Psychiatry and Psychology Commons^™

Searching For A Sense Of Place: The Process Of How Adolescent Girls Overcome Suicidality, Tamara Keefner

Electronic Theses and Dissertations

Suicide and self-harming behaviors are significant public health problems among children and adolescents globally and in the United States. Despite significant advances in recent decades to understand, prevent, and treat childhood and adolescent self-harming and suicide, suicide rates remain high. Since the National Action Alliance for Suicide Prevention set a goal to reduce suicide deaths and attempts by 40% by 2020, there has been a paradigm shift in the study of suicide yielding significant advances in the understanding of suicide and other forms of self-inflicted injury. This dissertation highlights some of the new developments in the study of suicide. First, …

Processing Youth Adventure Wellness Experiences: Poetic Representations Of Youth’S Peace Bus Experiences, Ty Th Nguyen

Theses and Dissertations (Comprehensive)

This narrative inquiry explored how youth are processing their Peace Bus program experiences two and a half years after program completion. The purpose was to gain an understanding of (1) what program components the participants reflect on, (2) how they conceptualize their program experiences, and (3) what factors contribute to their reflection processes. This research sought to address the gap in literature where little is understood about the ongoing experiences of program participants of adventure wellness programs and the processes that lead to positive changes. As the researcher, I conducted a qualitative study using narrative inquiry and poetic representation methods. …

Telebehavioral Health Program Needs Assessment Conducted At Aurora Mental Health Center, Iwei Wang

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

The purpose of this project was to conduct a needs assessment for a Telebehavioral Health Program at Aurora Mental Health Center (AuMHC) to determine how telebehavioral health aligns with the organization’s interests, needs, services, target population, and readiness for telebehavioral health services. This investigator used survey and content analysis methods to conduct this investigation. Findings of this assessment showed that both literature and existing programs at AuMHC were supportive of moving forward with telebehavioral health services. Considerations of AuMHC’s contextual conditions and recommendations for successful implementation are provided.

Measuring Glutamate And Oxygen In Brain Reward Circuits In Animal Models Of Cocaine Abuse And Decision-Making, Seth Richard Batten

Theses and Dissertations--Psychology

Drug-specific reward and associated effects on neural signaling are often studied between subjects, where one group self-administers drug and a separate group self-administers a natural reinforcer. However, exposure to drugs of abuse can cause long-term neural adaptations that can affect how an organism responds to drug reward, natural reward, and their reward-associated stimuli. Thus, to isolate drug-specific effects it is important to use models that expose the same organism to all of the aforementioned. Multiple schedules provide a means of dissociating the rewarding effects of a drug from the rewarding effects of food within a single animal. Further, drug users …

Depressive Symptoms In Older Versus Younger People With Epilepsy: Findings From An Integrated Epilepsy Self-Management Clinical Research Dataset, Zaira Khalid, Hasina Momotaz, Farren Briggs, Kristin A. Cassidy, Betsy K. Wilson, Martha Sajatovic

Faculty Scholarship

Aim: There are limited data on psychological outcomes in older people with epilepsy (PWE). This analysis, from a large pooled dataset of clinical studies from the Managing Epilepsy Well (MEW) Network, examined clinical variables including depressive symptom severity, quality of life and epilepsy self-management competency among older (age 55+) vs younger (

The Effects Of Compassion Fatigue On Burnout Among Inpatient Psychiatric And Intensive Care Unit Nurses, Amita Madan Neidlinger

DNP Projects

PURPOSE: This DNP project is relevant to nurses of the psychiatric and Intensive Care Unit (ICU) setting, as high stress environments may produce higher rates of compassion fatigue and burnout. Investigation of these areas may help illuminate unnecessary healthcare costs that are associated with these phenomena. This DNP project is important to the University of Kentucky’s healthcare system, its patients, and nurses. Increased absenteeism and increased medication errors are positively associated with the prevalence of compassion fatigue and burnout in nurses. Outcomes from this project will allow identification of unnecessary healthcare costs and encourage administrators to focus on reducing nurse …

Treatment Of Nightmares In Psychiatric Inpatients With Imagery Rehearsal Therapy: An Open Trial And Case Series, Thomas E Ellis, Katrina A Rufino, Michael R Nadorff

Staff and Researcher Publications

Objectives: This study sought to assess the utility of Imagery Rehearsal Therapy (IRT) for nightmares in an inpatient psychiatric setting. Although IRT enjoys a substantial evidence base for efficacy in various populations, data with psychiatric inpatients are lacking.

Participants: Participants were 20 adult psychiatric inpatients (11 male, 9 female; mean age=43.4), in an extended stay psychiatric inpatient facility. All participants were diagnosed with multiple, treatment resistant, comorbid conditions, including mood disorders, anxiety disorders, personality disorders, and substance-related disorders. Patients with active psychosis or significant cognitive impairment were excluded.

Methods: This was an open trial utilizing a case series design. In …

Resting-State Functional Connectivity Of The Habenula In Mood Disorder Patients With And Without Suicide-Related Behaviors, Elisa Ambrosi, David B Arciniegas, Kaylah N Curtis, Michelle A Patriquin, Gianfranco Spalletta, Gabriele Sani, B Christopher Frueh, J Christopher Fowler, Alok Madan, Ramiro Salas

Staff and Researcher Publications

The habenula is a small midbrain structure that is important for brain signaling and learning from negative events. Thus, the habenula is strongly connected to both the reward system and motor regions. Increasing evidence suggests a role for the habenula in the etiology of psychiatric disorders, including mood and substance use disorders. However, no studies to date have investigated habenular resting-state functional connectivity (rsFC) in suicide-related behaviors (SB). The authors enrolled 123 individuals with major depressive disorder (MDD) or bipolar disorder and a history of suicide-related behaviors (SB+), 74 individuals with MDD or bipolar disorder and a history of suicidal …

A Proof-Of-Mechanism Study To Test Effects Of The Nmda Receptor Antagonist Lanicemine On Behavioral Sensitization In Individuals With Symptoms Of Ptsd, Marijn Lijffijt, Charles E Green, Nicholas Balderston, Tabish Iqbal, Megan Atkinson, Brittany Vo-Le, Bylinda Vo-Le, Brittany O'Brien, Christian Grillon, Alan C Swann, Sanjay J Mathew

Faculty, Staff and Students Publications

Background: Individuals with post-traumatic stress disorder (PTSD) have a heightened sensitivity to subsequent stressors, addictive drugs, and symptom recurrence, a form of behavioral sensitization. N-methyl-D-aspartate receptors (NMDARs) are involved in the establishment and activation of sensitized behavior.

Objective: We describe a protocol of a randomized placebo-controlled Phase 1b proof-of-mechanism trial to examine target engagement, safety, tolerability, and possible efficacy of the NMDAR antagonist lanicemine in individuals with symptoms of PTSD (Clinician Administered PTSD Scale [CAPS-5] score ≥ 25) and evidence of behavioral sensitization measured as enhanced anxiety-potentiated startle (APS; T-score ≥ 2.8).

Methods: Subjects (n = 24; age range 21–65) …

Predictors And Health Outcomes Of Treatment-Resistant Depression Among Adults With Chronic Non-Cancer Pain Conditions And Major Depressive Disorder, Drishti Shah

Graduate Theses, Dissertations, and Problem Reports (ETD)

Understanding major depressive disorder (MDD) as a comorbidity in patients with chronic non-cancer pain conditions (CNPC) is of importance because of the high prevalence and well documented bi-directional relationship between MDD and pain. Furthermore, presence of CNPC among adults with MDD often reduces benefits of antidepressant therapy, thereby increasing the possibility of treatment resistance. Treatment-resistant depression (TRD) commonly defined as insufficient response to multiple antidepressant trials, often worsens depression and pain symptoms and can amplify the clinical and economic burden among adults with CNPC and MDD. Additionally, long-term opioid therapy (LTOT) may be prescribed at a higher rate to adults …

Structure-Activity Relationship Studies Of Synthetic Cathinones And Related Agents, Rachel A. Davies

Theses and Dissertations

Synthetic cathinones and related agents represent an international drug abuse problem, and at the same time an important class of clinically useful compounds. Structure-activity relationship studies are needed to elucidate molecular features underlying the pharmacology of these agents. Illicit methcathinone (i.e., MCAT), the prototype of the synthetic cathinone class, exists as a racemic mixture. Though the differences in potency and target selectivity between the positional and optical isomers of synthetic cathinones and related agents have been demonstrated to have important implications for abuse and therapeutic potential, the two MCAT isomers have never been directly compared at their molecular targets: the …

Translational Insights Into The Genetic Etiology Of Mental Health Disorders: Examining Risk Factor Models, Neuroimaging, And Current Dissemination Practices, Jessica L. Bourdon

Theses and Dissertations

Psychiatric genetics is a basic science field that has potential for practical application and effective translation. To date, translational frameworks utilized by this field have been linear (e.g., sequential) in nature, focusing on molecular genetic information. It is proposed that non-linear (e.g., socio-ecological) frameworks are a better way to immediately translate non-molecular genetic information. This dissertation explored the translation of psychiatric genetic information in two ways. First, a survey was sent to academic stakeholders to assess the state of the science regarding the translation of genetic information to the clinical care of mental health disorders. Findings from this indicate a …

As A Pediatrician, I Don’T Know The Second, Third, Or Fourth Thing To Do: A Qualitative Study Of Pediatric Residents’ Training And Experiences In Behavioral Health, Rachel Petts Phd, Jeffrey D. Shahidullah Phd, Paul W. Kettlewell Phd, Kathryn A. Dehart Md, Kris Rooney Md, Ilene G. Ladd Ms, Tyler Bogaczyk Bs, Sharon L. Larson Phd

International Journal of Health Sciences Education

Despite a mandated 1-month rotation in developmental-behavioral pediatrics (DBP), pediatric residents report inadequate training in behavioral health care. As a first step in much needed curriculum development in this area, this study sought to assess learner experiences regarding the management of behavioral health problems during residency. Four focus groups were conducted for residents in years 1-3 of training in 2 residency programs in a northeastern state. Transcripts were analyzed and coded by researchers through qualitative classical content analysis. The exploratory analysis revealed 9 key themes: time requirements, rapport building, resources and referrals for behavioral health, psychiatric medications, diagnosis vs. treatment, …

Addicted To The Answer, Charumathi Raman

Capstones

Hypochondria, which is now broadly known as health anxiety, is the fear of a serious illness that continues despite evidence to the contrary from laboratory tests and the reassurance of physicians. In the past people with this disorder would go from doctor to doctor seeking an answer, but now many people rely solely upon online information.

For people with health anxiety, the Internet provides a lot of fodder. Researchers have recently coined the term "cyberchondria" to describe the phenomenon of increased health anxiety due to online health searches.

Entering questions like “Who started World War Two?” or “Who was the …

Measuring Novel Antecedents Of Mental Illness: The Questionnaire Of Unpredictability In Childhood, Laura M. Glynn, Hal S. Stern, Mariann A. Howland, Victoria B. Risbrough, Dewleen G. Baker, Caroline M. Nievergelt, Tallie Z. Baram, Elysia P. Davis

Psychology Faculty Articles and Research

Increasing evidence indicates that, in addition to poverty, maternal depression, and other well-established factors, unpredictability of maternal and environmental signals early in life influences trajectories of brain development, determining risk for subsequent mental illness. However, whereas most risk factors for later vulnerability to mental illness are readily measured using existing, clinically available tools, there are no similar measures for assessing early-life unpredictability. Here we validate the Questionnaire of Unpredictability in Childhood (QUIC) and examine its associations with mental health in the context of other indicators of childhood adversity (e.g., traumatic life events, socioeconomic status, and parenting quality). The QUIC was …

Delphi Survey Of Maintenance Lithium Treatment In Older Adults With Bipolar Disorder: An Isbd Task Force Report, Martha Sajatovic

Faculty Scholarship

Objectives: Despite the growing numbers and proportion of older adults with bipolar disorder (OABD), there are very limited guidelines for the use of lithium with its double-edged potential for effectiveness and toxicity in this population. The primary aims of this Delphi survey were: (a) To determine the place of lithium among the preferred choices for maintenance treatment of OABD. (b) To provide detailed clinical guidelines for the safe and effective use of lithium in OABD. Methods: In the face of limited evidence, the Delphi survey method was used to achieve consensus by a group of 25 experts in OABD from …

The Critical Need For Mental Health Education To Be Mandated In New Mexico's Public Schools, Bonnie L. Murphy

Shared Knowledge Conference

Based on a review of research and best practices in mental health awareness and skills, this inquiry project argues for state legislative policies that would require mental health awareness and skills in the K-12 curriculum. Mental health affects individual accomplishments in every stage of people’s lives beginning in early childhood and throughout the life cycle. Prevention and treatment of mental illness plays a key role in the ability of an individual to cope with loss and develop resiliency and perseverance in challenging times and to make better decisions that improve the individual’s life and the lives of those around them. …

Ethical Implications Of Treatment For Gender Dysphoria In Youth, Kelsey Hayes

Journal of Health Ethics

This manuscript explores ethical implications on treatment for youth with diagnosed gender dysphoria. The ethical considerations outlined and analyzed in this essay involve illuminating an understanding of whether the administration of pubertal suppression with GnRH agonists, and cross-sex hormones to children with gender dysphoria is morally justified as treatment to manage their psychological distress, or if safer more understood alternatives exist. This essay emphasizes that as health care professionals we must ensure youth with gender dysphoria receive adequate medical treatment and care however, this essay concludes through extensive literature review, that the use of inconclusive and under researched methods to …

Spatio-Temporal Distribution Of Negative Emotions In New York City After A Natural Disaster As Seen In Social Media, Oliver Gruebner, Sarah R. Lowe, Martin Sykora, Ketan Shankardass, Sv Subramanian, Sandro Galea

Department of Psychology Faculty Scholarship and Creative Works

Disasters have substantial consequences for population mental health. We used Twitter to (1) extract negative emotions indicating discomfort in New York City (NYC) before, during, and after Superstorm Sandy in 2012. We further aimed to (2) identify whether pre- or peri-disaster discomfort were associated with peri- or post-disaster discomfort, respectively, and to (3) assess geographic variation in discomfort across NYC census tracts over time. Our sample consisted of 1,018,140 geo-located tweets that were analyzed with an advanced sentiment analysis called ”Extracting the Meaning Of Terse Information in a Visualization of Emotion” (EMOTIVE). We calculated discomfort rates for 2137 NYC census …

"Born Out Of Fear": A Grounded Theory Study Of The Stigma Of Bipolar Disorder For New Mothers, Walker Ladd Ph.D.

The Qualitative Report

Childbirth is an established trigger for the onset of bipolar disorders (BD) in the postpartum period, causing significant pathology and disability. Research has shown that the stigma of mental illness for new mothers is a powerful obstacle to care, preventing women from accessing critical treatment and social support. However, the majority of research has examined the relationship between the stigma and postpartum depression, leaving a gap in knowledge regarding stigma and postpartum bipolar disorder. The problem addressed in this grounded theory study was the lack of knowledge regarding the stigma of a diagnosis of bipolar disorder (BD) in the first …

Kinship Diversion In The District Of Columbia: A Review Of Local Practice To Inform National Policy, Marla P. Spindel, Beth A. Stekler, Stephanie Ridgway Mcclellan

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

This article addresses a practice commonly known in the child welfare community as “kinship diversion,” where a child welfare agency informally places children with relatives as an alternative to foster care. While evidence predominantly shows that abused and neglected children have better outcomes when they are placed with relatives when they cannot remain safely at home, serious concerns about these children’s safety and well-being arise when the placement with relatives is informal. Indeed, it is often not understood that these same relatives can be approved as foster parents and can receive essential financial assistance and supportive services to help safely …

What’S Your Story? Assessing Childhood Maltreatment Using The Thematic Apperception Test In An Adult Inpatient Population., Thachell C. Tanis

Dissertations, Theses, and Capstone Projects

There is a robust evidence that childhood maltreatment contributes to the development of adult psychopathology (Brown & Anderson, 1991; Johnson, Cohen, Brown, Smailes, & Bernstein 1999; Johnson, Smailes, Cohen, Brown, & Bernstein, 2000; Ruggiero et al., 1999). However, the identification of childhood maltreatment remains a methodological problem that results in inconsistencies in the reported incidence and psychological sequelae of maltreatment. A primary method for identifying histories of childhood maltreatment among adults is retrospective self-report measures which are susceptible to multiple biases (Briere, 1992; Cicchetti & Rizley, 1981; Shaffer, Huston, & Egeland, 2008). This present study suggests that childhood maltreatment can …

The Effect Of Exercise On Symptoms Of Depression In Adults Diagnosed With Clinical Depression: An Integrative Literature Review, Tibil Felix

Grace Peterson Nursing Research Colloquium

Background: While many healthcare providers are currently looking for alternative methods such as exercise to treat depression, there are limited studies to report how exercise effects symptoms of depression in adults diagnosed with clinical depression and whether an ideal exercise prescription exists.

Objective: The purpose of this integrative literature review was to evaluate the effect of exercise on adults with clinical depression.

Method: An integrative literature review was used. The tidal model of mental health as proposed by Dr. Phil Barker and Poppy Buchanan-Barker was used as a basis for this review. The keywords “clinical depression, exercise, adults, depression treatments, …

A Markov Approach For Increasing Precision In The Assessment Of Data-Intensive Behavioral Interventions, Vincent Berardi, Ricardo Carretero-González, John Belletierre, Marc A. Adams, Suzanne C. Hughes, Melbourne Hovell

Psychology Faculty Articles and Research

Health interventions using real-time sensing technology are characterized by intensive longitudinal data, which has the potential to enable nuanced evaluations of individuals’ responses to treatment. Existing analytic tools were not developed to capitalize on this opportunity as they typically focus on first-order findings such as changes in the level and/or slope of outcome variables over different intervention phases. This paper introduces an exploratory, Markov-based empirical transition method that offers a more comprehensive assessment of behavioral responses when intensive longitudinal data are available. The procedure projects a univariate time-series into discrete states and empirically determines the probability of transitioning from one …

Depression, Anxiety, Post-Traumatic Stress Disorder And A History Of Pervasive Gender-Based Violence Among Women Asylum Seekers Who Have Undergone Female Genital Mutilation/Cutting: A Retrospective Case Review, Hazel Lever, Deborah Ottenheimer, Jimmitti Teysir, Elizabeth Singer, Holly G. Atkinson

Publications and Research

We sought to evaluate the frequency of anxiety, depression, PTSD, and any experiences of violence in women who had undergone Female Genital Mutilation/Cutting (FGM/C) and were seeking asylum in the United States. We undertook a retrospective qualitative descriptive study of FGM/C cases seen in an asylum clinic over a 2-year period. Standardized questionnaires provided quantitative scores for anxiety, depression and PTSD. Clients’ personal and physician medical affidavits were analyzed for experiences of violence. Of the 13 cases, anxiety and depression were exhibited by 92 and 100% of women, while all seven women screened for PTSD had symptoms. Qualitative analysis revealed …

Journey Interrupted: A Phenomenological Exploration Of Miscarriage, Marit A. Watson, Vanessa D. Jewell, Sarah L. Smith

The Open Journal of Occupational Therapy

Background: Miscarriage is a significant life event that impacts occupational performance, identity, and competence and that influences perceptions of motherhood. Because of the lack of social rituals often attributed to the death of a loved one, miscarriages may result in disenfranchised grief, which impedes coping.

Methods: This phenomenological study explored the impact of miscarriage on relationships, perceptions of motherhood, and the meaning of occupation in the context of grief. Data was collected through semi-structured interviews (N = 4) and completion of a brief demographic questionnaire. The interviews were digitally recorded, transcribed verbatim, and reviewed to ensure accuracy. Using inductive thematic …

Supervision In Community Mental Health: Understanding Intensity Of Ebt Focus., Leah Lucid, Rosemary Meza, Michael D Pullmann, Nathaniel Jungbluth, Esther Deblinger, Shannon Dorsey

Rowan-Virtua School of Osteopathic Medicine Departmental Research

The goal of the present study was to examine clinician, supervisor, and organizational factors that are associated with the intensity of evidence-based treatment (EBT) focus in workplace-based clinical supervision of a specific EBT, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Supervisors (n = 56) and clinicians (n = 207) from mental health organizations across Washington State completed online self-report questionnaires. Multilevel modeling (MLM) analyses were used to examine the relative influence of nested clinician and supervisor factors on the intensity of EBT focus in supervision. We found that 33% of the variance in clinician report of EBT supervision intensity clustered at the …

The Tragedy Of Child And Adolescent Suicide, Brad Hinman

Faculty Publications

"In 2015, the Centers for Disease Control and U.S. Department of Education reported that 20 to 28 percent of U.S. students in grades 6 to 12 have experienced bullying, 30 percent admitted to bullying others, and 70 percent witnessed bullying in some form. According to the report, children and young adults are affected by bullying and cyberbullying during their school-age years, and some even into adulthood.³ “School violence and bullying occurs throughout the world and affects a significant proportion of children and adolescents. It is estimated that 246 million children and adolescents experience school violence and bullying in …

Body Dissatisfaction And Suicidal Ideation Among Psychiatric Inpatients With Eating Disorders, Katrina A Rufino, Humsini Viswanath, Rebecca Wagner, Michelle A Patriquin

Staff and Researcher Publications

The current study the relationship between eating disorders (EDs) and suicidal ideation and suicide attempt in adult inpatients. In particular, the present study investigated one potential mechanism, body dissatisfaction (BD), which may contribute to increased risk for suicide in adult ED patients. A sample of 432 psychiatric inpatients ranging from 18 to 65 years of age participated in the current study. Findings indicated that patients who have higher levels of BD also had higher levels of passive and active suicidal ideation and previous suicide attempts. Higher levels of BD were also related to increased suicidal ideation after controlling for depression …

Contextualization Of Psychological Treatments For Government Health Systems In Low-Resource Settings: Group Interpersonal Psychotherapy For Caregivers Of Children With Nodding Syndrome In Uganda., Byamah B Mutamba, Brandon A Kohrt, James Okello, Janet Nakigudde, Bernard Opar, Seggane Musisi, William Bazeyo, Joop De Jong

Psychiatry and Behavioral Sciences Faculty Publications

BACKGROUND: Evidence for the effectiveness of psychological treatments in low- and middle-income countries is increasing. However, there is a lack of systematic approaches to guide implementation in government health systems. The objective of this study was to address this gap by employing the Replicating Effective Programs (REP) framework to guide contextualization of a psychological treatment in the Uganda public health system for caregivers of children affected by nodding syndrome, a neuropsychiatric disorder endemic to Sub-Saharan Africa associated with high morbidity and disability.

METHODS: To contextualize a psychological treatment, we followed the four components of the REP framework: pre-conditions, pre-implementation, implementation, …