Psychiatric and Mental Health Commons^™

Adverse Childhood Experiences Among Kenyan Adolescents: Psychometric Properties, Prevalence Rates And Correlates, Tom Osborn, Rosine Baseke, Faith Kamau, Winnan Munyasa, Christine Wasanga, Maureen Ngesa, Victoria Mutiso, Moses Nyongesa, Jasmit Shah, Zul Merali

Brain and Mind Institute

Background: Adverse Childhood Experiences (ACEs) have been consistently linked to poor mental health outcomes, yet research on their impact in low- and middle-income countries (LMICs) settings of Africa, remains relatively unexplored. In Kenya, where childhood adversity is widespread, there is a critical need to examine the validity of ACE measures and their associations with mental ill health. This study aimed to validate the Adverse Childhood Experiences questionnaire (ACE-10) in a Kenyan adolescent sample and assess its associations with symptoms of depression and anxiety, bullying, and sociodemographic factors.

Methods: Data was collected from N = 2,842 adolescents and young …

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 …

Legends, Lies, & Rewritten Lives: After The Little Bighorn: Forgotten Struggles Of Those Who Walked Away, 2nd Edition, Thomas B. Davidson

DU Textbooks

This Story surrounds an event that occurred one summer on June 25, 1876, along the banks of the Little Bighorn River in what is now the state of Montana. Seen from a 21st century perch, it is a story of a collision between two very different civilizations or empires. Both empire’s military fought in the manner of their society. This narrative will attempt to balance the believable truth of what happened in that contest between the military representatives of both societies while also trying to tell an engaging story, without drifting into naked partisanship, purple prose, or sensationalism. The narrative …

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 …

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, …

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 …

Navigating Burnout: The Role Of Workplace Support For Social Work Clinicians, Melanie Fulton

Journal of Global Awareness

The shortage of mental health workers is a growing concern in the United States, and social workers a substantial portion of employees who work with individuals with mental health concerns. This shortage stresses the importance of studying factors that impact burnout for mental health clinicians, particularly social work clinicians. While burnout among social workers in some settings have been documented in the literature, less research has focused on independently licensed clinical social workers in private practice. This study had participants complete a survey to examine the relationship between workplace support, burnout, and professional fulfillment among this population (N = 57). …

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 …

Psychosocial Predictors Of Depression And Anxiety In Thai Stroke Caregivers, Chanatip Tongyonk, Sorawit Wainipitapong, Chavit Tunvirachaisakul, Aurauma Chutinet, Michael Maes, Thitiporn Supasitthumrong

Chulalongkorn Medical Journal

Background: Caregivers of stroke survivors often face significant psychological challenges, yet limited research in Thailand has explored how patient and caregiver characteristics jointly influence caregiver mental health outcomes.

Objective: To identify characteristics of ischemic stroke patients and their caregivers that may predict distress, sadness, and anxiety symptoms in the caregivers.

Method: To measure caregivers' burden, stress, depression, and anxiety symptoms, the Hospital Anxiety and Depression Scale (HADS), Zarit Burden Interview (22-item ZBI), and Perceived Stress Scale (PSS-10) were utilized. To define a multi-step mediation model, we used partial least squares structural equation modelling (PLS-SEM).

Result: 97 stroke patients and their …

Implementing A Mindfulness Mobile Application, Smiling Mind To Reduce Stress Experienced By Inpatient Psychiatric Nurses, Justin Ruiz, Emma Mowery

Doctor of Nursing Practice Final Project Abstract

Purpose

To investigate the impact of implementing the use of the Smiling Mind app (a free and easily accessible mobile application that teaches mindfulness skills) among inpatient psychiatric nurses. The aims were to see a 20% reduction in Perceived Stress and improved Workplace Satisfaction after 10 weeks.

Background

Stressors experienced at work by inpatient psychiatric nurses include patient acuity, emotional demands, environmental factors, and policy implementation. Unmanaged stress can disrupt a nurse's work-life and harm the quality of care provided to patients.

Methodology

Using a pre-post implementation design, 7-day shift and 10-night shift nurses used the Smiling Mind app for …

Implementing A Mindfulness Mobile Application, Smiling Mind To Reduce Stress Experienced By Inpatient Psychiatric Nurses, Emma Jade Mowery, Justin D. Ruiz

Doctor of Nursing Practice Final Project Abstract

Purpose: To investigate the impact of implementing use of the Smiling Mind app (a free and easily accessed mobile application that teaches mindfulness skills) in inpatient psychiatric nurses. The aims: A 20% reduction in Perceived Stress and improved Workplace Satisfaction after 10 weeks.

Background: Workplace stressors experienced by psychiatric nurses include high patient acuity, emotional strain, environmental factors, and new policies. Unmanaged stress can harm nurse's well being and affect quality of care.

Methodology: Using a pre-post implementation design, 7 dayshift and 10 night-shift nurses used the Smiling Mind app for 10 weeks. Perceived stress (PSS-10) and workplace satisfaction (WPS) …

Schizophrenia And Multiple Dka Episodes Leading To Neurocognitive Deficits In A 37yo Patient, Andrew Harmon D.O.

Rowan-Virtua Research Day

Patient is a 37 year old female with a PPHx of schizoaffective disorder and PMH of type 1 Diabetes who has had numerous admissions to the ICU due to uncontrolled blood sugars in the setting of continued delusions and medication noncompliance. With continued episodes of DKA, patient continued to psychiatrically decline over the course of multiple years. Studies have shown that anti-psychotic treatment in schizophrenia can help improve cognitive functioning.

Mental Health Comorbidities And Ibd Outcomes In Patients Treated With Anti–Il-23 Therapy, Jashanveer S. Johal, Archana Salek, Mahmoud Al-Bataineh, Bianca Patel, Om Patel, Yecheskel Schneider, Jason Hyman, Abdallah Hussein

Rowan-Virtua Research Day

Background: Depression and anxiety are prevalent in inflammatory bowel disease (IBD) and may adversely influence outcomes. We evaluated the impact of comorbid mood disorders on clinical outcomes among IBD patients treated with anti–IL-23 agents.

Methods: Using a global de-identified electronic health record network, adults with Crohn's disease or ulcerative colitis initiating an anti–IL-23 agent were identified. Cohort 1 included patients with a documented mood disorder (depression and/or anxiety) at or prior to treatment initiation; Cohort 2 included those without mood disorders. Propensity score matching (1:1) on demographics and comorbidities yielded 3,546 patients per cohort. Primary outcomes included inpatient/ED encounters, abscess/fistula, …

Unmasking Neurosyphilis: A Psychotic Presentation With A Hidden Cause, Fazal Choudhary Do, Lalitya Karra Do

Rowan-Virtua Research Day

No abstract provided.

Mental Health Vs Substance Misuse: Predicting Restraint Use In The Emergency Department, Chloe Lafosse Bs, Michael Witt Md, Mph

Rowan-Virtua Research Day

Introduction: Violence in the emergency department affects approximately 30% of hospital staff every 6 months. Presenting complaints may contribute to violence risk, particularly in those with mental health or substance misuse issue where there are heightened risks of cognitive impairment and involuntary holds.

Methods: We conducted a systematic review of literature published between 1957-2025 using multiple databases, identifying studies that observed physical restraint use on adult emergency department patients. All relevant data was recorded and imputed into SPSS for a chi-square test.

Results: Thirteen studies (2019-2025) met inclusion criteria, with sample sizes ranging from 58 to 1,035,522 participants. All studies …

Impostor Phenomenon In Healthcare: Prevalence, Implications, And Educational Responses, James Espinosa, Robin Lahr, Sergey Medlenov, Swet Patel, Nicholas Tomasello, James Lee, Neel Parikh, Alan Lucerna, Henry Schuitema

Rowan-Virtua Research Day

The impostor phenomenon describes persistent self-doubt and fear of being exposed as a fraud despite objective evidence of competence. The term 'impostor phenomenon' is preferred over the term "imposter syndrome" because it is not a psychiatric diagnosis and avoids pathologizing normal developmental uncertainty. The original authors used the term 'phenomenon' (Clance & Imes, 1978), and contemporary scholarship increasingly adopts this terminology.

First described by Clance and Imes (1978), the construct has since been studied across diverse professional domains, including medicine, nursing, and academic leadership. Subsequent research demonstrates that impostor experiences occur across genders, training levels, and healthcare roles (Bravata et …

Mental Health Comorbidities And Ibd Outcomes On Anti-Tnf Therapy, Jashanveer S. Johal, Mahmoud Al-Bataineh, Archana Salek, Bianca Patel, Om Patel, Jason Hyman, Yecheskel Schneider, Abdallah Hussein

Rowan-Virtua Research Day

Background: Depression and anxiety are prevalent in inflammatory bowel disease (IBD) and may adversely affect biologic therapy outcomes. We evaluated the impact of comorbid mood disorders on clinical outcomes among IBD patients treated with anti-TNF agents.

Methods: Using a global de-identified electronic health record network, adults with Crohn's disease or ulcerative colitis initiating an anti-TNF agent between 2018–2023 were identified. Cohort 1 included patients with a documented mood disorder (depression and/or anxiety) at or prior to anti-TNF initiation; Cohort 2 included those without mood disorders. Propensity score matching (1:1) on demographics and comorbidities yielded 9,605 patients per cohort. Primary outcomes …

Effect Of Pcos Treatment On Mental Health Outcomes, Audriti Mazumder, Aubrey Olson

Rowan-Virtua Research Day

Abstract (250 words)

Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with a range of physical symptoms, including hirsutism, acne, weight gain, insulin resistance, and infertility. While its metabolic and reproductive manifestations are well characterized, the impact of PCOS on mental health remains underexplored. This study aims to evaluate the relationship between PCOS and mental health outcomes, with a particular focus on changes in symptoms following treatment and the influence of demographic factors.

A survey-based study was conducted using a Qualtrics questionnaire distributed via QR code and social media platforms. Questions were modeled after validated screening tools, including …

Barriers To Accessing Mental Healthcare Among Refugee Populations In Southern New Jersey, Paul Cardillo, Hijab Zaidi, Jacob Trainer, Alison Mancuso Do, Facofp

Rowan-Virtua Research Day

This project examines barriers to accessing mental healthcare among refugee populations in Southern New Jersey, with a focus on individuals with limited English proficiency (LEP). Using a narrative review of peer reviewed studies and government reports, key challenges were identified, including language barriers, cultural stigma, and limited familiarity with the U.S. healthcare system. Findings show that refugee populations experience significantly higher rates of mental health disorders, including PTSD and depression, driven by trauma, structural inequities, and social disadvantage. Effective interventions emphasize culturally competent care, integration of bicultural staff, and community based approaches. Addressing these barriers is essential to improving equitable …

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 …