Psychiatry and Psychology Commons^™

Rural Mental Health Care During A Global Health Pandemic: Addressing And Supporting The Rapid Transition To Tele-Mental Health, Shawnda Schroeder, Holly Roberts, Thomasine Heitkamp, Brandy Clarke, Heather J. Gotham, Erika Franta

Indigenous Health Faculty Publications

The adoption of tele-mental health by mental health professionals has been slow, especially in rural areas. Prior to 2020, less than half of mental health agencies offered tele-mental health for patients. In response to the global health pandemic in March of 2020, mental health therapists across the U.S. were challenged to make the rapid shift to tele-mental health to provide patient care. Given the lack of adoption of tele-mental health previously, immediate training in tele-mental health was needed. This article describes collaborative efforts between two mental health technology transfer centers and one addiction technology transfer center in rural regions of …

Eco-Interoception: What Plants, Fungi And Protista Have Taught My Body, Sara Riley Dotterer

Art Theses and Dissertations

To me, ecology is the relational, full-body awareness that I am made up of and deeply connected to everything around me; and for better or worse, this is reciprocal. I form ecotones, an ecological transitional zone between two ecosystems, with the world around me. I use this ecotonal lens to blur binaries and dissolve boundaries between me and the world “outside my body.” During my Masters of Fine Arts at Southern Methodist University, I have continuously explored and represented the lives of various more-than-human species outside of my body, including plants, fungi and protista through an ecotonal lens. Although these …

Social Cognition Across Bipolar Disorder And Behavioral Variant Frontotemporal Dementia: An Exploratory Study, Izabela Guimarães Barbosa, Flávia Da Mata Chiácchio Leite, Maxime Bertoux, Henrique Cerqueira Guimarães, Luciano Inácio Mariano, Leandro Boson Gambogi, Antônio Lúcio Teixeira, Paulo Caramelli, Leonardo Cruz De Souza

Faculty, Staff and Student Publications

OBJECTIVES: Bipolar disorder type 1 (BD1) and behavioral-variant frontotemporal dementia (bvFTD) share similar behavioral and cognitive symptoms, rendering the differential diagnosis between them a clinical challenge. We investigated the accuracy of social cognition (SC) measures to differentiate bvFTD from BD.

METHODS: We included three groups of participants: early-onset BD1 (in remission, n=20), bvFTD (n=18), and cognitively healthy controls (HC) (n=40), matched for age, schooling, and sex. All participants underwent cognitive assessment, including the Facial Emotion Recognition (FER) and Modified Faux-Pas (mFP) tests, which assess mentalizing.

RESULTS: Compared to HC, BD1 and bvFTD patients underperformed on both SC measures. BD1 and …

A Multimodal Intervention Treatment Plan For Adults With Generalized Anxiety Disorder In Primary Care, Morgan Cullings

Evidence-Based Practice Project Reports

Generalized anxiety disorder (GAD) is a debilitating psychological condition that affects 3.1% of the American population and is one of the leading causes of disability (Anxiety and Depression Association of America, 2022; Baxter, 2014). The purpose of this evidence-based practice project was to implement a multimodal intervention to decrease GAD symptoms in adults in the primary care setting. The PICOT question that guided this project was: In adults, over the age of 18, who have been diagnosed with generalized anxiety disorder (GAD), does the combination of digital cognitive behavioral therapy (CBT) through a smartphone application, lifestyle modification education, and pharmacotherapy …

Rapid Neuroplasticity Changes And Response To Intravenous Ketamine: A Randomized Controlled Trial In Treatment-Resistant Depression, Jared Kopelman, Timothy A Keller, Benjamin Panny, Angela Griffo, Michelle Degutis, Crystal Spotts, Nicolas Cruz, Elizabeth Bell, Kevin Do-Nguyen, Meredith L Wallace, Sanjay J Mathew, Robert H Howland, Rebecca B Price

Staff and Researcher Publications

Intravenous ketamine is posited to rapidly reverse depression by rapidly enhancing neuroplasticity. In human patients, we quantified gray matter microstructural changes on a rapid (24-h) timescale within key regions where neuroplasticity enhancements post-ketamine have been implicated in animal models. In this study, 98 unipolar depressed adults who failed at least one antidepressant medication were randomized 2:1 to a single infusion of intravenous ketamine (0.5 mg/kg) or vehicle (saline) and completed diffusion tensor imaging (DTI) assessments at pre-infusion baseline and 24-h post-infusion. DTI mean diffusivity (DTI-MD), a putative marker of microstructural neuroplasticity in gray matter, was calculated for 7 regions of …

Tf-Cbt Training Augmented With A Self-Care Focus: Understanding Facilitators And Barriers To Treatment Implementation., Julie P. Harrison, Esther Deblinger, Elisabeth Pollio, Beth Cooper, Robert A Steer

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Clinicians working with youth exposed to trauma may be at increased risk for experiencing elevated levels of stress and symptoms of secondary traumatic stress, which can negatively impact clinician wellbeing and ultimately contribute to reduced access to quality care for clients. An innovative Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) training incorporating self-care practices (i.e., Practice What You Preach; PWYP) was developed to help facilitate the implementation of TF-CBT and to enhance clinicians' coping and decrease stress. The primary purpose of this study was to determine whether the PWYP-augmented training met three Objectives: (1) increase clinicians' feelings of TF-CBT competency; (2) improve …

Enacting Stories: Discovering Parallels Of Narrative And Expressive Therapies, A Literature Review, Zoe Reddig

Expressive Therapies Capstone Theses

This literature review will analyze the use of narrative therapy (NT) techniques, dance/movement therapy (DMT) techniques, and expressive therapy (ET) techniques in an effort to distinguish where theoretical parallels exist between these methods of counsel. Narrative therapy is a postmodern framework of counseling that assists clients in resisting damaging stories that have been embedded through bioecological systems of exposure throughout development. Narrative therapy structures its philosophy through processes of externalization and deconstruction, and encourages the process of reframing or re-authoring one’s personal self-narrative. At their core, DMT and ET already utilize components of foundational NT practices, through processes of enactment, …

Biopsychosocial Impacts Of Social Distancing Due To Covid-19 In People Over 65: A Literature Review, Nicole Lacap

Rowan-Virtua Research Day

Background: Since the beginning of the Covid-19 pandemic in January 2020, elderly populations aged 65+ have been deemed at-risk for severe symptoms and poor prognosis. Because it is important to protect this vulnerable population, policies such as social distancing and shelter-in-place orders have been implemented in the United States in order to prevent the spread of Covid-19. However, many older citizens may live alone or may not have access to technology, and therefore may be limited in their ability to maintain important relationships and social interactions throughout shelter-in-place orders and social distancing. Therefore, it is important to understand the cost …

Mental Health Of Medical Students Regarding The Covid-19 Pandemic, Parth Patel, Richard Jermyn, Arvind Venkataraman

Rowan-Virtua Research Day

Mental health has taken a global priority as more realize that it is just as important as physical health in the overall health of a person. Medical students have faced mental health issues for decades and have been shown to suffer more than the general population. The recent COVID-19 pandemic has only deteriorated this issue. Many primary databases such as PubMed were used. The results indicate that medical students have extremely high rates of depression, burnout, anxiety, and stress that can affect their education but also carry over into their professions. Although many interventions increase mental wellness in medical school, …

Prevalence Of Disordered Eating In Female Athletes Of The New Jersey Athletic Conference, Desiree Brower, Joanna Petrides

Rowan-Virtua Research Day

Background: In 2018, the American Academy of Child and Adolescent Psychiatry published that, 1 out of every 10 adolescent females suffer from an eating disorder in the United States. Although it is known that eating disorders have an impact on the entire population, there are currently no studies on the prevalence of disordered eating in female athletes of the New Jersey Athletic conference (NJAC). This study aims to determine how many athletes in this population are affected.

Methods: This IRB-approved project utilized a survey-based approach to assess the prevalence of disordered eating among female athletes within the NJAC. To participate, …

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

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.

Analysis Of Implementing Best Practices For Co-Prescribing Naloxone In Your Agency Online Cme Training Module Via Pre- And Post- Knowledge Assessment., Alicia Podwojniak, Arvind Venkataraman, Richard Jermyn

Rowan-Virtua Research Day

The opioid epidemic poses substantial risk to society. Providers must ensure that their patients understand the uses and risks of both opioids and naloxone. One way to analyze this concept is via metacognition. This refers to a person’s knowledge about cognitive phenomena, and thus it regulates self-awareness abilities in decision making, such as planning and evaluating. It is not only important for providers to have knowledge on best practices, but also to have self-awareness, and confidence in their decision making to ensure optimal patient outcomes. True-false confidence weighted scoring can be utilized, whereby various levels of confidence are assessed from …

Effect Of The Covid-19 Pandemic On Hpv Vaccination Rates, Jennifer Sepede, Kathy Chen

Rowan-Virtua Research Day

Human papillomavirus (HPV) is a common sexually transmitted infection that potentiates cancer in both males and females. There are over 200 different types of HPV and while some strains, specifically HPV 6 and 11, may result in genital and skin warts, others remain clinically silent. High risk strains, HPV 16 and 18, are most associated with cervical cancer in women. During the COVID-19 pandemic, there was widespread hesitancy and rejection towards vaccination. Similarly, the Human Papilloma Virus (HPV) vaccine has also been met with distrust since it’s release. Studies have shown that there is a low vaccination rate due to …

Awareness & Prevention Of Health Hazards For Americans Embarking In Space Tourism, Krzysztof Zembrzuski

Rowan-Virtua Research Day

Since the beginning of spaceflight, keeping humans healthy has been a serious concern. Prior to 2021, astronauts had to undergo an elite selection process to embark in space travel. Now that commercial spaceflight is a reality, the criteria to experience space has been significantly loosened, raising health concerns to a larger and unhealthier pool of travelers. Most commercial spaceflight clients are anticipated to be middle-aged adults, which implies many will suffer from high blood pressure and heart disease, both of which are frequent ailments in this age group. Because of the massive compression the body undergoes during takeoff and return, …

Caretaker Burnout In Nj In Response To The Covid-19 Pandemic: A Study Focusing On Quality Of Life, Challenges And Coping Strategies., Abdullah Junayed, Joanna Petrides

Rowan-Virtua Research Day

There is a scarcity of literature regarding caretaker burnout in response to Covid-19, however one cross section survey study in Italy explored the perceived burden of caretakers of patients with Alzheimer’s disease during the pandemic.1 Maria G. Maggio et al showed that an increase in caregiver burden allowed for a deterioration in personal health conditions causing an increase in perceived stress levels. 1 Along with impaired management of stress and low quality of life, many caretakers were found to utilize avoidance strategies.1 However, the authors pointed out that the dysfunctional coping strategies did not affect stress levels and this study …

The Correlation Between Traumatic Brain Injury And Incarceration Among Adult Males In The United States, Shadi Shams

Rowan-Virtua Research Day

The United States has one of the largest growing prison populations in the world. A large amount of social and economic resources go towards the cost and maintenance of correctional facilities each year. Additionally, the current correctional programs are insufficient in assisting inmates with getting back to society; especially those with traumatic brain injury (TBI) who often remain undiagnosed and are usually treated unfairly in the prison system instead of receiving the appropriate help. Prior scholarly work has shown that patients in the post-TBI stage are more likely to enter the judicial system. In the recent population-based cohort study, the …

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 …

Case Report: Abrupt Psychosis Or Nmda Receptor Encephalitis?, Alexis Dunn, Neelesh Parikh, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 46-year-old female who was initially committed to a psychiatric facility for new onset schizophrenia symptoms. She later had an extensive workup in the hospital due to leukocytosis and was believed to have NMDA Receptor Encephalitis as the cause for her new behavioral symptoms. This case report aims to educate EM (emergency medicine) physicians to keep a broad differential diagnosis on patients who present with new onset, unprovoked psychosis later in life.

Transcendence: Exploring The Connections Between Transgender/Gender Non-Conforming Identities And Experiences Of Nature Through Art, Mc Jackson

Undergraduate Theses

“Transcendence: Exploring the connections between transgender/gender non-conforming identities and experiences of nature through art” is the written portion of a creative thesis revolving around an immersive art installation and short film. Transcendence, the installation, was created to promote connection by exploring the overlap between transgender and gender non-conforming (GNC) experiences and experiences of nature. Part of this installation is a short film of interviews conducted with transgender and GNC individuals about nature, their gender experiences, and the transcendent nature of the two. The written thesis analyzes existing literature on nature as a restorative, therapeutic, spiritual setting, offers insight into …

Targeting Social Connection In The Context Of Trauma: Functional Outcomes And Mechanisms Of Change, Andrew J. Smith, David Pincus, Bernard P. Ricca

Psychology Faculty Articles and Research

The current study presents and preliminarily tests a brief, theory driven intervention designed to target social connectivity as a transdiagnostic mechanism of health. We tested four hypotheses to examine whether and how explicitly targeting social behavior engagement (activating values-led behaviors towards specific network members) may improve other downstream aspects of social connectivity (i.e., social cognitions measured as loneliness, interpersonal closeness, perceived social support) and functioning (quality of life [QOL] and posttraumatic stress symptoms [PTS]). Methods. Participants included 15 patients (10 veterans, 5 firefighters) who completed the six-session intervention. Demographics: age (M = 46, SD = 17), 87% male, race (80% …

Improving Depression Screening Completion Rates For Medicare Patients In A Primary Care Setting, Kenneth J. Haluska

Evidence-Based Practice Project Reports

The United States Preventative Services Task Force recommends screening the general adult population for depression (Siu et al., 2016). Despite increasing clinical practice guidelines recommending depression screening, only 40-50% of depressed older adults are recognized and treated (Phoh et al., 2017). The purpose of this evidence-based practice (EBP) project was to implement a medical assistant (MA) depression screening protocol, using the PHQ-9 and staff education, to improve depression screening completion rates in Medicare patients in a primary care setting. An exhaustive literature search of eight databases yielded 14 pieces of evidence that made recommendations for best practice. The evidence was …

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 …

Characterization Of Differential Rearing And Sex On 5-Ht2ar Receptor Activation, Kelsey Lowe

Theses/Capstones/Creative Projects

The prevalence of substance use disorders (SUDs) continues to rise while the number of medications to combat this deadly disorder remains stagnant. Entirely new thinking about what exemplifies a possible therapeutic is needed. Hallucinogens are continually being studied more as possible treatments for many psychological conditions, including SUDs. Classic hallucinogens engage many serotonin and monoamine systems, but the hallucinogenic effects are driven by serotonin 5-HT_2A receptor (5-HT_2AR) activation. Forced social isolation induces chronic stress, increases 5-HT_2AR expression in the cortex and have been suggested to play a role in the comorbidity between stress, maladaptive coping, …

A Research Review Of Antidepressants For The Treatment Of Major Depressive Disorder, Connor Grady

Senior Honors Theses

The prevalence of major depressive disorder (MDD) in the U.S. has been significantly on the rise between 2015 and 2020, with adolescents and young adults (ages 18-34) contributing the most to this increase (Goodwin et al., 2022). The trend represents a disturbing downturn in the mental health of U.S. adults and warrants close attention and consideration. As the case number of MDD has continuously risen in the recent past, medical practitioners have been searching for more effective solutions. The techniques for combating the symptoms and curing the disease have varied, but one option consistently respected throughout the literature has been …

Uplifting An Invisible Population: How We Can Combine Psychology And Policy To Improve The Educational And Mental Health Outcomes Of Homeless Youth, Melissa Hamilton

Washington Semester Program

The goal of this thesis is to a) explain why homeless youth are frequently linked to poor mental health and education outcomes, and b) offer evidence-based suggestions that ought to be considered when developing any intervention aiming to improve the education and mental health of homeless youth. To accomplish this, prominent theories in both the psychology (ex: Maslow’s Hierarchy of Needs) and political science (ex: failed implementation of the McKinney-Vento Act) fields that pertain to student homelessness were reviewed, and a comparative analysis of existing intervention models was conducted. Three key trends were identified across successful homeless youth intervention models …

Resilience To Stress Across The Lifespan: Childhood Maltreatment, Heart Rate Variability, And Bereavement, Michelle A Chen, Robert Suchting, Julian F Thayer, Christopher P Fagundes

Faculty, Staff and Student Publications

Following a stressful life event, there is considerable variation in how individuals respond and adapt. Multiple models of risk and resilience show that adverse childhood experiences may be associated with an individual's response to stress later in life. While there is considerable support that early adversity can sensitize the stress response system and lead to adverse outcomes later in life, there is mounting evidence that in adolescence and young adulthood, certain biological predispositions to stress may be associated with resilience in the context of subsequent stressors. In this study, we evaluated how individual differences in vagally mediated heart rate variability …

The Kynurenine Pathway In Major Depressive Disorder, Bipolar Disorder, And Schizophrenia: A Systematic Review And Meta-Analysis Of Cerebrospinal Fluid Studies, Mehmet Enes Inam, Brisa S Fernandes, Estela Salagre, Iria Grande, Eduard Vieta, João Quevedo, Zhongming Zhao

Faculty, Staff and Student Publications

INTRODUCTION: The kynurenine pathway has been attracting attention as a relevant pathway in schizophrenia (SZ), bipolar disorder (BD), and major depressive disorder (MDD). We conducted a systematic review and meta-analysis of the kynurenine pathway metabolites from cerebrospinal fluid (CSF) samples in SZ, BD, and MDD.

METHODS: PubMed and Scopus databases were systematically searched to identify peer-reviewed case-control studies until April 2022 that assessed kynurenine metabolites, namely, tryptophan (TRP), kynurenine (KYN), kynurenic acid (KA), quinolinic acid (QA), and 3- hydroxykynurenine (3-HK) in SZ, BD, or MDD subjects compared with healthy controls (HC). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses …

Depression, Stress And Regional Cerebral Blood Flow, Joshua Chiappelli, Bhim M Adhikari, Mark D Kvarta, Heather A Bruce, Eric L Goldwaser, Yizhou Ma, Shuo Chen, Seth Ament, Alan R Shuldiner, Braxton D Mitchell, Peter Kochunov, Danny Jj Wang, L Elliot Hong

Faculty, Staff and Student Publications

Decreased cerebral blood flow (CBF) may be an important mechanism associated with depression. In this study we aimed to determine if the association of CBF and depression is dependent on current level of depression or the tendency to experience depression over time (trait depression), and if CBF is influenced by depression-related factors such as stressful life experiences and antidepressant medication use. CBF was measured in 254 participants from the Amish Connectome Project (age 18-76, 99 men and 154 women) using arterial spin labeling. All participants underwent assessment of symptoms of depression measured with the Beck Depression Inventory and Maryland Trait …

Association Between The Epigenetic Lifespan Predictor Grimage And History Of Suicide Attempt In Bipolar Disorder, Camila N C Lima, Emese H C Kovács, Salahudeen Mirza, Alexandra Del Favero-Campbell, Alexandre Paim Diaz, Joao Quevedo, Benney M R Argue, Jenny Gringer Richards, Aislinn Williams, John A Wemmie, Vincent A Magnotta, Jess G Fiedorowicz, Jair C Soares, Marie E Gaine, Gabriel R Fries

Faculty, Staff and Student Publications

Bipolar disorder (BD) has been previously associated with premature mortality and aging, including acceleration of epigenetic aging. Suicide attempts (SA) are greatly elevated in BD and are associated with decreased lifespan, biological aging, and poorer clinical outcomes. We investigated the relationship between GrimAge, an epigenetic clock trained on time-to-death and associated with mortality and lifespan, and SA in two independent cohorts of BD individuals (discovery cohort - controls (n = 50), BD individuals with (n = 77, BD/SA) and without (n = 67, BD/non-SA) lifetime history of SA; replication cohort - BD/SA (n = 48) and BD/non-SA (n = 47)). …