor metabolic control, inadequate control of diet, …

16pf® Traits As Predictors Of Emergency Medical Service Worker Tenure, Beverly J. Paschal

Walden Dissertations and Doctoral Studies

The United States is experiencing a severe shortage of Emergency Medical Service (EMS) paramedics. The job outlook for paramedics (EMT-P) for the years 2012-2022 is predicted to increase by 23%-33%, which is much faster than the 4% average increase of other first-response professions. The average tenure of paramedics is less than 4 years. There is a significant gap in the literature concerning paramedic personality traits and tenure. The primary objective of the current study is to provide empirical data on the personality traits possessed by long-term paramedics (5+ years), and compare them to those with shorter tenure (< 5 years). Using Allport's Trait Theory, I predicted that personality would affect paramedic longevity. The 6 personality traits tested were warmth, reasoning, emotional stability, liveliness, social boldness and openness to change. A socio-demographic questionnaire, determined the length of their EMS career, while the 16PF® Assessment, tested their personality traits. Using t tests, Mann-Whitney U tests, and a set of regression analyses, data were examined to determine if length of career and personality traits predicted paramedic tenure. The research sample consisted of long term paramedics and former paramedics. The results showed that of the 6 personality traits, only warmth was a significant predictor of paramedic tenure. A logistic regression showed for every additional point in warmth, the odds of leaving EMS prior to 5 years increased by a factor of 2.77. This study provides support for positive social change by helping EMS to learn how to increase recruitment and tenure. It also helps by advising EMS agencies to attend to the mental and emotional health of their paramedics by being aware of the level of their warmth personality trait.

Diminishing Stigma Sentiments In Individuals With Depression: Sociopsychological Predictors Of Deflecting And Challenging Coping Orientations, Jennifer Marie Lee

Walden Dissertations and Doctoral Studies

Individuals who suffer from depression can be stigmatized by labeling and resort to negative stigma coping orientations such as secrecy and withdrawal, resulting in internalized self-stigma. Self-stigma can have negative effects such as low self-esteem, low self-efficacy, isolation, and feeling like a failure. Guided by modified labeling theory, the purpose of this study was to fill a gap in the literature on predictors of two orientations (challenging and deflecting) of positive stigma coping. Challenging stigma involves taking action, and deflecting is a cognitive strategy; both are used to positively cope with the stigma of mental illness. Predictors included symptom severity, …

Outcomes Of Aggression Replacement Training For U.S. Adolescents In Residential Facilities, Coral Ann Ondrus

Walden Dissertations and Doctoral Studies

A National Survey indicated that 1.6 million adolescents in the U.S. were arrested in 2010 and 1.5 million in 2011 for erratic aggressive behaviors, thus showing a decline from the 2.18 million adolescent arrests in 2007. Residential facilities in the state of Pennsylvania offer a group intervention called Aggression Replacement Training (ART) to help adjudicated adolescents regain control of erratic behaviors. The purpose of this study was to examine the extent to which level of group participation in ART and certain demographic factors (age, gender, ethnicity, family socioeconomic status, parental involvement, and education) predict decreased aggression and increased anger control …

Experiences Of Colorado Parents As They Recognized Their Child's Mental Illness, Lori Salgado

Walden Dissertations and Doctoral Studies

Mental illness is not only the leading cause of disability among adults, but there is also an emerging public health crisis in childhood mental illness. A majority of parents do not recognize symptoms of psychological disorder in their children, and current policies and programs for mental health service delivery are not sufficiently responsive to the early help-seeking dynamics of families. Using a concurrent mixed methods design, this study explored how parents in the Pikes Peak region of Colorado learned to recognize their child's mental illness. Phenomenological interviews, augmented by poetic inquiry and quantitative measurements, were used to discover factors that …

An Exploration Of Male Batterers' Perceptions Of A Standardized Batterers' Treatment Program, Dionne Lynn Spooner

Walden Dissertations and Doctoral Studies

The focus of this hermeneutic phenomenological, qualitative study was to gather an in-depth understanding of the lived experiences of male batterers participating in a standardized Duluth-model batterers' treatment group. The study had three main goals: (a) to understand the experience of male batterers participating in a standardized male batterers' treatment program, (b) to improve the treatment being provided to male batterers, and (c) to improve services to those impacted by domestic violence. Results from previous studies indicated that treatment for male batterers is ineffective and inconsistent and that the treatment provided, regardless of framework or modality, has little or no …

High School Teachers' Perceptions Of Mental Health And Adolescent Depression, Christine Ann Breuer

Walden Dissertations and Doctoral Studies

Adolescents have a high rate of untreated mental health issues, specifically related to depression. Current literature does not indicate the impact of teachers' attitudes toward mental health on their decisions to refer students for services. This study provides understanding specifically, how teachers' beliefs about mental health, as well as their age, gender, ethnicity, years of education, and years of teaching, were analyzed to determine the impact each these characteristics had on the decision to refer a student for services. 92 high school teachers participated in this quantitative study by completing a survey measuring their attitudes of mental health, and then …

The Aftermath Of Violence: The Lived Experience Phenomena Of Assault In Nursing, Kathleen Clark

Walden Dissertations and Doctoral Studies

Despite the high incidence of violence directed at registered nurses while on duty, there is limited qualitative data that explores the lived experience of returning to the workplace after an assaultive incident. This phenomenological study sought to explore and analyze the phenomena of registered nurses who are employed in high-risk settings. The research questions considered the detailed descriptions of the experiences of nurses returning to the workplace. The conceptual framework was resiliency, as these participants continued to survive and thrive after the adverse assaultive events. Data were collected using in-depth interviews from purposeful sampling. Registered nurses working in the high …

Identifying Future Effective Foster Parent Characteristics: Using The Casey Foster Family Assessment, Jennifer Grimes-Vawters

Walden Dissertations and Doctoral Studies

In 2014, Washoe County Department of Social Services in Nevada, licensed only 50 of 400 parents who applied to foster children. Lack of long-term effective foster parents creates instability within the system. Significant concern over increased numbers of children entering foster care and a decreased number of qualified foster care applicants continues. The Casey Foster Family Assessment (CFFA), a comprehensive assessment of key traits of effective foster parents may further enhance the fostering application process. The identified CFFA subscales most predictive of future foster parent effectiveness, may help WCDSS more effectively identify applicants likely to provide long-term stable homes for …

The Effect Of Media Literacy Training On The Self-Esteem And Body-Satisfaction Among Fifth Grade Girls, Holly Mathews

Walden Dissertations and Doctoral Studies

Repeated exposure to media images that portray women as sex objects can have negative long-term effects on self-esteem beginning in preadolescence. Negative effects include decreased feelings of competence, increased focus on appearance, increased body dissatisfaction, and limited achievement in domains not related to appearance. There is a gap in the literature examining if media literacy training can mitigate the negative effects of exposure to sexualized media content. Festinger's social comparison theory and Vygotsky's theory of cognitive development provided the framework for this study. A quasi-experimental pre-post-test design was used to examine the interaction of media literacy training and time of …

Utilization And Intensity Of Integrated Behavioral Health Services Within A Primary Care Setting, Joseph Aron Shafer

Walden Dissertations and Doctoral Studies

Integrated behavioral health care within primary care has become a popular style of health care delivery within the United States. However, individuals with a behavioral health concern face several barriers in using these services. The purpose of this quantitative study was to identify key factors accounting for individuals' utilization and intensity of behavioral health services. Andersen's behavioral model of health care use and the integrated theory of health behavior change served as the theoretical framework. It was hypothesized that gender, age, race, ethnicity, family size, payer type, poverty level, and certain preexisting medical conditions (obesity, diabetes, hypertension, and tobacco use) …

Reducing Length Of Hospital Stay For Intellectually Disabled Psychiatric Patients With Chronic Medical Problems, Joseph Wigwe

Walden Dissertations and Doctoral Studies

Length of hospital stay (LOS) is a major indicator for measuring efficient care. Intellectually disabled psychiatric patients (IDPP) with chronic medical problems have longer LOS due to challenges faced by providers in jointly managing both psychiatric and medical problems. The purposes of this study were to understand the significance of LOS for IDPP, create an intervention toolkit to reduce LOS, establish the content validity of the toolkit, and recommend its implementation. The items of the toolkit are pharmacology, somatic, rehabilitation, psychosocial, and monitoring patients' psychiatric and medical symptoms across care domains. The toolkit was created from the constructs of the …

Evaluating The Implications Of Parental Mental Illness For Children Using An Ecological Perspective, Jessica Elizabeth-Rose Carroll

Walden Dissertations and Doctoral Studies

Researchers have extensively studied the experiences and potential consequences of being a child whose parent has a mental illness (COPMI). However, there is no consensus on the best way to support these children, in general or in schools. The purpose of this quantitative study was to examine the effects of parental mental illness on children by using an ecological approach. Researchers have used ecological theory to illustrate the importance of internal characteristics, skills, and supports for children to enhance resiliency. This study looked at whether COPMI differed significantly from the children of parents of parents with no current or past …

The Impact Of African-Centered Psychotherapy On Depressive Symptoms And Africentric Worldview In African Americans, Larae Tillis

Walden Dissertations and Doctoral Studies

Depression is a prominent issue in the African American community. However, there are significant gaps in the literature on the delivery and outcomes of culturally relevant mental health psychotherapy to African Americans. Cultural variables, such as worldview, have been noted to impact an individual's overall psychosocial functioning and have significant implications for mental health service delivery. The purpose of this study was to use archival data to analyze the impact of African-centered therapeutic services on depressive symptoms and on Africentric worldview among African Americans. Archival data on 38 African American adults, recorded from 2012-2015, were obtained from a community mental …

Equine Facilitated Psychotherapy For Veteran Survivors With Full Or Partial Ptsd, Mark Aaron Mayfield

Walden Dissertations and Doctoral Studies

Symptom severity among veteran survivors with partial or full posttraumatic stress disorder (PTSD) continues to increase, with approximately 40% of U.S. veterans reporting significant symptomology 10 years after initial onset of the condition. Veteran survivors often struggle to find therapeutic interventions that meet their specific needs and have a difficult time maintaining a therapy that is both equitable and evidenced based. Grounded in the Rogerian, client-centered theory, the purpose of this qualitative collective exploratory case study was to explore the effects of equine-facilitated psychotherapy with 3 veteran survivors with partial or full PTSD. A 4-stage process was used to collect …

Prevalence And Determinants Of Postpartum Depression In A Tertiary Care Hospital, Shiyam Sunder Tikmani, Tufail Soomro, Prashant Tikmani

Community Health Sciences

Purpose: Postpartum depression is one of the common complication of postpartum period and a major public health issue. It adversely affects the mother, her child, and the family. To determine the prevalence and determinants of postpartum depression in women delivered in a tertiary hospital Karachi.
Methods: This was a cross-sectional study carried out in a private hospital of Karachi, from 1^st February 2014 to 31^st January 2016. All women having age between 20-49 years between 4-6 weeks postpartum period consented to participate were included. Women with pre-existing co-morbid like diabetes mellitus, hypertension, physical and psychiatric illnesses, having multigestation …