Psychiatry and Psychology Commons^™

Bringing A Behavioral Health Consultant To Residency: Implications For Practice And Training, Natasha Gouge, Jodi Polaha, Rebecca Powers

International Journal of Health Sciences Education

This study examined pediatric residents’ responsiveness and experiences in the context of a new pilot program, building an on-site Behavioral Health Consultant (BHC) into their primary care training site. Fifteen pediatric residents were divided so that 9 had access to an on-site BHC and 6 did not. Over the first year of the program, research assistants observed 322 patient visits to record concerns raised, residents’ responses, and visit length. Data regarding BHC activity and residents’ subjective impressions of the program were also collected. Results showed that at least one BH concern was raised in 24% of observed visits. Residents with …

Mental Health Referral In Primary Care: Influence Of A Screening Instrument And A Brief Educational Intervention, Michael T. Miesner

Electronic Theses and Dissertations

Although less than half of all patients with mental disorders seek mental health treatment per se, approximately 80% of all people will visit their primary care physician (PCPs) within a year (Strosahl, 1998). However, it is not well understood how to best handle patients presenting with mental health issues in primary care practices. The purpose of this project was to implement an intervention involving a screening measure for anxiety and mood disorders in a primary care setting to increase the volume of anxiety and mood disorder screening, to increase the accuracy of disorder detection, and to also enhance PCPs patterns …

Basic Psychological Needs, Suicidal Ideation, And Risk For Suicidal Behavior In Young Adults, Peter C. Britton, Kimberly A. Van Orden, Jameson K. Hirsch, Geoffrey C. Williams

ETSU Faculty Works

Associations between the satisfaction of basic psychological needs of autonomy, competence, and relatedness with current suicidal ideation and risk for suicidal behavior were examined. Two logistic regressions were conducted with a cross-sectional database of 440 university students to examine the association of need satisfaction with suicidal ideation and risk for suicidal behavior, while controlling for demographics and depressive symptoms. Suicidal ideation was reported by 15% of participants and 18% were found to be at risk for suicidal behavior. A one standard deviation increase in need satisfaction reduced the odds of suicidal ideation by 53%, OR (95% CI) = 0.47 (0.33–0.67), …

Trends And Determinants Of Up-To-Date Status With Colorectal Cancer Screening In Tennessee, 2002-2008, Sreenivas P. Veeranki, Shimin Zheng

ETSU Faculty Works

BACKGROUND:

Screening rates for colorectal cancer (CRC) are increasing nationwide including Tennessee (TN); however, their up-to-date status is unknown. The objective of this study is to determine the trends and characteristics of TN adults who are up-to-date status with CRC screening during 2002-2008.

METHODS:

We examined data from the TN Behavioral Risk Factor Surveillance System for 2002, 2004, 2006 and 2008 to estimate the proportion of respondents aged 50 years and above who were up-to-date status with CRC screening, defined as an annual home fecal occult blood test and/or sigmoidoscopy or colonoscopy in the past 5 years. We identified trends …

A Coordinated School Health Approach To Obesity Prevention Among Appalachian Youth: Middle School Student Outcomes From The Winning With Wellness Project, William T. Dalton Iii, Karen Schetzina, Elizabeth Conway-Williams

International Journal of Health Sciences Education

The Winning With Wellness (WWW) project was a school-based obesity prevention program that was developed to promote healthy eating and physical activity in youth residing in rural Appalachia. The project was based on the Coordinated School Health model (Centers for Disease Control and Prevention (CDC), 2013a) and used a community-based participatory research approach with an emphasis on feasibility and sustainability. The purpose of this study was to examine self-reported health outcomes for middle school students across the course of the intervention. Sixth grade middle school students (N = 149; 52% girls) from four schools in Northeast Tennessee completed a …

Family Criticism And Depressive Symptoms In Older Adult Primary Care Patients: Optimism And Pessimism As Moderators, Jameson K. Hirsch, Kristin L. Walker, Ross B. Wilkinson, Jeffrey M. Lyness

ETSU Faculty Works

Objective: Depression is a significant global public health burden, and older adults may be particularly vulnerable to its effects. Among other risk factors, interpersonal conflicts, such as perceived criticism from family members, can increase risk for depressive symptoms in this population. We examined family criticism as a predictor of depressive symptoms and the potential moderating effect of optimism and pessimism.

Methods: One hundred five older adult, primary care patients completed self-report measures of family criticism, optimism and pessimism, and symptoms of depression. We hypothesized that optimism and pessimism would moderate the relationship between family criticism and depressive symptoms.

Results: In …

Perceived Barriers To Obtaining Psychiatric Treatment At Johnson City Community Health Center, Mychal Bolton

Undergraduate Honors Theses

The purpose of this study was to describe the perceived barriers to obtaining psychiatric treatment at the Johnson City Community Health Center. The context of the study was a rural area in Eastern Tennessee. Five patients with confirmed DSM-IV mental health diagnoses were recruited during treatment and interviewed at the Johnson City Community Health Center after their scheduled appointments with a Mental Health Nurse Practitioner (MHNP). The semi-structured interview focused on perceived barriers to obtaining treatment, perceptions of treatment received, and perceived availability of treatment. From those interviews, two themes were identified and each of which had two sub-themes identified: …

Optimism And Planning For Future Care Needs Among Older Adults, Silvia Sörensen, Jameson K. Hirsch, Jeffrey M. Lyness

ETSU Faculty Works

Aging is associated with an increase in need for assistance. Preparation for future care (PFC) is related to improved coping ability as well as better mental and physical health outcomes among older adults. We examined the association of optimism with components of PFC among older adults. We also explored race differences in the relationship between optimism and PFC. In Study 1, multiple regression showed that optimism was positively related to concrete planning. In Study 2, optimism was related to gathering information. An exploratory analysis combining the samples yielded a race interaction: For Whites higher optimism, but for Blacks lower optimism …

Health Behaviors Among College Students: The Influence Of Future Time Perspective And Basic Psychological Need Satisfaction, Preston L. Visser, Jameson K. Hirsch

ETSU Faculty Works

Health behavior change may prevent many fatal diseases, and may be influenced by social and motivational constructs. We assessed the interaction effect of future time perspective and basic psychological need fulfillment on positive and negative health behaviors. Future time perspective was associated with more positive, and less negative, health behaviors. Need fulfillment was associated with only positive health behaviors. In moderation analyses, individuals reporting both high need fulfillment and future perspective reported greater positive health behaviors, and were especially unlikely to smoke. Enhancing future-mindedness and supporting need satisfaction in interventions targeting modifiable health behaviors is encouraged.

Comparison Between Two Methodological Paradigms Of Conditioned Place Preference With Methlyphenidate., Bryce D. Watson

Undergraduate Honors Theses

The aim of this thesis is to examine the mechanisms of Methylphenidate (MPH) on Conditioned Place Preference (CPP), a behavioral test of reward. The psychostimulant MPH is therapeutically used in the treatment of ADHD, but has been implicated in many pharmacological actions related to drug addiction and is considered to have abuse potential. Past work in our lab and others have shown substantial sex-differences in the neuropharmacological profile of MPH. Here a discussion of the relevant mechanisms of action of MPH and its relationship to neurotrophins and CPP are reviewed. Furthermore, previous work is reviewed and a rationale for two …

Functional Impairment, Illness Burden, And Depressive Symptoms In Older Adults: Does Type Of Social Relationship Matter?, Joshua P. Hatfield, Jameson K. Hirsch, Jeffrey M. Lyness

ETSU Faculty Works

Objective: The nature of interpersonal relationships, whether supportive or critical, may affect the association between health status and mental health outcomes. We examined the potential moderating effects of social support, as a buffer, and family criticism, as an exacerbating factor, on the association between illness burden, functional impairment and depressive symptoms.

Methods: Our sample of 735 older adults, 65 years and older, was recruited from internal and family medicine primary care offices. Trained interviewers administered the Hamilton Rating Scale for Depression, Duke Social Support Inventory, and Family Emotional Involvement and Criticism Scale. Physician-rated assessments of health, including the Karnofsky Performance …

Accuracy Of Self-Reported Sun Exposure And Sun Protection Behavior, Joel J. Hillhouse, Robert Turrisi, James Jaccard, June K. Robinson

ETSU Faculty Works

The objective of this study was to compare the accuracy of self-reported skin cancer risk outcome measures proposed as standards by prevention experts to aggregated estimates of behavior from weekly diaries. Weekly electronic diaries of ultraviolet radiation (UVR) behaviors, initially validated by comparison with daily electronic diaries, were used to assess the accuracy of commonly used end-of-summer self-reported measures among 250 adults. Results revealed low biases, and good correspondence between simple open-ended self-reported estimates of days outside, hours outside, sunbathing days and hours, and days outside when not protected by either sunscreen, long-sleeved shirts, hats, or shade. Rating scale measures …

Random Inter Stimulus Interval Increases Signal-To-Noise Ratio., Juliane Armstrong

Undergraduate Honors Theses

Incremental improvements are continuously being made to P300-Speller BCI paradigms. Accurate classification depends on a high signal-to-noise ratio (SNR) between the target and nontarget items. Fixed presentation rates produce a large flash-evoked response that persists throughout the recording epoch, which can potentially undermine the classification of P300-responses. By introducing a random interstimulus interval (ISI) to a previously improved P300-Speller paradigm (i.e., Checkerboard Paradigm; CBP) we expect to reduce the deleterious flash-evoked responses and increase the P300 classification SNR. Data were recorded from 32 EEG locations (right mastoid referenced) from 13 subjects using the CBP with two conditions. In the Random …

Perceived Health In Lung Cancer Patients: The Role Of Positive And Negative Affect, Jameson K. Hirsch, Andrea R. Floyd, Paul R. Duberstein

ETSU Faculty Works

Purpose: To examine the association of affective experience and health-related quality of life in lung cancer patients, we hypothesized that negative affect would be positively, and positive affect would be negatively, associated with perceived health.

Methods: A sample of 133 English-speaking lung cancer patients (33% female; mean age = 63.68 years old, SD = 9.37) completed a battery of self-report surveys.

Results: Results of our secondary analysis indicate that trait negative affect was significantly associated with poor physical and social functioning, greater role limitations due to emotional problems, greater bodily pain, and poor general health. Positive affect was significantly associated …

Nicotine Sensitization And Brain-Derived Neurotrophic Factor Content In Adolescent Rats Neonatally Treated With Quinpirole., Addie Roberts

Undergraduate Honors Theses

Neonatal treatment of quinpirole in rats increases dopamine D2-like receptor sensitivity over the animal’s lifetime, a phenomenon referred to as D2 priming. Male and female Sprague-Dawley rats were given quinpirole (1mg/kg, i.p.) or saline on postnatal days (P)1-21. After habituation to a locomotor arena on P29-31, beginning P33, animals were administered nicotine (0.3 mg/kg, 0.5 mg/kg, or 0.7 mg/kg, i.p.) or saline and placed into a locomotor arena for behavioral testing every second day for a total of 9 treatments. The results showed that adolescents neonatally treated with quinpirole produced more enhanced sensitization to nicotine than controls. Brains tissues were …

Brain-Derived Neurotrophic Factor Levels In D2 Receptor Primed Adolescent Rats Given Twice Daily Nicotine Administrations., Josie Minnigh

Undergraduate Honors Theses

Nicotine use is very prevalent in the schizophrenic population, which is a 2.5 fold greater than the general population. In the present study, the drug quinpirole (dopamine D2/D3 agonist) or saline was given neonatally to 25 Sprague-Dawley male and female rats. Rats were randomly assigned to condition. Beginning postnatal day 33 animals were given twice daily administrations of nicotine (0.5 mg/kg free base). After the first of the daily injections they were placed in a locomotor arena every other day for behavioral testing. One day after behavioral testing, the dorsal striatum and nucleus accumbens were removed for brain-derived neurotrophic factor …

Genome-Wide Association Analysis Of Major Depressive Disorder And Its Related Phenotypes., Nagesh Ramarao Aragam

Electronic Theses and Dissertations

Major Depressive Disorder (MDD) is a complex and chronic disease that ranks fourth as cause of disability worldwide. Thirteen to 14 million adults in the U.S. are believed to have MDD and an estimated 75% attempt suicide making MDD a major public health problem. Recently several genome-wide association (GWA) studies of MDD have been reported; however, few GWA studies focus on the analysis for MDD related phenotypes such as neuroticism and age at onset of MDD. The purpose of this study is to determine risk factors for MDD, identify genome-wide genetic variants affecting neuroticism and age at onset as quantitative …

Elucidating The Role Of The Α7 Nicotinic Receptor In The Etiology Of Schizophrenia., Michelle Johnson Chandley

Electronic Theses and Dissertations

The α7 subunit of the nicotinic receptor, a ligand gated ion channel with an affinity for nicotine, has long been implicated in the pathophysiology of schizophrenia due to the extremely high rate of smoking within the patient population. However, the exact role of the receptor has never fully been determined. In the following studies, various functions the receptor may assume in disease state are evaluated. There is a strong relationship between the immune system and schizophrenia, with the α7 subunit possibly serving as the link between the two. One of the following studies looks at the possibility of the receptor …

An Epidemiological Study Of Maternal Depression: Findings From The National Institute Of Child Health And Human Development Study Of Early Child Care And Youth Development., Liang Wang

Electronic Theses and Dissertations

This study examined maternal depression status from month 1 to 36 after birth using data from the NICHD Study of Early Child Care and Youth Development. Maternal depression was assessed with the Center of Epidemiological Studies Depression Scale. The prevalence of maternal depression was highest at 1 month, decreased at 6 months, and then kept fairly stable to 36 months. The prevalence was higher in blacks than other races, in 18-24 than 25-46 years old, and in single mothers than non-single mothers. Mothers with better physical health, social support, or employed had a lower prevalence than their counterparts. Mothers in …

The Effects Of Nicotine Conditioned Place Preference In D2 Primed Adolescent Rats: Age-Related And Gender Effects., Yoko Emily Ogawa

Electronic Theses and Dissertations

This study investigated nicotine conditioned place preference (CPP) in two different ages of adolescence using a rodent model of schizophrenia. Both 2- and 3-chambered CPP apparatuses were used to test whether the CPP was due to an aversion to the white chamber. Animals were neontally treated with the dopamine D₂/D₃ agonist, quinpirole, or saline and raised to either early postweanling age (P 22) or adolescence (P 29). Rats were conditioned to prefer the white chamber using nicotine. Results showed that nicotine induced CPP and appeared to alleviate an increased stress response in D₂ primed animals, which …

An Analysis Of Nicotine Exacerbation Of Reductions In Ppi In A Rodent Model Of Schizophrenia., Amanda Marie Maple

Electronic Theses and Dissertations

Prepulse inhibition (PPI) is an operational measure of sensorimotor gating and is known to be reduced when the dopamine D² receptor is activated. We used a rodent model of psychosis in which increases in dopamine D_{2 receptor sensitivity are produced through neonatal quinpirole (a dopamine D2 / D3 agonist) treatment to rats. Rats were administered quinpirole (1mg/kg) or saline from postnatal day (P) 1-21. Rats were raised to adulthood and tested on PPI. Results showed that neonatal quinpirole treatment produced a significant reduction in PPI, and nicotine exacerbated this reduction. This reduction was partially blocked by …}

Nicotine Sensitization In A Rodent Model Of Schizophrenia: A Comparison Of Adolescents, Adults, And Neurotrophic Factors., Marla Kay Perna

Electronic Theses and Dissertations

The behavioral effects of nicotine on locomotor activity in a rodent model of psychosis were analyzed. This model is based on neonatal quinpriole treatment (a dopamine D2/D3 agonist) which causes increased D2 receptor sensitivity, a phenomenon known as D2 priming that is common in schizophrenia. D2-primed adolescent rats did not demonstrate nicotine-induced hypoactivity early in training, and males demonstrated more rapid sensitization to nicotine as compared to controls administered nicotine. D2-primed females administered nicotine demonstrated increased stereotypic behavior. D2-primed adult rats given nicotine demonstrated significantly more robust sensitization to nicotine than controls given nicotine. Brain-derived neurotrophic factor (BDNF) was analyzed …