Psychiatry and Psychology Commons^™

Designing And Implementing A De-Escalation Toolkit To Improve Staff Education And Competency On De-Escalation Within A Mental Health Outpatient Setting, Balraj Bajwa

Doctor of Nursing Practice (DNP) Projects

Background: The purpose of this study is to develop and implement a de-escalation toolkit to help improve memory, retention, and utility of de-escalation techniques within an outpatient mental health crisis stabilization unit.

Problem: The aforementioned crisis stabilization unit has elevated rates of patient aggression/violence and staff present with difficulty recalling de-escalation techniques due to the lapse in memory and/or retention.

Methods: The project was introduced to the stakeholders of the crisis stabilization unit and input was obtained on the design and components of the toolkit. Various analyses were conducted to ensure the appropriate implementation of the project.

Intervention: A de-escalation …

Ketamine As A Treatment Modality For Treatment-Resistant Depression, Tracy Wulff, Shen Cao

Physician Assistant Capstones, 2020-current

Many recent studies have demonstrated the ability of ketamine, an NMDA receptor antagonist, to produce antidepressant effects that may be effective in helping reduce treatment-resistant major depression. In particular, three double-blinded randomized control trials have been conducted to assess the viability and effectiveness of this medication for treatment. This systematic literature review will analyze these studies and determine if the overall research indicates that ketamine is useful in improving depression as measured by the Montgomery–Asberg Depression Rating Scale (MADRS)¹.

Objective: Assess the effectiveness of IV Ketamine in reducing treatment-resistant major depressive disorder as measured by the Montgomery–Asberg …

Giving Birth At A Critical Time: Assessing Perinatal Depression Among Syrian Refugees In Low Resource Settings, Nada Alnaji

Theses & Dissertations

Refugee mothers are at an increased risk of suffering from stress and mental health conditions during the first year after giving birth to a child. The objective of this study is to enhance the early identification of treatable mental health conditions among perinatal women living within humanitarian settings. The central hypothesis is that a culturally specific approach can be helpful for the long-term success of mental health efforts. In this study, we use qualitative interview methods to understand the cultural paradigms and predisposing factors for perinatal depression related to being a Syrian refugee in Lebanon during the COVID-19 pandemic. In …

The Ecology Of Mental Health And The Impact Of Barriers On Mental Health Service Utilization, Alisha Aggarwal

Theses & Dissertations

Mental health has emerged as a major public health concern in recent times with several disparities and barriers related to adequate health service utilization. Different age groups experience diverse symptoms and face distinct barriers in accessing and utilizing healthcare. Policies like Mental Health Parity and Addiction Equity Act and the Patient Protection and Affordable Care Act were launched to improve insurance coverage and delivery of mental health services. However, a large gap of unmet needs exists for adequate mental health service utilization in the country. This dissertation aims to describe the financial and non-financial barriers to mental health service utilization …

The Influence Of Comorbid Gad On Er Utilization In Urban Youth With Asthma, David A. Karpe

Theses and Dissertations

Current literature indicates a strong association between asthma and the early onset of comorbid generalized anxiety disorder (GAD) in minors and their primary caregivers. Studies show that asthma prevalence increases with certain demographic factors, such as ethnicity, socioeconomic status, and housing quality. Evidence also suggests that GAD influences decision-making, especially when deciding to utilize emergency room (ER) services for asthma-related concerns. This study analyzed the effect of comorbid GAD on minors with asthma and ER utilization. The data were provided by an earlier Stress & Justice Study (S&J) baseline survey, an investigation aimed at understanding the impact of parental criminal …

Systematic Review Of Pathways To Care In The U.S. For Black Individuals With Early Psychosis, Oladunni Oluwoye, Beshaun Davis, Franchesca S. Kuhney, Deidre M. Anglin

Publications and Research

The pathway to receiving specialty care for first episode psychosis (FEP) among Black youth in the US has received little attention despite documented challenges that negatively impact engagement in care and clinical outcomes. We conducted a systematic review of US-based research, reporting findings related to the pathway experiences of Black individuals with FEP and their family members. A systematic search of PubMed, PsycInfo, and Embase/Medline was performed with no date restrictions up to April 2021. Included studies had samples with at least 75% Black individuals and/or their family members or explicitly examined racial differences. Of the 80 abstracts screened, 28 …

Direct And Indirect Effects Of Alcohol Craving And Demand On Obsessive And Compulsive Drinking Characteristics: The Role Of Impulsivity, James V. Turner Iv

Theses and Dissertations

This study’s goal was to test a novel model of obsessive-compulsive thoughts about drinking. Young adults completed tasks measuring potential drinking characteristics. Findings indicated demand was related to higher OCTD, a significant effect of CIC on OCTD via demand, and that the relationship was particularly strong for impulsive individuals.

Mental Health Treatment In Juvenile Correctional Facilities: Utilizing Assessment To Inform Treatment, Sarah Riccio

Dissertations

Youth in juvenile correctional facilities face a wide range of mental health difficulties. Over the years, the juvenile justice system has prioritized the need for providing appropriate and effective treatment services to youth throughout their detainment. Despite these ongoing efforts, treatment practices in juvenile correctional facilities continue to fall short. This study will first focus on assessment practices within these facilities and the impact current practices have on diagnosis and subsequent treatment. Emphasis will be placed on the importance of comprehensive evaluations for informing diagnosis and determining the individual treatment needs of detained youth. An integrated approach to assessment will …

Mental Health Training, Adrienne Leonard, Seanghai Lim, Emma Booth, Jaeger Mccaulou, Saori Fukuoka

Nursing Leadership in Community Engagement Projects

Introduction

New Horizons is a Seattle-based non-profit organization that serves to aid homeless youth in the greater Seattle area, with an end goal of ending youth homelessness in Seattle and King County. New Horizons has been operating since 1978 and has reached out to homeless youth of all different backgrounds in order to meet their basic needs and help transition them into a stable living environment. (New Horizons, 2016). This type of work requires staff and volunteers to be able to accommodate a wide range of cultural backgrounds, lifestyle habits, and crucially, individuals with differing mental health states and disabilities. …

Pharmacologic And Clinical Considerations Of Nalmefene, A Long Duration Opioid Antagonist, In Opioid Overdose., Amber N. Edinoff, Catherine A. Nix, Tanner D. Reed, Elizabeth M. Bozner, Mark R. Alvarez, Mitchell C. Fuller, Fatimah Anwar, Elyse M. Cornett, Adam M. Kaye, Alan D. Kaye

School of Medicine Faculty Publications

No abstract provided.

Desire For Control Moderates The Relationship Between Perceived Control And Depressive Symptomology, Liam Alexander Mackenzie Myles, Emanuele Maria Merlo, Antonia Obele

Journal of Mind and Medical Sciences

Background. The prevalence of psychological difficulties is rising at an alarming rate, with an increasing number of individuals reporting symptoms of depression. A decline in both perceived control and desire for control has previously been associated with the onset of depression. However, previous research has failed to examine whether perceived control and desire for control interact in their relationship with depressive symptomology. Methods. A sample of 350 participants completed the Spheres of Control Scale, the Desirability of Control Scale and Beck’s Depression Inventory. Process Macro was used to examine whether desire for control moderated the relationship between perceived …

Depression Screening In Primary Care: Implications For Practice, Donna Pittman

Doctoral Projects

Depression is a mood disorder that has affected lots of people worldwide. Depression is a disease that affects an individual's social functioning, relationships, and finances. Individuals with depression may have feelings of sadness, loss of interest in formerly enjoyed activities, hopelessness, irritability, decreased energy, difficulty concentrating and sleeping changes in appetite, or chronic generalized aches and pains. Over the recent year, there has been a rise in individuals presenting to the primary care providers with symptoms of depression. Mental disorders attribute to one of the leading causes of disability in the United States.

Healthcare providers in the primary care setting …

Food Restriction And Body Image Distortion In Pregnant Mothers: Outcomes For Exposed Children, Kathryn M. Dana

Dissertations, Theses, and Capstone Projects

Background: Developmental trajectories in the growing child do not originate at birth. Rather, critical periods may exist in pregnancy, during which the determinants of malnutrition are especially vulnerable to the effects of stress and other complications. Prenatal malnutrition has been consistently associated with negative consequences for the growth, development, and overall physical and mental health of affected offspring in both human and animal models. While most available literature on human prenatal malnutrition comes from famine research, there is some evidence that restrictive eating disorders in pregnant women may be associated with similar outcomes.

Hypotheses: We hypothesize that prenatal exposure to …

Training And Individual Predictors Of Attitudes Toward Serious Mental Illness Amongst Clinical Psychology Doctoral Students, Lauren K. O'Connor

Dissertations, Theses, and Capstone Projects

Clinical psychologists are grossly underrepresented in treatment provision for individuals with serious mental illness (SMI; Roe, Yanos, Lysaker, 2006). Systemic (e.g., emergence of managed care) and training-based (e.g., limitations to SMI specific training) factors contribute to the establishment of this underrepresentation, while mental health stigma amongst psychologists may play a role in perpetuating it. Many individual and experiential factors have been found to impact clinicians’ attitudes toward those with SMI (Henderson et al., 2014; Schulzes, 2007). Though many of these factors are present and relevant from the beginning of one’s career and may involve elements related to training, little research …

Informed Consent: Foundations And Applications, Joanna Smolenski

Dissertations, Theses, and Capstone Projects

Since its advent in the 20th century, informed consent has become a cornerstone of ethical healthcare, and obtaining it a core obligation in medical contexts. In my dissertation, I aim to examine the theoretical underpinnings of informed consent and identify what values it is taken to protect. I will suggest that the fundamental motivation behind informed consent rests in something I’ll call bodily self-sovereignty, which I argue involves a coupling of two groups of values: autonomy and non-domination on the one hand, and self-ownership and personal integrity on the other. I will then go on to consider two 'case …

Enhancing Eating Routines To Support Occupational Functioning, Annamarie Sughair, Karen Park, Susan Macdermott, Becki Cohill

Summer 2021 Virtual OTD Capstone Symposium

As the prevalence of serious mental illness becomes more widespread annually, eating habits have become more recognized as a modifiable risk factor on worsening mental health symptoms (Godos et al., 2020). Eating routines are food-based activities that occur daily, weekly, monthly, and across the lifespan (Green et al., 2021). Food-based activities include obtaining food, preparing food, eating food, and more. Challenges with eating routines are prevalent in individuals in the earlier stages of mental illness (Teasdale et al., 2020). Evidence shows gaps in graduating occupational therapy students and comfortability with addressing eating routines (Wingo et al., 2018).

The purpose of …

Racial/Ethnic Disparities In Alzheimer’S Disease Risk: Role Of Exposure To Ambient Fine Particles, Diane Younan, Xinhui Wang, Tara Gruenewald, Margaret Gatz, Marc L. Serre, William Vizuete, Meredith N. Braskie, Nancy F. Woods, Ka Kahe, Lorena Garcia, Fred Lurmann, Joann E. Manson, Helena C. Chui, Robert B. Wallace, Mark A. Espeland, Jiu-Chiuan Chen

Psychology Faculty Articles and Research

Background

Whether racial/ethnic disparities in Alzheimer’s disease (AD) risk may be explained by ambient fine particles (PM_2.5) has not been studied.

Methods

We conducted a prospective, population-based study on a cohort of Black (n=481) and White (n=6004) older women (aged 65-79) without dementia at enrollment (1995-98). Cox models accounting for competing risk were used to estimate the hazard ratio (HR) for racial/ethnic disparities in AD (1996-2010) defined by DSM-IV and the association with time-varying annual average PM_2.5 (1999-2010) estimated by spatiotemporal model.

Results

Over an average follow-up of 8.3 (±3.5) years with 158 incident cases (21 in …

The Moderating Role Of Social Support In Stigma And Symptoms Of Anxiety And Depression, Taylor Phillips

Undergraduate Honors Theses

In this study, we examine the relationship between having a support system and the stigma individuals face with depression and anxiety symptoms. The aim of this study was to examine if having a support system acts as a buffer between perceived stigma and mental health symptoms. For this study, I conducted an online survey to measure symptoms of depression and anxiety, experiences with both perceived and internalized stigma, and social support. While 93 total participants engaged in the survey, only 52 fully completed the survey and passed two attention-check questions to ensure no invalid participation (e.g., BOTS) were present. In …

Exploration Of Patient Variables And Characteristics Best Suited For Medical Marijuana Treatment For Anxiety And Depressive Disorders, Corey Gazoo

Dissertations

Individuals with posttraumatic stress, anxiety and depressive disorders are currently being prescribed medical marijuana as a treatment in many states across the United States. However, marijuana is still considered a schedule one narcotic by the Drug Enforcement Administration and federal government, which provides several barriers and challenges to conduct research such as approval from the U.S. Food and Drug Administration and following guidelines from the National Institute on Drug Abuse issued by the DEA. Additionally, individuals prescribed medical marijuana for mental health disorders are not always thoroughly instructed on the type of medical marijuana, the dosage, and how frequently to …

Economic Insecurity, Poverty, And Parental Alcohol Misuse, Joey Tucciarone

Electronic Theses and Dissertations

Because parental alcohol misuse is associated with numerous negative outcomes for drinkers and other family members, it is important to examine factors predictive of alcohol misuse patterns among parents living with at least one child under the age of 18. Two possible factors include economic insecurity and poverty. This study sought to address whether measures of economic insecurity (i.e., housing and/or food insecurity in the past 12 months) and a dichotomous measure of poverty predict parental binge drinking and parental heavy alcohol consumption in a large population-based sample. It was hypothesized that economic insecurity and poverty, analyzed separately, would predict …

Relation Between Academic Advisor And Cohort Support With Well-Being In Graduate Students, Morgan Delong

Masters Theses, 2020-current

Well-being issues like the limitations of typical treatment protocols and common mitigating factors for mental health problems for graduate students, specifically the importance of therapeutic lifestyle changes (TLCs) were explored. The current study aims to determine if TLCs, individual engagement in the TLCs as well as support of them by mentors and peers, predict overall well-being, satisfaction with the graduate program, and job stress in masters’ students. This study was conducted during COVID-19 which is a limitation.

Implementing A Depression Screening In A Pediatric Acute Care Setting For Adolescents With Type 1 Diabetes, Kelcie Marler

Dissertations

Problem: Depression among adolescents with Diabetes Mellitus type 1 (DM 1) is three times more prevalent than adolescents without chronic disease. Diagnosis of depression has been found to negatively affect the quality-of-care management, quality of life, and results in an increase in hospital admissions with hypoglycemia or hyperglycemia events.

Methods: A depression screening, the patient health questionnaire 9 (PHQ-9), a validated screening tool for use among adolescents was implemented in this quality improvement (QI) project. It was the first cycle of a plan-do-study-act (PDSA) cycle for in a pediatric ICU. Adolescents between the ages of 12 – 18, were …

Examining Treatment Acceptability Of An Eight-Week Mindfulness-Based Stress Reduction Protocol, Blake William Palmer

Dissertations

The goal of this study is to examine whether levels of perceived stress, experiential avoidance, personality traits including openness to experience and agreeableness, and demographic variables will predict the treatment acceptability (indicated by responses on the Treatment Acceptability and Adherence Scale) of an eight-week Mindfulness-Based Stress Reduction (MBSR) program. This study collected data in the Spring of 2019. The final number of participants in the study was 116 (40 females, 76 males, Mage = 36, age range: 22-69 years). Participants completed measures including the Perceived Stress Scale (PSS), Acceptance and Action Questionnaire-II (AAQ-II), the agreeableness and openness to Experience domains …

Cerebellum-Seeded Functional Connectivity Changes In Trait-Anxious Individuals Undergoing Attention Bias Modification Training, Katherine Elwell

All NMU Master's Theses

Anxiety and anxiety related disorders are increasing at a drastic rate in the past decade, with the NIMH reporting that 31.1% of U.S. adults will experience an anxiety disorder at some point in their lives. Anxiety is commonly characterized by increased attention bias to threat. Attention Bias Modification (ABM) is a new treatment used to reduce individual’s attention bias towards threat. The extent to which ABM leads to underlying neural changes is still unknown. The cerebellum is a neglected brain structure, with new research provides evidence that cerebellum’s functional connectivity and shared networks with threat processing regions has a direct …

Postpartum Depression: Development Of A Screening Protocol In The Neonatal Intensive Care Unit, Kelsey T. Langdale

Doctor of Nursing Practice Projects

Postpartum depression (PPD) affects approximately 19% of all postpartum women. Evidence indicates an increased risk for mothers of hospitalized infants, with estimates ranging from 28% to 67%. The American Academy of Pediatrics and Bright Futures recommend mothers be screened for postpartum depression at the infants’ well-child appointments. During hospitalizations, there are no well-child appointments; thus, no postpartum depression screening. This project aims to 1) improve knowledge of PPD in the staff of the Neonatal Intensive Care Unit (NICU) and 2) investigate the staff’s interest level in implementing a PPD screening protocol. Utilizing the Plan-Do-Study-Act (PDSA) framework, a protocol was developed …

Longitudinal Trauma Treatment Outcomes In An Immigrant And Refugee Sample, Shuen-En Ho

Clinical Psychology Dissertations

Refugee and immigrant populations are at an increased risk of having posttraumatic stress disorder (PTSD) and exhibit a significant amount of variance in trauma treatment outcomes that may be impacted by sociocultural factors. This study examines the impact of demographic variables on treatment outcome and trajectory of PTSD symptoms in a clinic setting with trauma-focused treatments in refugee/immigrant and general populations. Data was collected from the electronic medical record at the Harborview Center for Sexual Assault and Traumatic Stress. A total of 817 participants completed intake, 58 of which self-identified as immigrant/refugee. One-way ANOVAs were conducted to examine group differences …

The Etiology Of Mdd In Sexual Minority Youth And Its Implications For Treatment, Keith Burns

Intuition: The BYU Undergraduate Journal of Psychology

Greater tolerance and understanding of homosexuality, transgenderism, and other forms of gender nonconformity have sparked an increased effort to reach out to and help sexual minorities (i.e., groups whose sexual identity, orientation, or practices differ from cisgender heterosexuality), especially those who experience mental health challenges. Despite immense progress in society, deeply rooted social stigma, prejudice, and discrimination have often left sexual minorities feeling bullied, ostracized, and isolated, which tends to reinforce a host of negative mental health outcomes, such as increased risk of major depressive disorder (MDD) and suicidality (Hatchel et al., 2018). While mental health clinicians have become increasingly …

Global Analysis Of High Cited Papers On “Impact Of Covid-19 On Mental Health” During 2020-21, Ghouse Modin Nabeesab Mamdapur Mr., Brij Mohan Gupta Dr., Sandeep Grover Dr.

Library Philosophy and Practice (e-journal)

A bibliometric analysis based on 160 highly cited papers extracted from the Scopus international database was carried out to provide insights into literature characteristics and publication performances of various participating actors on “Impact of COVID-19 on Mental Health”. Quantitative and qualitative Indicators were applied to measure the productivity and citation impact of most productive participating countries, organizations, authors, journals and significant keywords and to visualise and measure collaborative interaction among them using VOSviewer software. Results obtained from this study can provide valuable information for researchers and policy-makers to identify present and future hotspots in research on “Impact of COVID-19 on …

Music As A Gateway To Healing Speech Disorders And Mental Health Holistically In The Patient With Aphasia: A Literature Review, Susan Warren

Expressive Therapies Capstone Theses

People with some types of post-stroke aphasia often experience depression as well as loss of speech. Music therapy has unique properties that allow it to be used therapeutically to treat both speech impairment and depression yet it is rarely used to treat both disorders. This literature review seeks to examine the underlying causes for this discrepancy, review methods used by practitioners to treat both disorders and suggest future directions for additional research and implications for the treatment of patients with aphasia who have both language impairment and depression.

Exploring The Usefulness Of Mindfulness Practices Through Zoom Meetings In Reducing Anxiety And/Or Stress Of Adults With Learning And Developmental Disabilities During The Covid-19 Pandemic, Thatiane Abra

Expressive Therapies Capstone Theses

This thesis explored which mindfulness meditations or mindfulness practices could be beneficial in the online sessions, the extent to which adults with learning and developmental disabilities could learn the practices remotely, and how stress and anxiety disorders could be reduced through online mindfulness interventions. Furthermore, it was also necessary to address the online sessions as the only mental health treatment possibility during the Coronavirus pandemic for the clients observed and the benefits and limitations of these interventions. Additionally, the importance of structure and routine for this population, the multi-modal structure of the interventions, and how attunement plays an important role …