Psychiatry and Psychology Commons^™

Conceptualizing Self-Reported Adverse Childhood Experiences: From Epidemiologic Exposure To Psychometric Latent Variable, Marianna D. Lanoue, Richard W. Hass

College of Population Health Faculty Papers

In this paper, we apply a measurement science perspective to explore both the epidemiologic and psychometric frameworks for the conceptualization, operationalization and assessment of self-reported adverse childhood experiences (srACEs). The epidemiologic paradigm suggests that srACEs are 'exposures', while the psychometric paradigm views responses on srACEs instrumentation as 'indicators'. It is the central premise of this paper that srACEs cannot be both exposures and indicators of scales. We review issues of reliability and validity from both perspectives, examine the degree of agreement between objective and subjective reports of childhood maltreatment and the implications of poor agreement, and conclude that the for …

Effect Of Patient Resilience On Functional Outcomes After Meniscectomy, Adeeb Hanna, Andres Perez, Alice He, John Sonnier, Henson Destine, Rahul Muchintala, Ralph Cook, Sean Bryan, Fotios Tjoumakaris, Kevin Freedman

Rothman Institute Papers

BACKGROUND: Recent literature has identified that patient resilience may affect outcomes after meniscectomy. Research into psychological risk factors for poor surgical outcomes has been a focus in orthopaedic surgery.

PURPOSE/HYPOTHESIS: The purpose of this study was to examine the relationship between preoperative patient resilience and 2-year postoperative outcomes after arthroscopic meniscectomy. It was hypothesized that there would be no relationship between resilience and patient-reported outcomes after meniscectomy.

STUDY DESIGN: Cohort study; Level of evidence, 2.

METHODS: Patients who underwent meniscectomy between January and June 2020 at a single multicenter institution were identified, and those aged ≥18 years without evidence of …

Convergence Of Alcohol Consumption And Dietary Quality In Us Adults Who Currently Drink Alcohol: An Analysis Of Two Core Risk Factors Of Liver Disease, Peng-Sheng Ting, Wei-Ting Lin, Suthat Liangpunsakul, Madeline Novack, Chiung-Kuei Huang, Hui-Yi Lin, Tung-Sung Tseng, Po-Hung Chen

School of Public Health Faculty Publications

BACKGROUND/OBJECTIVES: Alcohol consumption and poor dietary habits are on the rise in the United States, posing significant challenges to public health due to their contribution to chronic diseases such as liver failure. While associations between alcohol consumption patterns and diet quality have been explored, the relationship between specific alcoholic beverage types and diet quality remains underexamined. This study aims to compare diet quality among consumers of different alcoholic beverage types. METHODS: We conducted a cross-sectional analysis of 1917 current alcohol drinkers from the National Health and Nutrition Examination Survey (NHANES) who completed a 24 h dietary recall survey. Diet quality …

The Recent History And Near Future Of Digital Health In The Field Of Behavioral Medicine: An Update On Progress From 2019 To 2024, Danielle Arigo, Danielle E Jake-Schoffman, Sherry L Pagoto

Rowan-Virtua School of Osteopathic Medicine Departmental Research

The field of behavioral medicine has a long and successful history of leveraging digital health tools to promote health behavior change. Our 2019 summary of the history and future of digital health in behavioral medicine (Arigo in J Behav Med 8: 67-83, 2019) was one of the most highly cited articles in the Journal of Behavioral Medicine from 2010 to 2020; here, we provide an update on the opportunities and challenges we identified in 2019. We address the impact of the COVID-19 pandemic on behavioral medicine research and practice and highlight some of the digital health advances it prompted. We …

Digital, Social Micro-Interventions To Promote Physical Activity Among Midlife Adults With Elevated Cardiovascular Risk: An Ambulatory Feasibility Study With Momentary Randomization., Danielle Arigo, Leah M Schumacher, Kiri Baga, Jacqueline A Mogle

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Although regular physical activity (PA) mitigates the risk for cardiovascular disease (CVD) during midlife, existing PA interventions are minimally effective. Harnessing social influences in daily life shows promise: digital micro-interventions could effectively engage these influences on PA and require testing.

PURPOSE: This feasibility study employed ecological momentary assessment with embedded micro-randomization to activate two types of social influences (i.e., comparison, support; NCT04711512).

METHODS: Midlife adults (N = 30, MAge = 51, MBMI = 31.5 kg/m2, 43% racial/ethnic minority) with ≥1 CVD risk conditions completed four mobile surveys per day for 7 days while wearing PA monitors. After 3 days …

Challenges In Paediatric Xenotransplantation: Ethical Components Requiring Distinct Attention In Children And Obligations To Patients And Society, Anthony Merlocco, Daniel J Hurst

Rowan-Virtua School of Osteopathic Medicine Departmental Research

The transplantation of non-human organs into humans, or xenotransplantation (XTx), has recently garnered new attention and is being developed to help address the problem of organ scarcity in transplantation. Ethical issues surrounding XTx have been studied since initial interest arose decades ago and have experienced renewed discussion in the literature. However, the distinct and relevant differences when applied to children has largely been overlooked with few groups attending to the concerns that XTx in children raises. In this paper, we explore ethical challenges to be expected in paediatric XTx, in particular exploring organ sizing concerns, infectious risks, psychological burdens, and …

Digital Education On Hospital Nutrition Diets: What Do Patients Want To Know?, Neha Gutta, Som Singh, Dharti Patel, Aleena Jamal, Fawad Qureshi

SKMC Student Presentations and Publications

INTRODUCTION: Therapeutic nutrition plays an imperative role during a patient's hospital course. There is a tremendous body of literature that emphasizes the systematic delivery of information regarding hospital nutrition diets. A major component of delivering healthcare information is the principle of providing quality healthcare information, but this has not yet been investigated on hospital nutrition diets. This study aimed to evaluate the comprehension and readability of patient education materials regarding therapeutic hospital diets.

METHODOLOGY: The methodology employed the use of publicly available questions regarding hospital nutrition diets and categorized them per Rothwell's Classification of Questions. Additionally, the questions were extracted …

Increasing The Frequency Of Behavior Assessment To Reduce Physical Restraint, Breanne N. Ford

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement (QI) project was to implement a system that routinely assesses for behavior changes in psychiatric patients presenting to the emergency department to improve staff intervention of escalating behaviors and decrease physical restraint use.

Background: The project was implemented in a 45-bed emergency department in a community-based hospital affiliated with a large hospital system in Houston, Texas.

Methodology: The project utilizes the Behavioral Activity Rating Scale (BARS) to assess patients' behaviors at routine intervals throughout shifts and a comfort cart that houses several non-pharmacological intervention items to use to de-escalate adverse behaviors. The staff …

Emotional Display Rules Of Deaf Culture, Nicholas M. Gala, Lawrence Pick

JADARA

Emotional display rules refer to the expression of culturally prescribed and socially acceptable emotions across different people and situations (Wu & Schulz, 2020). The display rules among hearing adults across several cultures are well defined and depend on the type of emotion, the individuals involved in the exchange, and the situation. Regarding Deaf culture in the United States, this minoritized group may follow unique display rules (Hosie et al., 2000), but there has been almost no research conducted with this population and the existing studies have focused on youth. The present study explores perceived emotional expressions among a sample of …

Providing End-Of-Life Counseling: A Narrative Inquiry, Carol Hecht, Sibyl West

Adultspan Journal

This qualitative study aimed to address the gap in the research related to end-of-life counseling by exploring the experiences of counselors working with clients at end of life. While counseling literature and education are lacking regarding end of life, many counselors will work alongside clients approaching death. The purpose of this study was twofold: (a) to better understand the nuanced experiences of counselors providing end-of-life counseling and (b) to explore the supports and preparations helpful for counselors to provide end-of-life counseling. A narrative approach, using the Listening Guide (Gilligan, 2015), was employed to analyze and present the stories of three …

Considerations Of Medicare Telehealth Services With Older Adults, Sonah Kho, Amanda Dediego

Adultspan Journal

The onset of the COVID-19 pandemic set in motion a rapid expansion of mental health services offered via telehealth. With this rapid expansion came the need to examine how policy and practice should be shaped in a future where telehealth is considered common in counseling practice. For counselors to understand how to support older adult clients in using telehealth services, they must understand telehealth policy. Following the eligibility of licensed counselors to participate in Medicare, counselors need to stay abreast of regulatory changes regarding restrictions and regulations on use of telehealth for mental and behavioral health services, including video and …

Correspondence To "A Preliminary Study Of Collaborative Group Intervention With Recovered Peer Supporters For Eating Disorders: Analyses Including Comparisons Between In-Person And Online Sessions", Nirjal Thapa, Don D Shamilov, David F Lo

Rowan-Virtua School of Osteopathic Medicine Departmental Research

We read with pleasure the article by Mochizuki et al., ¹ titled “A preliminary study of collaborative group intervention with recovered peer supporters for eating disorders: Analyses including comparisons between in‐person and online sessions.” We would like to offer additional commentary on the conclusions regarding group intervention and peer support and its heavy influence on combating eating disorders. We hope these perspectives may provide insight into areas that may require further research and improvement.

Prevalence And Associated Risk Factors Of Current Hepatitis C Infection Among U.S. General Population And Injection Drug Users Aged 20-59 Years: Nhanes 2009-2018, Harun Mazumder, Md Faruk Hossain, Pratibha Shrestha, Sultan Mahmud, Maidul Husain, Rebeka Ahmed

School of Public Health Faculty Publications

INTRODUCTION: The people who inject drugs (PWID) are attributed to high-risk groups for transmission of the Hepatitis C virus (HCV). This study assessed the prevalence and associated factors of current HCV infection (CHI) among U.S. general population and PWID of ages between 20 and 59 years old. METHODS: This study utilized cross-sectional data from the 2009-2018 National Health and Nutrition Examination Survey, conducting separate analyses for the U.S. general population, including PWID and non-PWID, as well as specific analyses focusing solely on PWID. The analytical methods included the estimation of CHI prevalence, Rao-Scott chi-square test to compare CHI-positive and CHI-negative …

Leveraging Generative Artificial Intelligence Models In Patient Education On Inferior Vena Cava Filters, Som Singh, Aleena Jamal, Farah Qureshi, Rohma Zaidi, Fawad Qureshi

SKMC Student Presentations and Publications

Background: Inferior Vena Cava (IVC) filters have become an advantageous treatment modality for patients with venous thromboembolism. As the use of these filters continues to grow, it is imperative for providers to appropriately educate patients in a comprehensive yet understandable manner. Likewise, generative artificial intelligence models are a growing tool in patient education, but there is little understanding of the readability of these tools on IVC filters. Methods: This study aimed to determine the Flesch Reading Ease (FRE), Flesch–Kincaid, and Gunning Fog readability of IVC Filter patient educational materials generated by these artificial intelligence models. Results: The ChatGPT cohort had …

Self-Harm In Female Youth With Undiagnosed Adhd: Implementing American Academy Of Pediatrics Screening Guidelines, Roselie M. Woodard

Dissertations

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. If undiagnosed or untreated, ADHD can lead to severe psychosocial issues such as academic failure, substance abuse, unplanned pregnancy, and incarceration. The financial burden in the U.S. from diagnostic errors creates an immense, rising fiscal impact. Early diagnosis and management are crucial to prevent these complications.

Females with ADHD, particularly those with the inattentive subtype, often face diagnostic challenges due to symptom masking and over-compensation. This results in poorer cognitive functioning and self-esteem compared to males with ADHD. ADHD is linked to autonomic nervous …

Bridging The Gap: Psychopharmacologic Education And Side Effect Screening For Non-Prescribing Mental Health Professionals, Elaine Fitzgerald

Dissertations

Abstract

Problem: The United States is experiencing a growing demand for pediatric mental health support. Surges in mental health diagnoses and psychotropic medication prescriptions have occurred, compounded by a shortage of psychiatric providers. Non-prescribing mental health professionals are well-positioned to recognize psychotropic medication side effects. However, psychologists and counselors lack formal pharmacology education.

Methods: The quality improvement (QI) initiative was guided by the Plan-Do-Study-Act (PDSA) model. The evidence-based psychopharmacologic education for non-prescribers utilized a quasi-experimental pre- and post- test design. Data collected from clinicians included knowledge, confidence, and skill concerning psychotropic medications. The Psychotropic Medication Monitoring Checklist (PMMC) screen clients …

Emerging Treatments And Therapies For Autism Spectrum Disorder: A Narrative Review, Alan D. Kaye, Kaitlyn E. Allen, Van S. Smith Iii, Victoria T. Tong, Vivian E. Mire, Huy Nguyen, Zachary Lee, Maria Kouri, Carlo Jean Baptiste, Chizoba N. Mosieri, Adam M. Kaye, Giustino Varrassi, Sahar Shekoohi

School of Medicine Faculty Publications

The prevalence of autism spectrum disorder (ASD) has increased over the last decade. In this regard, many emerging therapies have been described as ASD therapies. Although ASD does not have a cure, there are several management options available that can help reduce symptom severity. ASD is highly variable and, therefore, standard treatment protocols and studies are challenging to perform. Many of these therapies also address comorbidities for which patients with ASD have an increased risk. These concurrent diagnoses can include psychiatric and neurological disorders, including attention deficit and hyperactivity disorder, anxiety disorders, and epilepsy, as well as gastrointestinal symptoms such …

Using Machine Learning To Determine A Functional Classifier Of Reward Responsiveness And Its Association With Adolescent Psychiatric Symptomatology, Robert James Richard Blair, Johannah Bashford-Largo, Ahria Dominguez, Matthew Dobbertin, Karina S. Blair, Sahil Bajaj

Center for Brain, Biology, and Behavior: Faculty Publications

Background. Machine learning (ML) has developed classifiers differentiating patient groups despite concerns regarding diagnostic reliability. An alternative strategy, used here, is to develop a functional classifier (hyperplane) (e.g. distinguishing the neural responses to received reward v. received punishment in typically developing (TD) adolescents) and then determine the functional integrity of the response (reward response distance from the hyperplane) in adolescents with externalizing and internalizing conditions and its associations with symptom clusters.

Methods. Two hundred and ninety nine adolescents (mean age = 15.07 ± 2.30 years, 117 females) were divided into three groups: a training sample of TD adolescents …

Second Language Learning In Older Adults Modulates Stroop Task Performance And Brain Activation, Douglas H. Schultz, Alison Gansemer, Kiley Allgood, Mariah Gentz, Lauren Secilmis, Zoha Deldar, Cary R. Savage, Ladan Ghazi Saidi

Center for Brain, Biology, and Behavior: Faculty Publications

Introduction: Numerous studies have highlighted cognitive benefits in lifelong bilinguals during aging, manifesting as superior performance on cognitive tasks compared to monolingual counterparts. Yet, the cognitive impacts of acquiring a new language in older adulthood remain unexplored. In this study, we assessed both behavioral and fMRI responses during a Stroop task in older adults, pre- and post language-learning intervention.

Methods: A group of 41 participants (age: 60–80) from a predominantly monolingual environment underwent a four-month online language course, selecting a new language of their preference. This intervention mandated engagement for 90 minutes a day, five days a week. …

Financial Incentives For Smoking Cessation Among Socioeconomically Disadvantaged Adults: A Randomized Clinical Trial, Darla Kendzor, Michael Businelle, Summer Frank-Pearce, Joseph Waring, Sixia Chen, Emily Hébert, Michael Swartz, Adam Alexander, Munjireen Sifat, Laili Kharazi Boozary, David Wetter

Kimmel Cancer Center Faculty Papers

IMPORTANCE: Socioeconomically disadvantaged individuals (ie, those with low socioeconomic status [SES]) have difficulty quitting smoking and may benefit from incentive-based cessation interventions.

OBJECTIVES: To evaluate the impact of incentivizing smoking abstinence on smoking cessation among adults with low SES.

DESIGN, SETTING, AND PARTICIPANTS: This study used a 2-group randomized clinical trial design. Data collection occurred between January 30, 2017, and February 7, 2022. Participants included adults with low SES who were willing to undergo smoking cessation treatment. Data were analyzed from April 18, 2023, to April 19, 2024.

INTERVENTIONS: Participants were randomized to usual care (UC) for smoking cessation (counseling …

Less Activity Means Improved Welfare? How Pair Housing Influences Pinyon Jay (Gymnorhinus Cyanocephalus) Behaviour, London M. Wolff, Jeffrey R. Stevens

Center for Brain, Biology, and Behavior: Faculty Publications

The activity level and specific behaviours exhibited by captive animals are crucial indicators of welfare. Stereotypies, or repetitive behaviours that have no apparent function or goal, are performed by animals experiencing poor conditions in their environment and indicate welfare concerns. Changes in the housing environment in particular may have critical influences on behaviour and welfare. Here, we measured behavioural changes in a captive pinyon jay (Gymnorhinus cyanocephalus) population (n = 10) associated with a shift from single to pair housing. Using automated video processing, we show that pair housing greatly reduced overall activity levels in these birds. The …

Accessible Real-Time Eye-Gaze Tracking For Neurocognitive Health Assessments, A Multimodal Web-Based Approach, Daniel C. Tisdale

Master's Theses

We introduce a novel integration of real-time, predictive eye-gaze tracking models into a multimodal dialogue system tailored for remote health assessments. This system is designed to be highly accessible requiring only a conventional webcam for video input along with minimal cursor interaction and utilizes engaging gaze-based tasks that can be performed directly in a web browser. We have crafted dynamic subsystems that capture high-quality data efficiently and maintain quality through instances of user attrition and incomplete calls. Additionally, these subsystems are designed with the foresight to allow for future re-analysis using improved predictive models, as well as enable the creation …

Emotion Regulation Strategies And Perceived Emotional Intelligence: The Effect Of Age., Iwanna Sepiadou

Adultspan Journal

The aim of this study was to investigate the relationship between perceived emotional intelligence and the reported use of cognitive reappraisal and expressive suppression. We also investigated the possible effects of age on the aforementioned variables. The total sample consisted of 379 people (158 men, 220 women, 1 unreported). Across participants, 273 were young (20-39 years old) and 106 were middle-aged (40-65 years old). We found statistically significant positive correlations between the dimensions of perceived emotional intelligence and the reported use of cognitive reappraisal and negative primarily correlations between the dimensions of perceived emotional intelligence and the reported use of …

Patient-Centered Preimplant Education Session And Bi-Weekly Text Message Adherence Reminders In Patients With A Newly Implanted Cardiomems® Device: A Quality Improvement Study, Elizabeth M. Miller, Alicia Abboud, Audrey Cooper

Doctor of Nursing Practice Projects: College of Nursing

Rationale

Heart failure is a deadly disease, affecting over 6.2 million individuals and costing the United States an estimated 30.7 billion dollars (Virani et al., 2020). By 2023, heart failure costs in the United States are estimated to grow to 70 billion dollars with 75-80% of these costs attributed to inpatient hospitalizations (Heidereich et al., 2022). The CardioMEMs® is a small device placed in the patient’s pulmonary artery via a minimally invasive procedure by an interventional cardiologist. The use of remote patient data from the CardioMEMs® device has been shown to reduce hospital re-admissions, facilitate tailored medication management, detect increased …

The Effect Of Covid-19 Pandemic On Sanitation Practices And Anxiety In The General Population, Leah Cliatt, Joanna Petrides

Rowan-Virtua Research Day

Background: Illness anxiety and fear of contracting coronavirus increased considerably during the COVID-19 pandemic. The media, being in lockdown, and cyberchondria had the largest impact on the population’s anxiety surrounding illness. While this kind of reaction to illness is expected during the pandemic, there is limited data on post-pandemic illness anxiety levels in the general population. Patients’ perception of disease impacts medicine at every level; medical professionals need to understand the concerns and fears of their patients in order to treat the post-pandemic patient. We hypothesized that sanitation practices and anxiety surrounding illness have not returned to baseline pre-COVID-19 …

Over The Counter Overdose: A Case Of Tylenol Toxicity, Swet M. Patel, James A. Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 51-year-old man presenting to the Emergency Department (ED) with suicidal ideations (SI) endorsing an intentional overdose of acetaminophen. Just as important is the clinical presentation; it is equally important to obtain a detailed history of patient's presentation leading to the ED visit when evaluating a suicide attempt. Tylenol (acetaminophen) is a common over the counter (OTC) medication available to the public. Management of Tylenol overdose follows a standard outline of things to observe and intervene on. In this case, we discuss how Tylenol overdose is managed in a clinical setting through a patient who …

Interactive Distraction Techniques Versus Midazolam In Anxiolysis In Pediatric Patients: A Systematic Review And Meta-Analysis, Uzay Cagatay, Jon Elias, Alexander King

Rowan-Virtua Research Day

Background: Many pediatric patients experience high levels of anxiety prior to undergoing surgery. Midazolam is currently one of the most commonly used sedative drugs in the pediatric preoperative environment. A number of studies have evaluated the use of non-pharmacological methods of relaxing pediatric patients prior to surgery, known as ‘Interactive Distraction’. These techniques involve using various methods of distracting the child from the preoperative anesthetic procedures. Some examples of these methods involve giving the patient an iPad with which they can play video games. There have yet to be any systematic reviews comparing the usage of Midazolam alone against utilizing …

Investigation Of The Utility Of A Ptsd Coaching Mobile App To Address Mental Health Services Demand In A Primary Care Clinic: Analysis Of Caps-5 Measures, Sindhura Nemani, Danielle Rae Schweitzer, Anne C. Jones

Rowan-Virtua Research Day

The COVID-19 pandemic affected countless people globally, resulting in a greater need for mental health professionals and resources¹. The demand for mental health care is soaring yet the limitation of resources has strained the healthcare system, making it challenging to help patients in a timely manner². This poster represents a snapshot of a larger project that is striving to investigate an intervention to help bridge the gap between patient need and prompt referral through a warm handoff approach and use of the PTSD Coach mobile application as well as exploring patients’ satisfaction^3,4,5,6,8,9. In this …

Using Fmri To Assess Effectiveness Of Olanzapine Treatment For Schizophrenia, William Kyle Copenhaver, David F. Lo, Hanna Rothenberg, Eeshan Khurana, Valerie Rome, Uzayr Wasif, Don D. Shamilov

Rowan-Virtua Research Day

Schizophrenia is a complex mental illness with neurobiological underpinnings and misconceptions about violence. Schizophrenia is associated with high levels of creativity and structural traits like fewer D2 receptors. Patients face reduced life expectancy due to cardiovascular diseases and cope through smoking and sedentariness. Treatment involves pharmacological antipsychotics like olanzapine and nonpharmacological approaches. Olanzapine works by antagonizing D2 receptors but has side effects like weight gain and diabetes risk. fMRI is used to study treatment mechanisms and predict response, but research on olanzapine's brain network effects is limited.

Review Of Missing Data Elements For Client Enrollment In The Minority Aids Initiative For High-Risk Men Of Nj, Vrushank Shah

Rowan-Virtua Research Day

The Minority AIDS Initiative study funded in NMI seeks to enhance healthcare outcomes for underserved individuals. Implementing outreach programs, the initiative provides healthcare and post-treatment follow-up to this demographic. The proposed project, a component of this study, concentrates on individuals with substance abuse disorder, specifically targeting those who have been onboarded but subsequently lost to follow-up. In the United States, approximately 20 million people are diagnosed with substance abuse disorder, yet in 2016, only 3.8 million received treatment. Within this cohort, between 20% and 70% of individuals undergoing residential substance abuse treatment disengage before completion. Various factors hinder the sustained …