Psychiatric and Mental Health Commons^™

Opioid System's Involvement In Ketamine's Antidepressant-Like Effects, Fan Zhang

Theses and Dissertations

Depression is one of the most debilitating disorders in the world. The currently available medications typically have a 2-4 week delay in their therapeutic effects and are ineffective for about 40% of patients. In 2000, a subanesthetic dose (0.5 mg/kg i.e.) of the dissociative anesthetic ketamine was reported to have both rapid and robust antidepressant effects in in treatment-resistant depressed patients. However, the mechanisms responsible for ketamine’s antidepressant effects remain unclear. In 2018, a clinical study reported that pretreatment with the nonselective opioid antagonist naltrexone attenuated the rapid antidepressant effect of ketamine in depressed patients. The current study investigated the …

Anxiety Screening In Children & Adolescents With Type 1 Diabetes Using The Gad-7 Tool, Allison B. Reynolds

DNP Projects

BACKGROUND: Children and adolescents with type 1 diabetes (T1DM) can encounter a variety of factors that affect proper management of their diabetes, including mental health. Youth with diabetes have significantly higher rates of depression, anxiety, and mental health problems compared to the general population. Anxiety is especially prevalent. PURPOSE: The objective of this project was to evaluate anxiety screening of children and adolescents with T1DM during their routine diabetes visits. Specifically, to assess for any trends in anxiety levels and patient characteristics including demographics, insulin regimen and A1C levels. METHODS: A cross- sectional, retrospective review of ambulatory electronic health records …

Long-Term Mental Health And Quality Of Life Outcomes Of Neonatal Insults In Kilifi, Kenya, Dorcas N. Magai, Hans M. Koot, Charles R. Newton, Amina Abubakar

Institute for Human Development, East Africa

We examined the mental health and quality of life (QoL) outcomes and their correlates of school-aged survivors of neonatal jaundice (NNJ), hypoxic-ischemic encephalopathy (HIE), and a comparison group. The Child Behavior Checklist and the Pediatric Quality of Life Inventory were administered to assess the mental health and QoL of 375 children (134 with NNJ, 107 with HIE, and 134 comparison group) aged 6 to 12 years [Median age 9 (interquartile range 7 to 11)]. The results showed that survivors of NNJ and HIE have mental health problems and QoL similar to the comparison group. Maternal mental health was the predominant …

The Harm In Seeking Care: Assessing The Relationship Between Healthcare Discrimination And Healthcare Avoidance Behaviors In The Past Year And Since The Start Of The Coronavirus Pandemic In A Transgender And Gender Independent Sample, Kyle L. Mason

Theses and Dissertations

Background: Gender minorities encounter a myriad of barriers to accessing general and gender affirming healthcare. Financial disparities impacting affordability of healthcare costs and insurance-based denials for gender-affirming care are among prominent barriers discussed. Considerations of the prevalence of stigma, discrimination, and erasure of gender minority identities must not be neglected when seeking to understand healthcare accessibility and utilization in this population. Previous researchers have examined gender minority patients’ experiences of discrimination in healthcare settings and delaying care due to fear of discrimination. There is a dearth of knowledge about the relationship between lifetime exposure to varied forms of healthcare discrimination …

Exploring Superivsion, Efficacy Beliefs, And The Supervisory Working Alliance When Counselors-In-Training Work With Lgbtgeqiap+ Clients, Sandra Gene Gavin

Graduate Research Theses & Dissertations

The focus of this study was to explore the perception of the supervisory working alliance (SWA) and counseling efficacy beliefs for CITs who work with LGBTGEQIAP+ client(s). There is evidence that supports the importance of a strong SWA that aids in CIT development and the importance of counseling self-efficacy in clinical supervision. However, few researchers have explored the perceptions of the SWA, counseling self-efficacy, other-efficacy beliefs on CITs counseling self-efficacy with no models that explored these concepts when CITs work with LGBTGEQIAP+ clients. This study was conducted to explore these perceptions of the SWA, counseling efficacy beliefs, and how these …

Grief Experiences Of Counselors: A Photovoice Exploration And Interpretative Phenomenological Analysis, Paige S. Spangler

Graduate Research Theses & Dissertations

There is a lack of research on practicing counselors and how personal and painful experiences, such as grief, influence their identity. Grief can impact counselors’ wellness and result in emotional impairment. CACREP standards do not require training in grief counseling. Thus, there are vacancies in understanding the influence of grief and a lack of preparation in navigation and dialogue of grief in counselor education programs. This qualitative study explored the phenomenological experiences of how grief influences counselor identity. The methodology used in this study was photovoice with interpretative phenomenological analysis (IPA). Photovoice allowed participants to describe their experiences through their …

The Impact Of Social Isolation And Cognitive Decline In Older Adults: A Systematic Literature Review, Jody L. Doll-Wilhelm

All Graduate Theses, Dissertations, and Other Capstone Projects

Background: During the COVID-19 pandemic, deaths of Alzheimer’s Disease (AD) and dementia patients surged. Increased social isolation and decreased activity levels in older adults have been suggested as contributing factors to accelerating AD and dementia. However, assessment tools to gauge interventions and outcomes of cognitive decline are variable among the literature.

Objective: Examine the impact of social engagement versus social isolation, like that experienced with the COVID-19 pandemic, on cognitive decline/dementia in older adults (greater than 60 years of age).

Method: A systematic search for studies evaluating the relationship between social isolation and social activity in cognitive …

Predicting Mental Health Counseling Professionals’ Willingness To Discuss Sexuality Issues With Clients, Becca L. Thompson

All Graduate Theses, Dissertations, and Other Capstone Projects

Sexuality is fundamental to the human experience and sexuality issues will affect every individual across the lifespan. Mental health counseling professionals (MHCPs) will likely encounter a client in their practice that presents with some facet of sexuality concern. MHCPs may be challenged by these disclosures or neglect to inquire about these needs due to underlying factors that contribute to decreased willingness to discuss sexuality with clients. This study explored the relationships of some of these factors, including sexual intervention self-efficacy, state anxiety, and trait anxiety, and further examined the extent to which these factors predict willingness to discuss sexuality with …

The Lived Experiences Of Black Youth Who Recidivate In Diversion Programs, Justin Richards

Walden Dissertations and Doctoral Studies

There are high rates of recidivism among U.S. Black youth when compared to other races, such as Whites and Hispanics. The purpose of the study was to examine the lived experiences of Black youth in the juvenile justice system and in diversion programs. Using a phenomenological qualitative method, twelve Black adults between the ages of 18 to 40 were interviewed about their lived experiences while participating in mental health courts and in-home probation as youth. The conceptual framework of the study was based on the risk, need, and responsivity model. The primary research question examined the lived experiences and perceptions …

Reimbursement Of Mental Health Service For Individuals Seeking Services At Primary Care Facilities, Keith Avant

Walden Dissertations and Doctoral Studies

The purpose of this quantitative study was to explore the relationship between primary care services, mental health services, patient visits, and insurance reimbursement for individuals with a mental health diagnosis who visit primary care facilities. The theoretical integrated theory of health behavior changes has been vital in identifying the contributing factors to the relationship between primary care, mental health services, and insurance reimbursement. The research questions explored whether any relationship existed between mental health diagnosis and office visits, outpatient versus inpatient, the amount paid for treatment, and reimbursement of services. This study used a quantitative approach along with a Pearson …

Mental Health Provider Experiences Among Juvenile Offenders With Attention Deficit Hyperactivity Disorder, Vanessa West

Walden Dissertations and Doctoral Studies

Research has indicated various treatment options available such as medication management or family therapy for juvenile offenders struggling with a diagnosis of, or symptoms of, attention deficit hyperactivity disorder (ADHD). Exploring mental health clinicians’ perceptions may provide insight into treatment needed for this population to contribute positively to society. Past researchers refrained from obtaining mental health clinicians’ perspectives on treatment when working with this population. Rational choice theory indicates that individuals examine the costs and benefits of their actions prior to making decisions. Gestalt/feature-intensive processing theory promotes the inclusion of necessary information to help with processing when making decisions. Youth …

Educational Strategies For Healthcare Providers Of Postpartum Women With Substance Use Disorder, Agnes Denise White

Walden Dissertations and Doctoral Studies

AbstractProviding educational strategies to maternal-child staff members can improve their attitudes, perceptions, and stigma towards the childbearing age women who are substance users. In the United States, an increased number of pregnant women have substance abuse problems. It is important that the maternal child staff have the resources and are equipped to care for women who are substance users struggling with their addictions and motherhood. The purpose of this project was to determine whether an educational program provided to postpartum nurses increased knowledge on the special needs of the new mother with a substance abuse issue. The education of the …

Effects Of Attribution And Appraisal Of Control On Emergency Department Nurse Stress When Treating Patients With Severe Mental Illness, Cynthia Lynn Bentzen-Mercer

Walden Dissertations and Doctoral Studies

AbstractAs the prevalence of severe mental illness continues to rise and access to mental health care is scarce, an increasing number of U.S. adults seek treatment in emergency departments. Nurses who triage the severity of a medical emergency may appraise the situation both through the lens of mental illness stigma and the degree of confidence they have to control the outcome. However, the research community knows little about the extent to which attribution and appraisal of control affect nurses’ appraisal of stress. The purpose of this quantitative nonexperimental, canonical correlational study was to examine the extent to which various combinations …

Faith Leaders’ Perceived Role In Mental Health Promotion In Impoverished Communities, Kelly L. Cornish

Walden Dissertations and Doctoral Studies

The use of faith-based organizations (FBO) for health promotion in vulnerable communities has the potential to improve mental health outcomes by providing resources to community members. The purpose of this generic qualitative study was to explore how faith leaders perceived their role in mental health promotion as a resource to improve access to mental health care in impoverished communities. The health belief model and theory of planned behavior were used as the conceptual framework. Purposeful and snowball sampling was used to recruit eight faith leaders who led a FBO and resided in Cumberland County, NJ. Data were collected using semistructured …

Examining The Impact Of Mental Health Education On Bias And Stigma In Cit Trained Officers, Jennifer L. Krause

Walden Dissertations and Doctoral Studies

The purpose of this quantitative, correlational nonexperimental research was to examine the relationship between the mental health education received through Crisis Intervention Team (CIT) training and the perceptions of public mental health stigma, self-stigma, and attitudes toward seeking mental health services among law enforcement officers. The study’s theoretical framework integrated gender-role conflict theory and Goffman’s stigma theory in explaining the influence of the police culture on officers’ adoption of more traditional masculine roles. This research used three instruments: the Attitudes to Mental Illness questionnaire to measure perceptions of public stigma, the Self-Stigma of Seeking Help Scale to measure self-stigma, and …

A Retrospective Analysis Of Integrative Group Medical Visits For Low-Income Patients With Anxiety Disorders In Primary Care, Annamma Udaya Thomas

Walden Dissertations and Doctoral Studies

High utilization of the emergency department (ED) by patients with anxiety symptoms has brought attention to mental health access disparities among low-income racially/ethnically diverse populations. The health system in this study attempted to increase access to mental health care with integrative group medical visits (IGMVs), a nonpharmacological intervention with biomedical care consultation, health education, and peer support. The purpose of this retrospective comparative analysis, guided by integrative health equity in primary care framework, was to determine whether patients with diagnoses of anxiety who attended four or more IGMVs had reduced nonemergent ED utilization, reduced prescribed doses of benzodiazepine (BZD), and …

Teacher Perception On Integrating School Psychology In The Developing Nation Of Grenada, Carla Erica Maria St. Louis

Walden Dissertations and Doctoral Studies

AbstractInternationally, formalized school psychology and related services strive to address the academic and mental health of students in schools. In developing nations, teachers are the primary professionals to address students’ needs in schools. Little research has focused on teachers’ perceptions of students’ needs, available services’ quality, and how formalized structures with qualified certified professionals can further address students’ needs. Bronfenbrenner’s ecological systems and Nastasi’s participatory culture-specific intervention model are the theoretical underpinnings of this qualitative study and focus group interviews were used to investigate special education needs (SEN) teachers’ perceptions. Data were collected using open ended questions and probes with …

Mental Health Literacy Among Rural And Urban Young Adults In Zambia, Etta Y. Mwambwa-Johnson

Walden Dissertations and Doctoral Studies

Misconceptions that negatively influence attitudes and beliefs about mental illness are still prevalent in Zambia. Researchers have reported that young adults are the most impacted population for mental disorders in Zambia. Researchers have also highlighted mental health literacy (MHL) as a useful strategy for influencing positive attitudes and beliefs about mental disorders. The purpose of this quantitative cross-sectional study was to investigate the relationship between levels of MHL and attitudes and beliefs about mental illness and health-seeking behaviors of Zambian young adults aged 18 to 24. The study used the health belief theoretical model. A MHL questionnaire was used to …

Helping In The Home: Counselors’ Experiences Providing Clients With In-Home Services, Melissa Jane Franzen

Walden Dissertations and Doctoral Studies

Counseling is an essential service that helps individuals work through struggles and live their best lives. Such service now includes providing counseling in clients’ homes. Counselors may require specific training or education to prepare for counseling in a home environment. This need for training and education is due to a lack of knowledge of the lived experiences of counselors providing services in the home. Transcendental phenomenology was used to guide a qualitative exploration into the lived experiences of counselors providing services in clients’ homes. Participants were 7 professional counselors, 5 female and 2 male, having met minimum state licensure requirements …

Lived Experiences Of Pakistani American Women Who Sought Mental Health Treatment, Marriam Ashraf

Walden Dissertations and Doctoral Studies

AbstractDespite the research on how mental illness manifests in the United States, there is more to be known about mental health in the Pakistani American population. The goal of this qualitative phenomenological study was to understand the lived experiences of Pakistani American women who sought mental health treatment. Ecological theory provided the framework for the study. Data were collected from semi structured interviews with 10 participants via telephone and face-to-face conversations. Data were analyzed using managing, reading, memoing, describing, classifying, interpreting, representing, and visualizing techniques. Findings indicated that seeking help for mental health played a positive role in participants being …

Examining Clinicians' Perspectives Screening For Depression In Patients With Type 2 Diabetes Mellitus, Vickie Lavette Bland

Walden Dissertations and Doctoral Studies

The United States has a significant diabetes problem. This chronic disease affects the body physically and mentally. One of the emotional effects of diabetes is depression. Depression is often present in individuals with diabetes, chiefly in those with type 2 diabetes mellitus (T2DM). While depression is common in T2DM and can interfere with treatment adherence, clinician screening for depression in T2DM patients is low. The purpose of this study was to examine clinicians' attitudes, behaviors, and perceptions concerning screening patients with T2DM for depression. Through a qualitative case study approach centered on reasoned action theory, 3 physicians and 5 nurse …

Coping Skills, Emotional Intelligence, Attachment, And Resilience On Post-Traumatic Stress Disorder In Private Sector Emergency Medical Technicians, Brenda-Joyce Gonzales Orozco Markert-Green

Dissertations

Problem

Private sector Emergency Medical Technicians (EMTs) are first responders who respond to traumatic incident scenes along with firefighters and police officers. However, news agencies and the public do not acknowledge private sector EMTs with the same vigor or accolade as public sector EMTs, nor are the risks to life, health, and mental well-being recognized among this population. Thus, the research literature has been sparse regarding how private sector EMTs experience PTSD, and what unique risk factors and needs may be present.

Purpose Statement

The purpose of this study was to examine the relationship between PTSD symptoms and coping skills, …

Maternal Depression Trajectories And Child Bmi In A Multi-Ethnic Sample: A Latent Growth Modeling Analysis, Charlotte V. Farewell, Ryley Donohoe, Zaneta Thayer, James Paulson, Jacinda Nicklas, Caroline Walker, Karen Waldie, Jenn A. Leiferman

Psychology Faculty Publications

Background

Perinatal (antenatal and postpartum) depression impacts approximately 12% of mothers. Perinatal depression can impact everyday functioning for mothers, and the relationship with, and development of, their children. The purpose of this study was to investigate depression trajectories from the antenatal period through 54-months postpartum and associations with child body mass index at 54-months postpartum.

Methods

This study applied latent growth modeling to the Growing Up in New Zealand study, which is a longitudinal pregnancy cohort study that provides nationally representative-level data, to investigate associations between depression at three time points (antenatal, 9-months postpartum, 54-months postpartum) and child body mass …

As Time Goes By: Understanding Child And Family Factors Shaping Behavioral Outcomes After Traumatic Brain Injury, Linda Ewing-Cobbs, Janelle J Montroy, Amy E Clark, Richard Holubkov, Charles S Cox, Heather T Keenan

Faculty, Staff and Student Publications

Objective: To model pre-injury child and family factors associated with the trajectory of internalizing and externalizing behavior problems across the first 3 years in children with pediatric traumatic brain injury (TBI) relative to children with orthopedic injuries (OI). Parent-reported emotional symptoms and conduct problems were expected to have unique and shared predictors. We hypothesized that TBI, female sex, greater pre-injury executive dysfunction, adjustment problems, lower income, and family dysfunction would be associated with less favorable outcomes.

Methods: In a prospective longitudinal cohort study, we examined the level of behavior problems at 12 months after injury and rate of change from …

The Strategically Broken System: A Grounded Theory Study Of The Clinical Implications Of Immigration Law, Policy, And Practice, Kelle Agassiz

Antioch University Dissertations & Theses

The majority of clinicians do not receive education pertaining to the legal aspects of immigration in their curriculum, training, or continuing education. In addition, the process of navigating the immigration system has been exacerbated in recent years due to rapid policy changes under the Trump administration, which has contributed to a hostile political climate, particularly for immigrants from Central America and Mexico. Using a classic grounded theory research approach, this study explored the relationship between the psychological implications of immigration and the legal challenges that immigrants face today, with a specific focus on immigration from Central America and Mexico. Through …

The Rise In Use Of Emotional Support Animals By College Students: The Impact Of Parenting Styles, Misty G. Smith, Samantha Ballard, Jill Willis

Journal of Higher Education & Student Affairs

As the generational context of higher education shifts, a rise of Emotional Support Animals (ESA) and mental health concerns are present for students on college campuses. While previous studies have aimed to address the relevancy and controversy of ESAs in higher education as well as their effectiveness in supporting individuals, less research has explored underlying factors that contribute to the use of an ESA. The purpose of this study was to explore the parenting behaviors of parents/caregivers of students with ESAs in comparison to parents/caregivers of students without ESAs. An embedded mixed methods design was used. Participants completed the Parenting …

Lived Experiences Of Former Commercialized Sex Workers Seeking Harm Reduction Services In Nevada, Arlynda Yvette Almond

Walden Dissertations and Doctoral Studies

Commercialized sex work has been considered a high-risk profession. Understanding the social context and application of services that foster wellbeing for this population is of research concern. There is a risk of ineffective service when programs are designed by providers who are not formerly of the profession and not familiar with the unique needs of this population. The problem is that commercialized sex workers who need but do not seek harm reduction services may experience ill-health and lack of wellbeing. The purpose of this qualitative phenomenological study was to explore the lived experiences of 10 commercialized sex workers who pursued …

Post-Conflict Mental Health Policy And Substance Use Among Liberian Adults, Ekua Amonoo-Lartson

Walden Dissertations and Doctoral Studies

AbstractThe objective of post-conflict countries after an extended period of war and trauma is to maintain peace and stability. However, the physical and psychological effects of substance use to cope with the devastation of war remains long after the crisis has ended. The purpose of this qualitative phenomenological study was to examine substance use among Liberian working-age adults, including their substance use habits, experiences with substance use, and access to mental health rehabilitative treatment. The access to medical care theoretical framework was used to guide the study. Data were collected from face-to-face semistructured interviews with 15 individuals regarding their experiences …

The Experience Of Recovery From Childhood Sexual Abuse Among Black Men, Zeneth Myrie

Walden Dissertations and Doctoral Studies

Childhood sexual abuse (CSA) can result in consequences that are devastating and long lasting. Differences in the nature of CSA for males and females potentially influence recovery and the role of moderating factors, such as spirituality. Studies of recovery from CSA, especially men's experiences of recovery, are relatively few indicating that this is an under researched area. This lack of studies is particularly evident for ethnic minority groups. While addressing the gap in the literature, the purpose of this study was to explore the lived experience of recovery from CSA among African, Caribbean, Black identified male survivors of CSA living …

Reducing The Rate Of Physical Interventions By Increasing Staff Confidence When Using Verbal De-Escalation Techniques, Elizabeth Pavlesich

Walden Dissertations and Doctoral Studies

When working with patients who have the potential to become physically aggressive, verbal de-escalation is an important technique that can defuse a dangerous situation. At the project site in the mental health emergency department (MHED), workplace violence was on the rise based on the reported use of physical interventions (rates of brief holds and physical restraint use). The purpose of this quality improvement evaluation project was to determine whether an educational training program on verbal de-escalation techniques would increase staff's confidence in the use of verbal de-escalation and decrease the rate of physical interventions used in the MHED. The change …