Psychiatry and Psychology Commons^™

Can Variables From The Electronic Health Record Identify Delirium At Bedside?, Ariba Khan, Kayla Heslin, Michelle Simpson, Michael L. Malone

Journal of Patient-Centered Research and Reviews

Delirium, a common and serious disorder in older hospitalized patients, remains underrecognized. While several delirium predictive models have been developed, only a handful have focused on electronic health record (EHR) data. This prospective cohort study of older inpatients (≥ 65 years old) aimed to determine if variables within our health system’s EHR could be used to identify delirium among hospitalized patients at the bedside. Trained researchers screened daily for delirium using the 3-minute diagnostic Confusion Assessment Method (3D-CAM). Patient demographic and clinical variables were extracted from the EHR. Among 408 participants, mean age was 75 years, 60.8% were female, and …

Evaluating Sbirt In A Behavioral Health Urgent Care, Christina L. Williams

Dissertations

Background: Adolescent substance use (SU) is a major health concern. Most youth who engage in alcohol and other SU do not meet criteria for SU disorder (SUD). Nonetheless, evidence shows SU during adolescence impacts cognitive, social, and emotional development, increases risk of physical injury, and may progress to SUD in adulthood. Only half of clinicians properly screen adolescents for SU; those identified with SUD often receive no intervention. Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based intervention to address this problem. The purpose of this project was to evaluate implementation of SBIRT using CRAFFT 2.1+N, a SU …

Spectral Clustering Of Single-Cell Multi-Omics Data On Multilayer Graphs, Shuyi Zhang, Jacob R Leistico, Raymond J Cho, Jeffrey B Cheng, Jun S Song

Staff and Researcher Publications

Motivation: Single-cell sequencing technologies that simultaneously generate multimodal cellular profiles present opportunities for improved understanding of cell heterogeneity in tissues. How the multimodal information can be integrated to obtain a common cell type identification, however, poses a computational challenge. Multilayer graphs provide a natural representation of multi-omic single-cell sequencing datasets, and finding cell clusters may be understood as a multilayer graph partition problem.

Results: We introduce two spectral algorithms on multilayer graphs, spectral clustering on multilayer graphs and the weighted locally linear (WLL) method, to cluster cells in multi-omic single-cell sequencing datasets. We connect these algorithms through a unifying mathematical …

Visualizing Depressive Symptom Improvement: Implementing The 17-Item Hamilton Depression Rating Scale, Briana Raterman

Dissertations

Visualizing Depressive Symptom Improvement: Implementing the 17-Item Hamilton Depression Rating Scale

Abstract

Problem

Depression, a mental health diagnosis, has affected about 18.5% of adults (Villarroel & Terlizzi, 2020). Ketamine, a medication initially used as an anesthetic, has improved depressive symptoms in individuals struggling with treatment-resistant depression.

Method

This quality improvement (QI) project used the 17-item Hamilton Depression Rating Scale questionnaire to assess depressive symptom changes in patients receiving intramuscular ketamine for treatment-resistant depression. The questionnaire was administered to patients pre-and post-intramuscular ketamine administration. The data was collected on injections one, three, and six on each participant’s set schedule of injections …

Evaluating Patient Health Questionnaire-9 (Phq-9) Use In Burn Survivors, Chelsey Friend

Dissertations

Problem: A burn injury affects both psychological and physical health, resulting in a greater than 50% major depressive disorder morbidity. The purpose of this quality improvement (QI) project is to evaluate the use of the Patient Health Questionnaire-9 (PHQ-9) in adult burn survivors, with an aim to increase the use of the screening tool.

Methods: A mixed-methods pre/post-survey design with an educational component was utilized to assess nurse knowledge, confidence, willingness, and barriers to completion of the PHQ-9. Aggregate data were collected to determine PHQ-9 completion rates for patients admitted to and discharged from the unit during the two months …

J Mich Dent Assoc July 2022

The Journal of the Michigan Dental Association

Monthly, The Journal of the Michigan Dental Association brings news, information, and feature articles to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists! In this July 2022 issue, the reader will find the following original content:

• A cover feature on negotiating reimbursement rates with PPO contracts.
• A cover feature on guarding against employee embezzlement.
• A 10-Minute EBD on rampant caries management and prevention with ADHD patients taking stimulant medications.
• A Back Page look at the 2022 MDA award winners.
• News you need: an Editorial, guidance on dental practice cybersecurity, and regular department …

Distress Tolerance: Prospective Associations With Cognitive-Behavioral Therapy Outcomes In Adults With Posttraumatic Stress And Substance Use Disorders, Anka A Vujanovic, Heather E Webber, Shelby J Mcgrew, Charles E Green, Scott D Lane, Joy M Schmitz

Faculty, Staff and Student Publications

Distress tolerance (DT; perceived or actual ability to tolerate aversive physical or emotional states) is related to both posttraumatic stress disorder (PTSD) symptoms and substance use disorders (SUD). This investigation evaluates self-report and behavioral measures of DT as potential predictors of PTSD and SUD cognitive-behavioral therapy outcomes. Participants included 41 treatment-seeking adults (53.7% women; 73.2% African American; Mage= 44.90, SD = 9.68) who met at least four symptoms of DSM-5 PTSD and DSM-IV substance dependence, assessed via structured interviews. At baseline (pre-treatment), participants completed the Distress Tolerance Scale (DTS), Mirror-Tracing Persistence Task (MTPT), Breath Holding task, and Paced Auditory …

Health Inequities As Measured By The Eq-5d-5l During Covid-19: Results From New York In Healthy And Diseased Persons, Erica I. Lubetkin, Di Long, Juanita A. Haagsma, Mathieu F. Janssen, Gouke J. Bonsel

Publications and Research

Introduction: The effects of the COVID-19 pandemic caused considerable psychological and physical effects in healthy and diseased New Yorkers aside from the effects in those who were infected. We investigated the relationship between known risk-enhancing and health-promoting factors (social and medical), comorbidity indicators, and, as the primary outcome, health-related quality of life (HRQoL).

Methods: Between April 22 and May 5, 2020, a market research agency (Dynata) administered a digital survey including the EQ-5D-5L and items related to individual characteristics, social position, occupational and insurance status, living situation, exposures (smoking and COVID-19), detailed chronic conditions, and experienced access to care to …

Dose-Related Effects Of Ketamine For Antidepressant-Resistant Symptoms Of Posttraumatic Stress Disorder In Veterans And Active Duty Military: A Double-Blind, Randomized, Placebo-Controlled Multi-Center Clinical Trial, Chadi G Abdallah, John D Roache, Ralitza Gueorguieva, Lynnette A Averill, Stacey Young-Mccaughan, Paulo R Shiroma, Prerana Purohit, Antoinette Brundige, William Murff, Kyung-Heup Ahn, Mohamed A Sherif, Eric J Baltutis, Mohini Ranganathan, Deepak D'Souza, Brenda Martini, Steven M Southwick, Ismene L Petrakis, Rebecca R Burson, Kevin B Guthmiller, Argelio L López-Roca, Karl A Lautenschlager, John P Mccallin, Matthew B Hoch, Alexandar Timchenko, Sergio E Souza, Charles E Bryant, Jim Mintz, Brett T Litz, Douglas E Williamson, Terence M Keane, Alan L Peterson, John H Krystal

Staff and Researcher Publications

This study tested the efficacy of repeated intravenous ketamine doses to reduce symptoms of posttraumatic stress disorder (PTSD). Veterans and service members with PTSD (n = 158) who failed previous antidepressant treatment were randomized to 8 infusions administered twice weekly of intravenous placebo (n = 54), low dose (0.2 mg/kg; n = 53) or standard dose (0.5 mg/kg; n = 51) ketamine. Participants were assessed at baseline, during treatment, and for 4 weeks after their last infusion. Primary analyses used mixed effects models. The primary outcome measure was the self-report PTSD Checklist for DSM-5 (PCL-5), and secondary outcome …

Gender Dysphoria Versus Acute Psychosis: Can One Properly Diagnose Gender Dysphoria Solely During Acute Psychosis?, Kristy A. Fisher, Samantha Scemla, Clara L. Alvarez Villalba, Jessica Kroin

HCA Healthcare Journal of Medicine

Gender dysphoria occurs when a discrepancy between one’s sex assigned at birth and one’s gender identity causes distress or impairment in function, which can lead ultimately to seeking treatment in the forms of psychotherapy, hormonal therapy, and/or gender-affirming surgery. Clinical care guidelines also recommend pharmacological treatment of psychiatric comorbidities if indicated. A review of the current literature demonstrates comorbidity between gender dysphoria and psychosis, including cases of gender dysphoria with schizophrenia and the occurrence of gender dysphoria symptoms during manic or psychotic episodes. The existing literature has yet to specifically examine gender dysphoria amongst individuals with schizoaffective disorder. The authors …

Through The Cracks: The Disposition Of Patients With Schizophrenia Spectrum Disorders In The Post-Asylum Era, Briana Tillman, Erin Smith, Alicia Cho, Colt Kennington, Alexandra Kreis

HCA Healthcare Journal of Medicine

This paper aims to explore current disposition options for patients with psychosis in light of shifts toward community care and changes in mental healthcare funding in the post-asylum era and to propose systemic-level improvements based upon local successes. It evaluates critiques of long-term psychiatric care programs, claims of transinstitutionalization to incarceration, shelters, and emergency rooms, and programs initiated to address deinstitutionalization. The authors conclude that while Assertive Community Treatment, Partial Hospitalization Programs, intermediate-level care, and housing interventions can improve outcomes for many persons with psychotic illness, a significant portion of these patients would still be best served in long-term psychiatric …

Phq-2 Scores In Broward County’S Homeless: Prevalence, Barriers, And Proposed Solutions To Mental Health Disparities, Jeena A. Kar, Reeja Raj, Ariba Hashmi, Tahia Hossain, Joshua Berko, Joseph S. Degaetano, Patrick Hardigan

Cooper Rowan Medical Journal

Introduction: Florida ranks 9th in states with highest prevalence of mental illness among homeless individuals. The state also ranks 43rd of 52 states in providing adequate access for mental health concerns in homeless individuals. This study surveyed people experiencing homelessness in Broward County to investigate utilization of healthcare and mental health resources and accessibility of the target population to adequate care.. Aims included a collection of demographics concerning homelessness such as age and gender, prevalence of mental illness, history of substance use and emergency department, and then correlating these with scores from a standardized depression rating scale (PHQ-2). Methods: The …

Anxiety Symptoms Among Extension Professionals' During The Covid-19 Pandemic With The Gad-2, Glenn D. Israel, Colleen E. Gariton, Harsha E. James

Journal of Rural Social Sciences

According to the National Institute of Mental Health, anxiety disorders are a common mental health disorder but often remain undetected and undertreated. During the COVID-19 pandemic, Extension professionals have worked hard to address emerging issues that communities face, possibly impacting the amount of anxiety they experience. This study determined the prevalence of anxiety symptoms among Extension professionals in the United States. Participants from 24 states completed a survey containing the Generalized Anxiety Disorder 2-item (GAD-2) screener. Almost one-quarter of Extension professionals had a GAD-2 score greater than three, an indicator of anxiety with a possibility of generalized anxiety disorder, which …

A Review On Psychosocial Distress Among General Population Of Pakistan During Covid-19 Pandemic, Anosh Arshad Chaudhary, Iqra Arooj, Amina Elahi

Journal of Bioresource Management

The COVID-19 crisis in 2019 significantly impacted human life all over the globe. Psychological health of general population has been affected by the unpredictable circumstances and impulsion of living in isolation, if suspected positive for coronavirus. During COVID-19 outbreak, escalation of various types of psychosocial distresses such as anxiety, sleep disorders and depression has been observed in the general population globally. Thus, there is an urgent need to combat these issues through well planned strategies. The focus of this review is to conduct a thorough evaluation of the available research on the effects of COVID-19 pandemic on the mental status …

Mobile Health Applications For Postpartum Depression Management: A Theory-Informed Analysis Of Change-Use-Engagement (Cue) Criteria In The Digital Environment, Alexandra Zingg, Laura Carter, Deevakar Rogith, Sudhakar Selvaraj, Amy Franklin, Sahiti Myneni

Faculty, Staff and Student Publications

Postpartum Depression (PPD) is the most common childbirth complication, with approximately 15% of postpartum women experiencing depression symptoms. Mobile applications have potential to expand delivery of mental health interventions. However, our understanding of how these tools engage women with PPD and facilitate positive behavioral changes is limited. In our paper, we analyze 15 commercial PPD applications to understand their role as facilitators of change, engagement, and sustained use. Applications reviewed contained an average of four theory-based behavioral change techniques, and highest patient engagement level reached was to empower patients through patient-generated data. Heuristic violations were identified in areas including user …

A Qualitative Study On Nurse Facilitators Of Mind-Body Skills Groups, Paula D. Blake-Beckford

Mindfulness Studies Theses

The Center for Mind-Body Medicine (CMBM), founded by Dr. James Gordon, provides communities with evidence-based Mind-Body Skills Groups (MBSGs) that foster self-care, self-awareness, and self-expression. MBSGs range from 8 to 12-week series on various mind-body practices wherein group members meet, practice, and reflect on the impact of mind-body skills in their lives. Research has demonstrated that participants in MBSGs have positive outcomes. Healthcare professionals (HCPs), especially nurses, gain resiliency from MBSGs. As facilitators of MBSGs, nurses develop essential skills transferable to clinical and educational settings. MBSGs are therapeutic for adult participants with chronic stress. Prior to this thesis, only one …

Where I’M From: Internal Manifestations Among Cambodian Women Using The Expressive Arts A Literature Review, Noeun Chhim

Expressive Therapies Capstone Theses

Chronic mental illness has affected many Cambodian people, but, culturally, Cambodians aren’t accustomed to opening up and discussing their feelings, rather defining mental illness to craziness and seeking help is presumed taboo. Thus, Cambodians are often reluctant to talk about their experiences and/or their related illnesses. Though Cambodians have experienced inconceivable suffering and violence during the Khmer Rouge era, for the purpose of this thesis, I will be discussing the role of Cambodian women and investigate the extent of what they’ve witnessed and experienced. Cambodian women have suffered through many years of trauma and grief, during and after the Khmer …

Touch In Drama Therapy: A Literature Review, Sara Hood

Expressive Therapies Capstone Theses

This article is a cursory look at how touch is perceived in the field of drama therapy. Touch is integral to our experience as humans and can be present in drama therapy sessions. Ethical guidelines for touch in the literature are identified and relevant drama therapy texts and articles describing touch are discussed. While drama therapy has a clear voice when it comes to ethically engaging in touch with a client, very little research was found exploring the intention and outcome of touch in a drama therapy session. Other therapeutic modalities, specifically Developmental Transformations and dance/movement therapy, are identified as …

Using Expressive Arts Therapies To Aid The End-Of-Life Transition For Older Adults: A Literature Review, Rosemary Lape

Expressive Therapies Capstone Theses

This literature review presents the use of expressive arts therapies as they may be applied to end-of-life care for older adults. Death is inevitable and if given the chance to prepare, the expressive arts modalities provide a foundation to process the emotions associated with the ending of a life on earth. Expressive arts provide the opportunity to communicate in non-traditional ways which have the ability to locate subconscious themes. End-of-life care previously revolved around pain management. In more recent years it has evolved to caring for the whole person emotionally, socially, psychologically, and physically. Sources were found utilizing resources provided …

Healing Our Connection With Nature: An Expressive Arts Community Engagement Project, Meghan Mccrillis

Expressive Therapies Capstone Theses

A community engagement project was created and implemented, comprised of two events for which the author facilitated nature-based expressive arts experiences to explore the integration of nature and expressive arts therapy. The events were offered to two different groups of community members, one for nature-curious adults held outdoors on the trails of a local conservation trust, and another for young children at a local library. The healing impact of nature connection and nature connection experiences are explored through a literature review, event methods, and the author’s personal experiences of the project via artmaking. The results include an emphasis on nature …

How Geek Therapy Plays Into Expressive Arts Therapy: A Literature Review, Caroline Bryan

Expressive Therapies Capstone Theses

Within this paper, I explore how geek therapy plays well with the methods of expressive arts therapy. The combination of geek therapy and expressive arts therapy can assist clinicians in immediately connecting with their clients and identifying strength-oriented narratives that honor the client’s preferences, modes of expression, and pop culture affinities. This engagement with expressive approaches utilizing affinity-based interventions can lead to a deeper sense of understanding of the client’s intra-, inter-, and extra-personal relationships. Through this literature review of expressive arts therapy and geek therapy, primarily focusing on video games in therapy, clinicians from all walks of life can …

Delivery Of Parent-Child Interaction Therapy In A Telehealth Format: Reducing Disruptive Behaviors In Pediatric Traumatic Brain Injury, Emily D. Pogue

Dissertations, 2020-current

Traumatic brain injuries (TBIs) in childhood have been associated with disruptive behaviors and attentional problems that may worsen over time and are often experienced as challenging for those in caregiving roles. Parents of children with TBI may evoke negative interactions to manage their child’s behavior through reliance on ineffective parenting practices. This results in increasingly maladaptive parent-child interactions that maintain or worsen problem behaviors of the child and further disrupt family functioning. Despite the importance of family functioning on child post-injury outcomes, the availability of family-based treatments for children with TBI is extremely limited. Parent-Child Interaction Therapy (PCIT) is an …

Is Tai Chi A Beneficial Treatment For Anxiety In The Elderly Community?, Carolyn Kenney

Honors Projects in Applied Psychology

This study attempted to explore the relationship between tai chi practice and anxiety in the elderly population. The mental health disorder that I looked at was anxiety, as the elderly often experience anxiety related to contributing factors such as mental and physical decline. Anxiety among the elderly is a great concern as there is an increase in the world’s population of individuals aged 65 years or older. This will directly impact health care prices as more resources will have to be distributed to this age population. One solution to this problem is tai chi. Tai chi is a cost-effective way …

Effects Of Music Exposure On Autobiographical Memory In Alzheimer's Patients: A Systematic Review And Meta-Analysis, Gregory Vance

Honors Theses

The progression of Alzheimer’s disease is primarily characterized by a loss of memory concerning past events, as well as a lack in ability to create new memories. While this spans across many subsets of memory, such as recognition, recall, and autobiographical memory, there seems to be a lesser impact on musical memory in those with Alzheimer’s. Multiple studies have suggested that exposure to music and introduction of music therapy can even improve other aspects of memory in Alzheimer’s patients. This systematic review and meta-analysis sought to examine the relationship between music exposure and autobiographical memory specifically. A pool of electronic …

Neuronal Activity Within The Ventral Tegmental Area Is Correlated With Cocaine-Seeking Behavior In Male, But Not Female, Rats, Colton D. Spencer, Nicole M. Hinds, Ireneusz D. Wojtas, Desta M. Pulley, Daniel Manvich

Rowan-Virtua Research Day

The objective of this study was to begin to determine the neurobiological underpinnings of psychosocial stress-induced cocaine seeking. Social defeat stress, achieved using the well-established resident-intruder procedure, is an ecologically-valid psychosocial stressor in rodents that may more closely recapitulate those psychosocial experiences that elicit cocaine craving and relapse in human cocaine users. Our laboratory has developed a model of psychosocial stress-induced relapse in rats in which extinguished cocaine seeking is reinstated by re-exposure to a discrete cue that signals impending social defeat stress. We previously reported that an individual rat’s predilection towards the display of active coping behaviors during prior …

Treating Trichotillomania With Olanzapine, Christopher Lee

Rowan-Virtua Research Day

Trichotillomania (TTM) is characterized by repetitive pulling of one’s hair leading to hair loss and problems in social, occupational, or other important areas of functioning. Often individuals with TTM try to decrease or stop hair pulling, however are often unsuccessful without treatment. Community prevalence studies suggest that TTM is a common disorder with point prevalence estimate of 0.5% to 2.0% and with significant psychological comorbidity. Of note, people with TTM are often embarrassed about their condition, so epidemiology data may be underestimated compared to the true prevalence of this condition. The female to male ratio for this condition is 4:1. …

An Interesting Case Of Factitious Disorder Superimposed On Self: Factitious Disorder Vs Somatic Symptom Disorder, Michaela Margolis, Logan Noone, Jessica Baaklini

Rowan-Virtua Research Day

Factitious disorder superimposed on self (FDIS) was first described in 1951by Richard Asher, who associated the disorder with Baron Munchhausen, who narrated unrealistic and exaggerated stories about his life.

Suspicion for FDIS should be raised when patients with atypical presentations of medical disorders seek excessive use of healthcare services despite ongoing lack of clinical evidence. Patients with FDIS often demand hospitalization for their symptoms, leading to unnecessary tests and treatments. These patients show signs of pathological lying, deceitfulness, are obstinate with medical staff, and display erratic behavior. When medical investigation does not support their symptoms, patients often develop new “symptoms” …

The Need For Depression And Anxiety Screenings At A Student-Run Clinic, Shayna Peterzell, Sahil Parikh, Alicia Podwojniak, Vibha Chauhan, Riya Tandra, Emily Forester, Saumil Parikh, Jessica-Sophie Horoschak, Patrick Pearce, Roma Padalkar, Sobiah Khan, Tara Pellegrino

Rowan-Virtua Research Day

General anxiety and major depressive disorder are common and treatable mental health disorders. The US Preventive Services Task Force provides strong evidence that early screening helps identify depression in primary care settings, promotes intervention and facilitates treatment. Many medical offices use validated screening tools, GAD-7 and PHQ-9, to measure symptom severities and further help guide treatment modalities for patients with anxiety and depression, respectively. The Rowan Community Health Clinic (RCHC) in Lindenwold, NJ is a student-run free clinic that serves patients regardless of patient gender, race, income, or insurance status. This study aims to determine if there is a need …

Preferences For Support Resources Among Loved Ones Of Adults Prescribed Opioid Medications, Mansi Patel, Desta M. Pulley, Daniel Manvich

Rowan-Virtua Research Day

The opioid epidemic continues to be a leading cause of overdose and related deaths in America. While most interventions are focused on the individuals with opioid and substance use disorder (OUD/SUD); the impact caregivers and family can have on the treatment of patients with OUD is non-existent. The purpose of this study is to collect pilot data on peers, friends, and family members of patients with SUD/OUD to understand the barriers in psychosocial support and maintaining treatment retention; barriers to accessing medication assisted therapy (MAT) and naloxone; and caregiver fatigue and barriers for caregivers. The collected data will be used …

Seizure To Drug Induced Schizophrenia: A Rare Case Of Keppra-Induced Psychosis, Shadi Shams, Riddhima Issar, Nardin El-Shammaa, Munaza Khan

Rowan-Virtua Research Day

Levetiracetam is a broad-spectrum antiseizure medication and is approved as adjunctive therapy to treat focal-onset seizures in children and adults with epilepsy. Levetiracetam has a wide margin of safety and patient-friendly pharmacokinetics that distinguish it from other currently available antiepileptic drugs.

Most common side effects are fatigue, somnolence, dizziness, and upper respiratory infection. Neuropsychiatric symptoms are reported. Psychotic symptoms, paranoid ideation, hallucinations, and behavioral problems may occur in adult and pediatric patients. Among all adverse effects, the rate of psychosis is very low and ranges from less than 1% to 1.4%. A retrospective study showed that this rate is higher …