Psychiatry and Psychology Commons^™

Shared Genetic And Environmental Influences On Fear, Anxiety, Posttraumatic Stress, And Brain Morphometry, Chelsea Sawyers

Theses and Dissertations

Anxiety disorders (ADs) and stress-related disorders are some of the most common psychiatric disorders in the United States. Like other c0mplex psychiatric illness, genetics and neuroimaging research has focused on understanding their underlying neurobiology. Areas within the fear-network play important roles in threat perception, fear conditioning/learning, cognitive processing, and modulation of fear responses including contextual modulation and extinction and have been implicated in ADs as well as stress disorders such as posttraumatic stress disorder (PTSD). The primary gap in the current search for underlying biological mechanisms is in whether biomarkers associated with disorders share genetic influences with the disorders they …

Benzodiazepines Ii: Waking Up On Sedatives: Providing Optimal Care When Inheriting Benzodiazepine Prescriptions In Transfer Patients, Jeffrey Guina, Brian Merrill

Psychiatry Faculty Publications

This review discusses risks, benefits, and alternatives in patients already taking benzodiazepines when care transfers to a new clinician. Prescribers have the decision—sometimes mutually agreed-upon and sometimes unilateral—to continue, discontinue, or change treatment. This decision should be made based on evidence-based indications (conditions and timeframes), comorbidities, potential drug-drug interactions, and evidence of adverse effects, misuse, abuse, dependence, or diversion. We discuss management tools involved in continuation (e.g., monitoring symptoms, laboratory testing, prescribing contracts, state prescription databases, stages of change) and discontinuation (e.g., tapering, psychotherapeutic interventions, education, handouts, reassurance, medications to assist with discontinuation, and alternative treatments).

Stasi Brainwashing In The Gdr 1957 - 1990, Jacob H. Solbrig, Jacob Hagen Solbrig

LSU New Orleans Theses and Dissertations

This thesis examines the methods used by the Ministerium für Staatssicherheit (MfS), more commonly known as the Stasi, or East German secret police, for extraction of information from citizens of the German Democratic Republic for the purpose of espionage and covert operations inside East Germany, as it pertains to the deliberate brainwashing of East German citizens. As one of the most efficient intelligence agencies to ever exist, the Stasi’s main purpose was to monitor the population, gather intelligence, and collect or turn informants. They used brainwashing techniques to control the people of the GDR, keeping the populace paralyzed with fear …

Modifiable Lifestyle Risk Factors For Stroke Among A High Risk Hypertensive Population In Greater Kampala, Uganda; A Cross-Sectional Study, Carol Blixen, Elisabeth Welter, Martha Sajatovic

Faculty Scholarship

Objective: To describe the modifiable lifestyle risk factors for stroke among a high risk population for stroke. Africa suffers from rapid population growth, adoption of harmful western diets, and increased prevalence of hypertension and obesity. Results: A total of 440 study participants were screened and 87 individuals with hypertension plus at least one other known stroke risk factor were enrolled. The prevalence of hypertension and diabetes mellitus in the screened population was 19.7 and 1.8%, respectively. Among those with hypertension only 2.3% (2/87) had ever had serum lipid assessment. Seventy-two percent (68/87) had very high serum LDL-cholesterol, while 33.3% (29/87) …

Improving Detection Of Mental Health Problems In Community Settings In Nepal: Development And Pilot Testing Of The Community Informant Detection Tool, Prasansa Subba, Nagendra P. Luitel, Brandon A. Kohrt, Mark Jordans

Psychiatry and Behavioral Sciences Faculty Publications

Background

Despite increasing efforts to expand availability of mental health services throughout the world, there continues to be limited utilization of these services by persons with mental illness and their families. Community-based detection that facilitates identification and referral of people with mental health problems has been advocated as an effective strategy to increase help-seeking and service utilization. The Community Informant Detection Tool (CIDT) was developed for the community informants to identify people with depression, psychosis, alcohol use problems, epilepsy, and child behavioral problems in community settings. The CIDT has been validated in Nepal and found to be effective in promoting …

Increased Cancer-Specific Mortality In Individuals Developing Mental Disorders After Cancer Diagnosis: Biomedical Factors Versus Psychosocial Support, Siran M. Koroukian, Martha Sajatovic

Faculty Scholarship

No abstract provided.

A 6-Month Open-Label Extension Study Of Vortioxetine In Pediatric Patients With Depressive Or Anxiety Disorders., Robert L Findling, Adelaide S Robb, Melissa P Delbello, Michael Huss, Nora K Mcnamara, Elias H Sarkis, Russell E Scheffer, Lis H Poulsen, Grace Chen, Ole M Lemming, Philippe Auby

Psychiatry and Behavioral Sciences Faculty Publications

OBJECTIVES: In this 6-month open-label extension (OLE) of NCT01491035 (a 14-day, open-label, pharmacokinetic/safety lead-in study), the long-term safety and tolerability of vortioxetine (5-20 mg/day) were investigated in children and adolescents with a DSM-IV-TR™ diagnosis of depressive or anxiety disorder in the United States or Germany. The study also was designed to provide data to inform dose selection and titration in future pediatric studies with vortioxetine.

METHODS: Safety evaluations included spontaneously reported adverse events (AEs), the Columbia Suicide Severity Rating Scale (C-SSRS), and the Pediatric Adverse Events Rating Scale (PAERS; clinician administered). Clinical effectiveness was determined by Clinical Global Impressions. Comorbid …

Finasteride As A Model For Personalized Medicine, Ion G. Motofei, David L. Rowland, Ioana Păunică, Octavian C. Tănăsescu, Petrişor Banu, Stana Păunică

Journal of Mind and Medical Sciences

The side effects of Finasteride are currently a subject of controversy. Some studies report minor or acceptable adverse effects, which decrease after a variable period of time so that they do not necessitate terminating Finasteride administration. However, several clinical and neuro-endocrine studies show that some adverse effects persist indefinitely in the form of post-Finasteride syndrome, even after the drug cessation. This paper presents a possible explanation for these inconsistent findings. First, the study design of either informing or not informing patients prior therapy about possible adverse effects can influence the incidence and magnitude of reported adverse effects. Second, structural and …

The Relationship Between Self-Reported Borderline Personality Features And Prospective Illness Course In Bipolar Disorder., Georg Riemann, Nadine Weisscher, Robert M Post, Lori Altshuler, Susan Mcelroy, Marc A Frye, Paul E Keck, Gabriele S Leverich, Trisha Suppes, Heinz Grunze, Willem A Nolen, Ralph W Kupka

Psychiatry and Behavioral Sciences Faculty Publications

Background

Although bipolar disorder (BD) and borderline personality disorder (BPD) share clinical characteristics and frequently co-occur, their interrelationship is controversial. Especially, the differentiation of rapid cycling BD and BPD can be troublesome. This study investigates the relationship between borderline personality features (BPF) and prospective illness course in patients with BD, and explores the effects of current mood state on self-reported BPF profiles.

Methods

The study included 375 patients who participated in the former Stanley Foundation Bipolar Network. All patients met DSM-IV criteria for bipolar-I disorder (n = 294), bipolar-II disorder (n = 72) or bipolar disorder NOS ( …

Onset Of Multiple Chronic Conditions And Depressive Symptoms: A Life Events Perspective., Maureen Wilson-Genderson, Allison R Heid, Rachel Pruchno

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Background: While the association between depressive symptoms and chronic illness has been the subject of many studies, little is known about whether depressive symptoms differ as a function of the illnesses people have as they transition to living with multiple chronic conditions.

Methods: Self-reports of five diagnosed chronic conditions (arthritis, diabetes, heart disease, hypertension, and pulmonary disease) and depressive symptoms were provided by 3,396 people participating in three waves of the ORANJ BOWL

Results: Between 2006 and 2014, controlling for age, gender, income, race, and a lifetime diagnosis of depression, people who transitioned to having a diagnosis of multiple chronic …

Cortical Activation During Action Observation, Action Execution, And Interpersonal Synchrony In Adults: A Functional Near-Infrared Spectroscopy (Fnirs) Study, Anjana Bhat, Michael Hoffman, Susanna Trost, Mckenzie Culotta, Jeffrey Eilbott, Daisuke Tsuzuki, Kevin A. Pelphrey

Psychiatry and Behavioral Sciences Faculty Publications

Introduction: Humans engage in Interpersonal Synchrony (IPS) as they synchronize their own actions with that of a social partner over time. When humans engage in imitation/IPS behaviors, multiple regions in the frontal, temporal, and parietal cortices are activated including the putative Mirror Neuron Systems (Iacoboni, 2005; Buxbaum et al., 2014). In the present study, we compared fNIRS-based cortical activation patterns across three conditions of action observation (“Watch” partner), action execution (“Do” on your own), and IPS (move “Together”).

Methods: Fifteen typically developing adults completed a reach and cleanup task with the right arm while cortical activation was …

Attitudes Toward Antipsychotic Treatment Among Patients With Bipolar Disorders And Their Clinicians: A Systematic Review, Martha Sajatovic

Faculty Scholarship

Introduction: Antipsychotics are recommended as first-line therapy for acute mania and maintenance treatment of bipolar disorder; however, published literature suggests their real-world use remains limited. Understanding attitudes toward these medications may help identify barriers and inform personalized therapy. This literature review evaluated patient and clinician attitudes toward the use of antipsychotics for treating bipolar disorder. Materials and methods: A systematic search of the Cochrane Library, Ovid MEDLINE, Embase, and BIOSIS Previews identified English language articles published between January 1, 2000, and June 15, 2016, that reported attitudinal data from patients, health care professionals, or caregivers; treatment decision-making; or patient characteristics …

A Mixed Methods Study Of Multiple Health Behaviors Among Individuals With Stroke, Matthew Plow, Shirley M. Moore, Martha Sajatovic

Faculty Scholarship

Background: Individuals with stroke often have multiple cardiovascular risk factors that necessitate promoting engagement in multiple health behaviors. However, ob-servational studies of individuals with stroke have typically focused on promoting a single health behavior. Thus, there is a poor understanding of linkages between healthy behaviors and the circumstances in which factors, such as stroke impairments, may influence a single or multiple health behaviors. Methods. We conducted a mixed methods convergent parallel study of 25 individuals with stroke to examine the relationships between stroke impairments and physical activity, sleep, and nutrition. Our goal was to gain further insight into possible strategies …

A Randomized Controlled Trial Of Individual Versus Group-Format Exercise And Self-Management In Individuals With Parkinson's Disease And Comorbid Depression, Martha Sajatovic, Ellen M. Walter, Curtis M. Tatsuoka, Steven A. Gunzler, Christina M. Whitney, Benjamin L. Walter

Faculty Scholarship

Background: Depression is common in people with Parkinson’s disease (PD), and exercise is known to improve depression and PD. However, lack of motivation and low self-efficacy can make exercise difficult for people with PD and comorbid depression (PD-Dep). A combined group exercise and chronic disease self-management (CDSM) program may improve the likelihood that individuals will engage in exercise and will show a reduction in depression symptoms. The purpose of this study was to compare changes in depression in PD-Dep between individual versus group exercise plus CDSM and to examine participant adherence and perception of the interventions. Methods: Participants (N=30) were …

Journal Of Mind And Medical Sciences: Translational And Integrative Mission, David L. Rowland, Ion G. Motofei

Journal of Mind and Medical Sciences

Initiated four years ago, Journal of Mind and Medical Sciences (J Mind Med Sci.) established the mission to publish papers on mental and medical topics in distinct but closely interrelated domains. The editorial policy especially encourages interdisciplinary and integrative perspectives, being equally focused on basic research and clinical investigations and short reports.

The journal adheres to the philosophy that high quality, original ideas and information should be readily accessible and freely shared within and amongst the scientific community. Accordingly, J Mind Med Sci. is an online, open access, non-for-profit journal which, because of individual/ private support, has levied no charges …

Prevention Of Recurrent Affective Episodes Using Extinction Training In The Reconsolidation Window: A Testable Psychotherapeutic Strategy., Robert M Post, Robert Kegan

Psychiatry and Behavioral Sciences Faculty Publications

Stressors may initially precipitate affective episodes, but with sufficient numbers of recurrences, episodes can occur more autonomously. It is postulated the memory engram for these recurrent depressions moves from the conscious representational memory system to the unconscious habit memory system encoded in the striatum. If this were the case, cognitive behavior therapy targeted toward extinction of habit memories could be an effective maneuver for helping reverse the automaticity of affective episode recurrence. Extinction training in the reconsolidation window (which opens about 5 min to 1 h after active memory recall) can revise, reverse, or eliminate the long term memories associated …

Evaluation Of Outcomes For Psychosis And Epilepsy Treatment Delivered By Primary Health Care Workers In Nepal: A Cohort Study., M J D Jordans, L Aldridge, N P Luitel, F Baingana, B A Kohrt

Psychiatry and Behavioral Sciences Faculty Publications

Background: Most evaluations of task-shifting have focused on common mental disorders. Much less work has been done on severe mental neurological and substance use (MNS) disorders, such as chronic psychosis and epilepsy. Given the high burden associated with severe MNS and the lack of mental health professionals in low and middle income countries, evaluations on the impact of task-shifting for these disorders are important.

Methods: In a rural district of Nepal, a community mental health program, based on World Health Organization's Mental Health Gap Action Programme guidelines, was evaluated using a cohort study design. People with epilepsy and psychotic disorders …

Addressing Culture And Context In Humanitarian Response: Preparing Desk Reviews To Inform Mental Health And Psychosocial Support., M Claire Greene, Mark J D Jordans, Brandon A Kohrt, Peter Ventevogel, Laurence J Kirmayer, Ghayda Hassan, Anna Chiumento, Mark Van Ommeren, Wietse A Tol

Psychiatry and Behavioral Sciences Faculty Publications

Delivery of effective mental health and psychosocial support programs requires knowledge of existing health systems and socio-cultural context. To respond rapidly to humanitarian emergencies, international organizations often seek to design programs according to international guidelines and mobilize external human resources to manage and deliver programs. Familiarizing international humanitarian practitioners with local culture and contextualizing programs is essential to minimize risk of harm, maximize benefit, and optimize efficient use of resources. Timely literature reviews on traditional health practices, cultural beliefs and attitudes toward mental health and illness, local health care systems and previous experiences with humanitarian interventions can provide international practitioners …

Addressing Culture And Context In Humanitarian Response: Preparing Desk Reviews To Inform Mental Health And Psychosocial Support., M Claire Greene, Mark J D Jordans, Brandon A Kohrt, Peter Ventevogel, Laurence J Kirmayer, Ghayda Hassan, Anna Chiumento, Mark Van Ommeren, Wietse A Tol

Psychiatry and Behavioral Sciences Faculty Publications

Delivery of effective mental health and psychosocial support programs requires knowledge of existing health systems and socio-cultural context. To respond rapidly to humanitarian emergencies, international organizations often seek to design programs according to international guidelines and mobilize external human resources to manage and deliver programs. Familiarizing international humanitarian practitioners with local culture and contextualizing programs is essential to minimize risk of harm, maximize benefit, and optimize efficient use of resources. Timely literature reviews on traditional health practices, cultural beliefs and attitudes toward mental health and illness, local health care systems and previous experiences with humanitarian interventions can provide international practitioners …

Elucidating Adolescent Aspirational Models For The Design Of Public Mental Health Interventions: A Mixed-Method Study In Rural Nepal, Sauharda Rai, Safar Bikram Adhikari, Nanda Raj Acharya, Bonnie N. Kaiser, Brandon A. Kohrt

Psychiatry and Behavioral Sciences Faculty Publications

Background

Adolescent aspirational models are sets of preferences for an idealized self. Aspirational models influence behavior and exposure to risk factors that shape adult mental and physical health. Cross-cultural understandings of adolescent aspirational models are crucial for successful global mental health programs. The study objective was elucidating adolescent aspirational models to inform interventions in Nepal.

Methods

Twenty qualitative life trajectory interviews were conducted among adolescents, teachers, and parents. Card sorting (rating and ranking activities) were administered to 72 adolescents aged 15–19 years, stratified by caste/ethnicity: upper caste Brahman and Chhetri, occupational caste Dalit, and ethnic minority Janajati. …

Translating Mental Health Diagnostic And Symptom Terminology To Train Health Workers And Engage Patients In Cross-Cultural, Non-English Speaking Populations, Bibhav Acharya, Madhur Basnet, Pragya Rimal, David Citrin, Soniya Hirachan, Brandon Kohrt, +Several Additional Authors

Psychiatry and Behavioral Sciences Faculty Publications

Although there are guidelines for transcultural adaptation and validation of psychometric tools, similar resources do not exist for translation of diagnostic and symptom terminology used by health professionals to communicate with one another, their patients, and the public. The issue of translation is particularly salient when working with underserved, non-English speaking populations in high-income countries and low- and middle-income countries. As clinicians, researchers, and educators working in cross-cultural settings, we present four recommendations to avoid common pitfalls in these settings. We demonstrate the need for: (1) harmonization of terminology among clinicians, educators of health professionals, and health policymakers; (2) distinction …

Do Pediatric Gastroenterology Doctors Address Pediatric Obesity?, Suruchi Batra, Caitlin Yee, Bernadette Diez, Nicholas Nguyen, Michael J Sheridan, Mark Tufano, Natalie Sikka, Stacie Townsend, Suchitra Hourigan

Psychiatry and Behavioral Sciences Faculty Publications

Objectives:

To assess how often obesity is acknowledged at pediatric gastroenterology outpatient visits.

Methods:

A retrospective chart review was performed to identify obese children seen at a gastroenterology subspecialty clinic over a 1-year period of time; 132 children were identified. Demographics, obesity comorbidities, reasons for referral, diagnosis of obesity, and a plan to address obesity were abstracted. Chi-square or Fisher’s exact tests were used to examine statistical associations.

Results:

Only 49% of children were given a diagnosis of obesity. In total, 52% of children were given a body mass index reduction plan. Those diagnosed with obesity were more likely to …

Situational Analysis To Inform Development Of Primary Care And Community-Based Mental Health Services For Severe Mental Disorders In Nepal, Mangesh Angdembe, Brandon A. Kohrt, Mark Jordans, Damodar Rimal, Nagendra Luitel

Psychiatry and Behavioral Sciences Faculty Publications

Background

Nepal is representative of Low and Middle Income Countries (LMIC) with limited availability of mental health services in rural areas, in which the majority of the population resides.

Methods

This formative qualitative study explores resources, challenges, and potential barriers to the development and implementation of evidence-based Comprehensive Community-based Mental Health Services (CCMHS) in accordance with the mental health Gap Action Programme (mhGAP) for persons with severe mental health disorders and epilepsy. Focus Group Discussions (FGDs, n = 9) and Key-Informant Interviews (KIIs, n = 26) were conducted in a rural district in western Nepal. Qualitative data were coded using …

How Burroughs Plays With The Brain, Or Ritornellos As A Means To Produce Déjà-Vu, Antonio José Bonome

CLCWeb: Comparative Literature and Culture

In his article "How Burroughs Plays with the Brain, or Ritornellos as a Means to Produce Déjà-Vu" Antonio José Bonome discusses how the recurrence and significance of one of William S. Burroughs's most potent refrains, "dim jerky faraway," was inspired by its source text, Paul Bowles's second novel Let It Come Down (1952), where Tangiers-Interzone fuels the unwholesome descent of a US-American expatriate not unlike Bowles or Burroughs himself. "Dim jerky faraway" was used by Burroughs during more than two decades in different contexts, and its textual variations have sparked a mélange of colors, sounds, smells, and feelings oscillating in …

Detrending Changes The Temporal Dynamics Of A Semantic Fluency Task, Steven Lenio, Frances M. Lissemore, Martha Sajatovic, Kathleen A. Smyth, Curtis Tatsuoka, Wojbor A. Woyczynski, Alan J. Lerner

Faculty Scholarship

Objective: To study the dynamics of clustering semantic fluency responses and switching between clusters. Methods: We conducted a cross-sectional study of participants (N = 60) in a study of patient reported outcomes who were given the Saint Louis University Mental Status test. Sixty-second animal naming tests were scored for the timing of responses as well as the clustering of responses into semantic categories. Time scores were detrended to correct for exponential exhaustion and normalize the time scale across individuals. Results: Grouped by number of responses given, low performers (LP; Carter et al., 2012) switched between clusters fewer times than medium …

Can Academic Medicine Lead The Way In The Refugee Crisis?, Amir A Afkhami

Psychiatry and Behavioral Sciences Faculty Publications

The world is currently in the midst of the largest refugee crisis since World War II, with the highest interval of mass displacement in recorded history according to the United Nations. The United States has pledged to maintain its position as one of the world's top resettlement countries in response to this crisis. These new immigrants will arrive with exceptional chronic and acute medical needs, including higher rates of behavioral health disorders. The author describes the health care challenges experienced by refugees seeking asylum in the United States and outlines the ways in which our health care system is currently …

Late Life Bipolar Disorder Evolving Into Frontotemporal Dementia Mimic, Martha Sajatovic

Faculty Scholarship

Objectives: Although bipolar disorder has been understood classically as a cyclic disease with full recovery between mood episodes, in the last decade, evidence has accumulated supporting progressive features. The clinical picture of advanced or end-stage bipolar disorder is heterogeneous with possible deficits in cognition and behavior, as illustrated by our case series. Cases: From our neuropsychiatric outpatient clinic, we describe four cases with bipolar disorder gradually developing a clinical syndrome, including apathy, disinhibition, loss of empathy, stereotypical behavior, and compulsiveness, fulfilling the criteria for possible behavioral variant frontotemporal dementia. All cases were diagnosed with bipolar 1 disorder at least 10 …

Association Between Quality Of Life And Anxiety, Depression, Physical Activity And Physical Performance In Maintenance Hemodialysis Patients., Yi-Nan Li, Bryan Shapiro, Jun Chul Kim, Min Zhang, Janos Porszasz, Rachelle Bross, Usama Feroze, Rajeev Upreti, David Martin, Kamyar Kalantar-Zadeh, Joel David Kopple

Psychiatry and Behavioral Sciences Faculty Publications

OBJECTIVE: Maintenance hemodialysis (MHD) patients often have impaired quality of life (QOL), anxiety, depression, and reduced daily physical activity (DPA) and physical performance. The contributions of these latter factors to reduced QOL in MHD are poorly understood. We examined the association of QOL with anxiety, depression, DPA, and physical performance.

METHODS: Seventy-two relatively healthy adult MHD patients, vintage ≥6 months, and 39 normals of similar age range and gender distribution were studied. QOL was assessed using the Kidney Disease Quality of Life-Short Form (KDQOL-SF). Anxiety and depression were each evaluated with two questionnaires. DPA and physical performance were assessed with …

Effect Of A 72 Hour Stroke Care Bundle On Early Outcomes After Acute Stroke: A Non Randomised Controlled Study, Martha Sajatovic, Anthony J. Furlan

Faculty Scholarship

Background Integrated care pathways (ICP) in stroke management are increasingly being implemented to improve outcomes of acute stroke patients. We evaluated the effect of implementing a 72 hour stroke care bundle on early outcomes among patients admitted within seven days post stroke to the national referral hospital in Uganda. Methods In a one year non-randomised controlled study, 127 stroke patients who had ‘usual care’ (control group) were compared to 127 stroke patients who received selected elements from an ICP (intervention group). Patients were consecutively enrolled (controls first, intervention group second) into each group over 5 month periods and followed to …

Multiple Anti-Epileptic Drug Use In Children With Epilepsy In Mulago Hospital, Uganda: A Cross Ectional Study, Martha Sajatovic

Faculty Scholarship

Background: Seizures in up to one third of children with epilepsy may not be controlled by the first anti-epileptic drug (AED). In this study, we describe multiple AED usage in children attending a referral clinic in Uganda, the factors associated with multiple AED use and seizure control in affected patients. Methods: One hundred thirty nine patients attending Mulago hospital paediatric neurology clinic with epilepsy and who had been on AEDs for ≥6months were consecutively enrolled from July to December 2013 to reach the calculated sample size. With consent, the history and physical examination were repeated and the neurophysiologic and imaging …