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Full-Text Articles in Psychiatry and Psychology

Therapeutic Gardening For Addiction Recovery, Hayley Milleson May 2023

Therapeutic Gardening For Addiction Recovery, Hayley Milleson

Master's Projects and Capstones

The following study examines the potential benefits of implementing therapeutic gardening and outdoor activities as a supplemental resource for adult males with a history of substance abuse issues who have been affected by the criminal justice system and are seeking sobriety while in a residential treatment program. The goal is to investigate how therapeutic gardening can add to traditional addiction treatment methods. Through a review of current evidence-based practice, this study focuses on how alternative interventions such as therapeutic gardening and outdoor activity can improve overall mental health and well-being, promote a sense of community, improve social connections, alleviate stress …


The Associations Between Adolescent Motives For Social Media Use With Body Dysmorphia, Eating Disorder, And Anxiety And Depression Symptoms, Kaylan Melvin May 2023

The Associations Between Adolescent Motives For Social Media Use With Body Dysmorphia, Eating Disorder, And Anxiety And Depression Symptoms, Kaylan Melvin

Honors Theses

Adolescents spend a large amount of time on social media sites. This is notable, as adolescence is a crucial time for body image development. Additionally, recent findings suggest that using image-oriented social media sites, such as Facebook and Instagram, is associated with more body dissatisfaction and disordered eating. Among previous studies, certain social media motivations have been found to have an association with poor body satisfaction and well-being in adolescents. To our knowledge, no studies have directly examined the association between social media motivations and eating disorder, body dysmorphic disorder, and anxiety and depression symptoms in adolescents. The current study …


Nature-Based Group Therapy For Women Living With Depression Through A Narrative Lens, Cora Anderson May 2023

Nature-Based Group Therapy For Women Living With Depression Through A Narrative Lens, Cora Anderson

Dissertations, Theses, and Projects

The field of nature-based therapy treatment is rapidly expanding. With an emphasis on healing the disconnectedness of the modern world through experiencing interconnectedness with the natural world, this modality is particularly useful in treating symptoms of social isolation and hopelessness within populations living with major depressive disorder. The literature highlights emotional and biological benefits of mental health counseling in a natural setting with key therapeutic factors. Researchers highlighted these factors as the natural environment itself, the element of challenge, nature as a third-party influence on therapeutic relationship, and expansiveness and interconnectedness of the natural world (Naor & Mayseless, 2021). Within …


The Last Of Us In Therapy: How Mind-Controlling Fungi And Gut Bacteria Affect Your Mental Health, Anastasia Lyon May 2023

The Last Of Us In Therapy: How Mind-Controlling Fungi And Gut Bacteria Affect Your Mental Health, Anastasia Lyon

Journal of Pharmacology & Nutritional Sciences

The "psilocybiome" represents the mutually beneficial relationship between ourselves, our bacteria, and psychedelic drugs. This short review briefly discusses the benefits and limitations surrounding the potential for psychedelic therapy to synergize with gut bacteria to help regulate and maintain proper balance in the immune system, diet, and stress levels. Psychedelic therapy is a novel treatment strategy that has the potential to improve patient mental health, and, by identifying the types of gut bacteria present in patients, it can aid in personalizing medicine by determining how well their "psilocybiome" may respond.


Genetic Influences On The Response To Neuromodulation In Craving Behaviors, Carly J. Haring May 2023

Genetic Influences On The Response To Neuromodulation In Craving Behaviors, Carly J. Haring

Honors Thesis

Obesity and eating disorders are highly prevalent in the United States. People who suffer from obesity and/or eating disorders face serious health consequences and even death. Current treatments are not effective as recovery rates are low, so there is a dire need for an effective treatment for obesity and eating disorders. There have been studies investigating the use of transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS) of the dorsolateral prefrontal cortex (DLPFC) as a means of treatment for these people. While findings show promise, there is much variability. The goal of this study is to further prior …


Improving Depression Remission Screening Compliance, Crystal Wingerter May 2023

Improving Depression Remission Screening Compliance, Crystal Wingerter

Doctor of Nursing Practice Projects

Depressive disorders are widespread in the United States and are diagnosed and treated in the primary care setting. In 2019, there were an estimated 19.4 million adults that had at least one major depressive episode. The purpose of this project was to improve follow up and depression remission assessment for patients with a diagnosis of depression at a metropolitan family care practice clinic. The Patient Health Questionnaire (PHQ–9) was utilized for remission assessment. Front desk staff and providers were trained and granted access to the quality information system (QIS) in the electronic medical records (EMR) system which allowed easy identification …


Development Of Schizophrenia In A Genetically Predisposed Individual Following Covid-19, Sung Kang, Jonathan Yuh, Timothy Wong May 2023

Development Of Schizophrenia In A Genetically Predisposed Individual Following Covid-19, Sung Kang, Jonathan Yuh, Timothy Wong

Rowan-Virtua Research Day

We present a patient who is a 56-year-old female with a psychiatric history of anxiety disorder and a medical history of hypercholesterolemia and hyperthyroidism, who was admitted to the hospital after a witnessed seizure at an inpatient psychiatric facility. This patient’s family history is significant for her mother experiencing unspecified psychotic disorder that required psychiatric hospitalization. Our patient was first admitted to the psychiatric hospital after exhibiting worsening paranoid delusions and hallucinations that began several months prior. The patient had reportedly begun locking herself in the restroom and screaming “get out, they’re spying on me”, referring to her next-door neighbors …


Correlation Between Gut Biomarkers And Depression, Jianle Gao May 2023

Correlation Between Gut Biomarkers And Depression, Jianle Gao

Rowan-Virtua Research Day

The correlation between the gut-microbiota- brain axis and mental state in the context of mental disorders such as Major Depressive Disorder (MDD), Schizophrenia, etc. has been well studied. Production of inflammatory and non-inflammatory metabolites by the gut- microbiota directly and indirectly affects the brain and mood. Therefore, colonization by maladaptive, pro-inflammatory bacteria may cause mood dysregulation and depressive features. Metabolites from these bacteria can be quantitatively analyzed for use as biomarkers of Major Depressive Disorder. Biomarkers studied include: serotonin, dopamine, butyrate, acetate, and propionate.


Exploring Risk Factors For Major Depressive Disorder For Female Patients Aged 18 Or Older Living In Ocean County, New Jersey, James Mack May 2023

Exploring Risk Factors For Major Depressive Disorder For Female Patients Aged 18 Or Older Living In Ocean County, New Jersey, James Mack

Rowan-Virtua Research Day

Background: The incidence and prevalence of major depressive disorder has been increasing worldwide, in the United States of America, and on a local level. The population of Ocean County, New Jersey, a predominantly Caucasian, female, middle-aged population, may be at increased risk of developing major depressive disorder.

Purpose: To explore the social determinants of health and risk factors for major depressive disorder for female patients aged 18 or older living in Ocean County, New Jersey.

Methods: This literature review mainly used PubMed and Scopus for journal articles and utilized governmental databases for additional population data.

Results: Analyses conducted on social …


The Efficacy Of Neuroleptics On Mental Health Disorders, Rathea Hersi May 2023

The Efficacy Of Neuroleptics On Mental Health Disorders, Rathea Hersi

Honor’s College Freeman Research Journal

Mental health disorders affect a lot of people in the world and can be triggered by a wide variety of reasons. The treatment of mental health disorders varies based on the type of disorder one is dealing with, as well as the symptoms that each portrays. While history has changed how people view mental health disorders, it also shows that the models of treatment used have not always been beneficial to the wellness of human beings. Research shows that there are different ways in which mental health disorders affect the brain, which means that a study of the different parts …


Trauma, Found Family, And Their Influence On The Creation Of A Pitch Bible, David Scheele May 2023

Trauma, Found Family, And Their Influence On The Creation Of A Pitch Bible, David Scheele

All Theses

Trauma is a very common theme in works of fiction, as it is something that all of us
experience in our lives and as a result is emphasized in art. Whether it is injuries, abuse, the loss of loved ones, and much more, trauma is ubiquitous within the human experience. Sometimes trauma can have lasting impacts on an individual’s mental health, often taking the form of Post-Traumatic Stress Disorder, or PTSD as it is more commonly known. We see this form of mental illness portrayed quite often in the media that we consume. Examples across various artistic mediums include Sarah …


Early Life Stress Predicts Future Conduct Disorder In Adolescents, Savannah Ellis May 2023

Early Life Stress Predicts Future Conduct Disorder In Adolescents, Savannah Ellis

Biological Sciences Undergraduate Honors Theses

Early Life Stress (ELS) and adversity increase people’s risk for developing mental, social, or emotional dysregulation and disorders later in life. The objective of this study was to test whether ELS in adolescents could prospectively predict future conduct disorder. The study additionally tested potential neural mediators of the effect of ELS on future conduct disorder, and specifically targeted the structural connections from the anterior insula and medial prefrontal cortex to the Nucleus Accumbens (NAcc). Data for the project came from the Adolescent Brain Cognitive Development Study (ABCD study), which is a longitudinal multi-site consortium funded by the National Institutes of …


Mental Health And Psychological Well-Being Of Kenyan Adolescents From Nairobi And The Coast Regions In The Context Of Covid-19, Gideon Mbithi, Adam Mabrouk, Ahmed Sarki, Rachel Odhiambo, Mary Namuguzi, Judith Dzombo, Joseph Atukwatse, Margaret Kabue, Paul Mwangi, Amina Abubakar May 2023

Mental Health And Psychological Well-Being Of Kenyan Adolescents From Nairobi And The Coast Regions In The Context Of Covid-19, Gideon Mbithi, Adam Mabrouk, Ahmed Sarki, Rachel Odhiambo, Mary Namuguzi, Judith Dzombo, Joseph Atukwatse, Margaret Kabue, Paul Mwangi, Amina Abubakar

Institute for Human Development, East Africa

Background Despite the high burden of mental health problems during adolescence and its associated nega- tive consequences, it has remained neglected especially in sub-Saharan Africa. The 2019 novel Coronavirus disease (COVID-19) pandemic has placed additional stress on adolescent mental health. However, there are few studies docu- menting the burden of mental health problems and even fewer mental health services in the region. In relation to the limited body of knowledge, the present study aims to determine the psychological well-being of adolescents and to assess the risks and associated factors of mental health problems among adolescents in the context of COVID-19 …


Social Media And Wellbeing, Aditya Adsule May 2023

Social Media And Wellbeing, Aditya Adsule

Honors College Theses

This psychology thesis paper investigates the existing body of scientific literature surrounding the effects of social media on the wellbeing of adolescents and adults ages 18-29. The current body of scientific literature supports the overall finding that social media has a negative impact not only on mental health, but on physical health. There are also key findings showing the impact of social media on other facets of life such as sleep patterns, social interactions, and physical activity. Current intervention therapies need to be revisited and the DSM categorization of social media addiction needs to be investigated further.


Therapeutic Approaches To Working With Perinatal Loss Clients: A Grounded Theory Study, Heather H. Olivier May 2023

Therapeutic Approaches To Working With Perinatal Loss Clients: A Grounded Theory Study, Heather H. Olivier

University of New Orleans Theses and Dissertations

Perinatal loss (i.e., miscarriage, stillbirth, termination, and infant death) is commonly referred to in the literature as an invisible loss, non-loss, and even medical event. It is an ambiguous loss exhibiting the dialectical contradiction between the physical absence and psychological presence of the baby accompanied by disenfranchised grief, a reaction to a loss that is unacknowledged by society. Despite the likelihood of mental health clinicians working with clients who have experienced perinatal loss, there has yet to be a therapeutic model designed specifically for the unique grief and trauma reactions presented in this population. Existing grief models do not address …


The Effectiveness Of Targeted Education On Improving Nurses’ Self-Efficacy In Caring For Psychiatric Patients On Medical Surgical Units, Rachel Shirey Apr 2023

The Effectiveness Of Targeted Education On Improving Nurses’ Self-Efficacy In Caring For Psychiatric Patients On Medical Surgical Units, Rachel Shirey

Doctor of Nursing Practice Scholarly Projects

Individuals with mental illness are occasionally hospitalized on medical units, specifically medical-surgical units. Nurses working on medical-surgical units may find patients with mental illness more challenging due to the complexity of care they sometimes require. Nurses’ perceived ability to provide quality care for these patients is reduced in comparison to their perceived ability to care for patients without mental illness. Consequently, low self-efficacy can result in the provision of a lower quality of care for this population. The purpose of this quality improvement project was to improve the care that patients with mental illness receive while hospitalized on medical-surgical units. …


Long-Acting Injectable Antipsychotics Vs. Oral Antipsychotics In Treatment Adherence: Efficacy And Equity Of Care, Jason P. Peter Msn, Aprn, Fnp-Bc, Ashley F. Walker Bsn, Rn, Sharon Little Dnp, Aprn, Fnp-Bc Apr 2023

Long-Acting Injectable Antipsychotics Vs. Oral Antipsychotics In Treatment Adherence: Efficacy And Equity Of Care, Jason P. Peter Msn, Aprn, Fnp-Bc, Ashley F. Walker Bsn, Rn, Sharon Little Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Summary

Background: Compliance with oral antipsychotic medications (OAP) in the treatment of patients with schizophrenia has been a challenge. Challenges to OAP include medication side effects, lack of ability to obtain medications, and missing doses, among other factors. As a result of this non-compliance, those taking oral antipsychotic medication are at greater risk for exacerbation of their illness. The consequence of relapse carries considerable risks with each psychotic event. The study aims to compare if medication treatment adherence is greater in clients with schizophrenia using oral antipsychotics (OAPs) vs. long-acting injectable (LAI) antipsychotic medications.

Methods: In this scoping review, 15 …


Emotional Reactivity Predicts Dissociation In Maltreated Youth, Jaelin Isquith, Kinsey Ellis Apr 2023

Emotional Reactivity Predicts Dissociation In Maltreated Youth, Jaelin Isquith, Kinsey Ellis

Undergraduate Research Symposium Posters

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) defines dissociation as “disruption in the usually integrated functions of consciousness, memory, identity or perception of the environment”11. Dissociation most commonly occurs after a traumatic experience and can take many forms; Subtypes include dissociative amnesia, absorption and imaginative involvement, passive influence, and depersonalization and derealization. Dissociation has been linked to several negative outcomes such as increased risk for development of personality disorders, suicidal ideation, and self-harm2,3. Risk factors for dissociation have been understudied in child and adolescent populations. One factor that has been found to be related to severity of dissociative …


Traumatization, Underrepresentation, And Identity Crises, Afsah Hussain, Marshall Johnson, Andrew Gonedes, Barbara Gracious Apr 2023

Traumatization, Underrepresentation, And Identity Crises, Afsah Hussain, Marshall Johnson, Andrew Gonedes, Barbara Gracious

South Atlantic Division GME Research Day 2023

No abstract provided.


The Relationship Between Quality Of Life And Functionality In Patients With Schizophrenia – A Preliminary Report, Vlad Dionisie, Mihnea Costin Manea, Manea Mirela, Lavinia Steluta Bonciu, Sorin Riga, Maria Gabriela Puiu Apr 2023

The Relationship Between Quality Of Life And Functionality In Patients With Schizophrenia – A Preliminary Report, Vlad Dionisie, Mihnea Costin Manea, Manea Mirela, Lavinia Steluta Bonciu, Sorin Riga, Maria Gabriela Puiu

Journal of Mind and Medical Sciences

This research aimed to investigate the relationship between quality of life and level of functioning in a group of Romanian patients with schizophrenia. A cross-sectional, observational, prospective study on 47 patients with schizophrenia was conducted. Socio-demographic and clinical data were documented and WHOQOL-BREF and Life Skills Profile-16 instruments were further administered. To examine the correlation between variables, Person correlation test was employed. The mean age of the sample was 38.32±12.32 years and 66% of the patients were males. Significant correlations were found between all aspects of the quality of life (physical health, psychological, social relationships and environmental health) and total …


Postpartum Depression; Associated Factors And Underdiagnosis, Andra Iancu, Valeria-Anca Pietrosel, Teodor Salmen, Cristina Ioana Bica, Ioana Păunică, Liliana Florina Andronache, Florentina Gherghiceanu, Cecilia Curis Apr 2023

Postpartum Depression; Associated Factors And Underdiagnosis, Andra Iancu, Valeria-Anca Pietrosel, Teodor Salmen, Cristina Ioana Bica, Ioana Păunică, Liliana Florina Andronache, Florentina Gherghiceanu, Cecilia Curis

Journal of Mind and Medical Sciences

Post-partum depression is one of the most severe types of depression and can be developed at any age, no matter of cultural of social status. Objectives. To determine the factors associated with the psychological impact of pregnancy and to emphasize the psychological and psychiatric risks after giving birth for a woman. Materials and Methods. The study enrolled 35 patients diagnosed with postpartum depression that have been hospitalized in a tertiary-care center for psychiatric disorders between 2016 and 2020. Data were collected from patients’ observation charts. Results. The incidence of postpartum depression is higher in the age range 30-45 years old …


Dental Fear, Anxiety, And Phobia – Behavioral Management And Implications For Dentists, Nadya Tsetsova Avramova Apr 2023

Dental Fear, Anxiety, And Phobia – Behavioral Management And Implications For Dentists, Nadya Tsetsova Avramova

Journal of Mind and Medical Sciences

Clinical management of patients with dental fear, anxiety, and phobia could be a major challenge to daily practice of dental professionals. The aim of the current review was to expand the modern consideration with respect to these issues, and therefore to discuss basic approaches and psychological techniques for management of oral health behaviors that should be employed in dentistry. This paper presents detailed description of the characteristics of dentist-patient therapeutic relationship as well as the most used techniques to cope with dental fear, anxiety, and phobia - relaxation techniques, cognitive-behavioral therapy (CBT), hypnosis and melotherapy. We can still argue that …


The Effects Of School-Based Art Therapy On Depressed Adolescents, Jasmine Nicolas Apr 2023

The Effects Of School-Based Art Therapy On Depressed Adolescents, Jasmine Nicolas

Nursing | Student Research Posters

Depression in adolescents is associated with deficient behavioral and health outcomes (Fletcher, 2019). Art therapy has been shown to be effective in treating mental health condition such as depression. A student’s academic success heavily depends on treating their depression. Community health nurses can play a vital role in advocating for adequate mental health support to improve a student’s overall well-being and academic success. The literature review contains six articles on the prevalence and impact of depression among adolescents, art therapy as an intervention for improving psychological outcomes and resilience among adolescents, and experiences of adolescent clients in art therapy within …


Oxytocin Receptor Binding In The Substantia Nigra In Schizophrenia, Ariel Snowden Apr 2023

Oxytocin Receptor Binding In The Substantia Nigra In Schizophrenia, Ariel Snowden

Student Research Symposium

Schizophrenia is a chronic, psychiatric disorder characterized by hallucinations, delusions, cognitive deficits, and social cognitive impairments. Although antipsychotic drugs are typically effective in treating psychotic symptoms in schizophrenia, the social cognitive symptoms often persist. As social cognitive functioning is predictive of successful life outcomes in schizophrenia, there is a critical need to determine the biological basis of social cognitive impairments. Due to its ability to affect social behaviors in animals and humans, the oxytocin (OXT) system has become a therapeutic target of interest for schizophrenia. Although several studies examine the OXT system in schizophrenia in the periphery, it is currently …


Healthcare Service Use, Help-Seeking Behaviors, And Health And Wellbeing In Attenuated Psychosis, Jasmine Ranjbari-Sisan, William D. Spaulding, Tierney K. Lorenz Apr 2023

Healthcare Service Use, Help-Seeking Behaviors, And Health And Wellbeing In Attenuated Psychosis, Jasmine Ranjbari-Sisan, William D. Spaulding, Tierney K. Lorenz

Honors Program: Senior Projects (Public)

Persons with serious mental illness (SMI) receive poorer-than-standard healthcare, contributing to a 20-year reduction in the average life expectancy of persons with SMI. While extant literature describes the health disparities experienced by persons with SMI, little research examines the relationship between attenuated psychotic symptoms, healthcare service use, and help-seeking behaviors that may contribute to the disparities in this vulnerable population. This study explores the relationships between attenuated psychotic symptoms, physical health symptoms and related distress, healthcare service use, and help-seeking intentions to better understand health disparities in vulnerable and marginalized populations, such as individuals with SMI. Only a portion of …


Co-Occurrence Of Depression, Anxiety, And Perinatal Posttraumatic Stress In Postpartum Persons, Shelby Howard, Caitlin Witt, Karla Martin, Ateshi Bhatt, Emily Venable, Sarah Buzhardt, Andrew G. Chapple, Elizabeth F. Sutton Apr 2023

Co-Occurrence Of Depression, Anxiety, And Perinatal Posttraumatic Stress In Postpartum Persons, Shelby Howard, Caitlin Witt, Karla Martin, Ateshi Bhatt, Emily Venable, Sarah Buzhardt, Andrew G. Chapple, Elizabeth F. Sutton

School of Medicine Faculty Publications

Background: The study aim was to describe the incidence of depression, anxiety, perinatal-post-traumatic stress disorder (PTSD), and their co-occurrences in the early postpartum period in a low-resource OB/GYN clinic serving majority Medicaid-eligible persons. We hypothesized that postpartum persons screening positive for depression will have an increased risk of a positive screen for anxiety and perinatal PTSD. Methods: A retrospective study of postpartum persons receiving care in Baton Rouge, Louisiana was conducted using responses abstracted from the electronic medical record (EMR) of the Patient Health Questionnaire-9 (PHQ9), Generalized Anxiety Disorder-7 (GAD7), and Perinatal Post Traumatic Stress Disorder Questionnaire-II (PPQII). Categorical distributions …


The What And When Of Psychomotor Retardation: A Multimodal Approach, Ole Edvard Granrud Apr 2023

The What And When Of Psychomotor Retardation: A Multimodal Approach, Ole Edvard Granrud

LSU Master's Theses

Psychomotor retardation (PMR) is a diagnostic criterion that reflects a gross slowing of movement, speech, and thought. More so, PMR is a transdiagnostic, pervasive source of impairment and distress that can be observed across disorders, such as Major Depressive Disorder (MDD), Schizophrenia (SZ), and Bipolar Disorder (BD). In clinical settings, PMR is associated with more severe psychopathology and is used to both inform treatment and predict long-term treatment outcomes. However, despite being clinically meaningful, PMR is poorly understood and is often conceptualized as a motor disturbance that happens in isolation from, rather than concurrently with, higher-order cognitive-emotional processes – such …


An Exploration Of The Social And Economic Factors That Influence The Mental Health Of Lgbtq College Students, Alexandria Mh Fossum Apr 2023

An Exploration Of The Social And Economic Factors That Influence The Mental Health Of Lgbtq College Students, Alexandria Mh Fossum

Senior Theses

LGBTQ individuals face a much higher prevalence of psychiatric disorders and mental health issues than their heterosexual, cisgender counterparts. The added academic pressures of college introduce a unique set of challenges that LGBTQ students face. This thesis includes a review of academic literature and data examining the intersections between social isolation, institutional discrimination, and financial insecurity and the effects they have on the mental health outcomes of LGBTQ college students. The paper is accompanied by a documentary consisting of a set of interviews of LGBTQ college students, giving a more personal insight into the multitude of factors that affect their …


Moral Injury To Inform Analysis Of Post-Traumatic Stress Disorder, Amanda Julia Manea Apr 2023

Moral Injury To Inform Analysis Of Post-Traumatic Stress Disorder, Amanda Julia Manea

Senior Theses

Post-traumatic stress disorder (PTSD) is a mental health condition that almost one out of ten veterans struggle with. Although the National Center for PTSD has made extensive progress in characterizing and developing new treatments for PTSD, most veterans still experience symptoms of PTSD following treatment. Novel avenues of investigation, such as developing algorithms to review electronic health record (EHR) data and better understanding moral injury, are being pursued to address the gap that still exists when it comes to treating veterans. Moral injury is the individual evaluation of exposure to a potentially morally injurious event (PMIE) and can lead to …


Single-Case Pilot Study For Longitudinal Analysis Of Referential Failures And Sentiment In Schizophrenic Speech From Client-Centered Psychotherapy Recordings, Travis A. Musich Apr 2023

Single-Case Pilot Study For Longitudinal Analysis Of Referential Failures And Sentiment In Schizophrenic Speech From Client-Centered Psychotherapy Recordings, Travis A. Musich

Dissertations

Though computational linguistic analyses have revealed the presence of distinctly characteristic language features in schizophrenic disordered speech, the relative stability of these language features in longitudinal samples is still unknown. This longitudinal pilot study analyzed schizophrenic disordered speech data from the archival therapy audio recordings of one patient spanning 23 years. End-to-end Neural Coreference Resolution software was used to analyze transcribed speech data from three therapy sessions to identify ambiguous pronouns, referred to as referential failures, which were reviewed and confirmed by multiple raters. Speech samples were analyzed using Google Cloud Natural Language API software for sentiment variables (i.e., score, …