Psychiatry and Psychology Commons^™

Increasing Naloxone Co-Prescribing Among At-Risk Individuals: Evaluation Of A Quality Improvement Project In A Large Health System, Sarah Hemphill Ba, Kristen Silvia Md, Marc D. Kimball Md

Journal of Maine Medical Center

Background: Naloxone availability and early administration is key in preventing death following opioid overdose. The CDC advises that naloxone should be made available to all at-risk individuals. In 2017, providers at Maine Medical Center noted that only 6% of at-risk patients had naloxone prescriptions

Methods: Included in this study were all patients of MaineHealth, a health system comprising 9 hospitals and 30 primary care practices, serving approximately 1.1 million patients. Between 2017 and 2020, we implemented several system-wide quality improvement interventions to increase rates of naloxone co-prescribing among at-risk individuals. Risk factors included prescribed opioids ≥50 morphine milligram equivalents, concurrent …

Contribution Of Early-Life Unpredictability To Neuropsychiatric Symptom Patterns In Adulthood, Andrea D. Spadoni, Meghan Vinograd, Bruna Cuccurazzu, Katy Torres, Laura M. Glynn, Elysia P. Davis, Tallie Z. Baram, Dewleen G. Baker, Caroline M. Nievergelt, Victoria B. Risbrough

Psychology Faculty Articles and Research

Background

Recent studies in both human and experimental animals have identified fragmented and unpredictable parental and environmental signals as a novel source of early-life adversity. Early-life unpredictability may be a fundamental developmental factor that impacts brain development, including reward and emotional memory circuits, affecting the risk for psychopathology later in life. Here, we tested the hypothesis that self-reported early-life unpredictability is associated with psychiatric symptoms in adult clinical populations.

Methods

Using the newly validated Questionnaire of Unpredictability in Childhood, we assessed early-life unpredictability in 156 trauma-exposed adults, of which 65% sought treatment for mood, anxiety, and/or posttraumatic stress disorder (PTSD) …

A Survey Of The Mental Health Of Uk Olympic And Paralympic Sport Athletes., Sandra D. Leyland Dr, Alan Currie Prof, Elizabeth Board Dr, Amit D. Mistry Dr, Rod Jaques Dr, Craig Ranson Dr

Journal of Athlete Development and Experience

Abstract

This study examined the prevalence of psychological distress and well-being amongst elite athletes in the UK.

An online survey was emailed to 753 athletes within the English Institute of Sport. Response rate 52.3%. 371 participants (median age 25) completed measures of psychological distress and subjective well-being alongside demographics and sport-related variables.

High or very high psychological distress was reported by 23.7%. Poor subjective well-being was reported by 18.8%. Of those reporting psychological distress, 9% also reported good subjective well-being. The odds of psychological distress and poor well-being increased if the athlete was female (OR 2.03, distress; OR 2.00, poor …

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

Dissertations

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

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

Staff and Researcher Publications

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

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

Age-Related Changes In Diffuse Optical Tomography Sensitivity Profiles From Childhood To Adulthood, Xiaoxue Fu Ph.D., John E. Richards

Faculty Publications

Significance: Diffuse optical tomography (DOT) uses near-infrared light spectroscopy to measure changes in cerebral hemoglobin concentration. Anatomical interpretations of the brain location that generates the hemodynamic signal require accurate descriptions of the DOT sensitivity to the underlying cortex. DOT sensitivity profiles are different in infants compared with adults. However, the descriptions of DOT sensitivity profiles from early childhood to adulthood are lacking despite the continuous head and brain development.

Aim: We aim to investigate age-related differences in DOT sensitivity profiles in individuals aged from 2 to 34 years with narrow age ranges of 0.5 or 1 year.

Approach: We implemented …

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

Dissertations

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

Abstract

Problem

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

Method

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

Life Matters, Marina Fischer

Dissertations

Problem: One of the challenges facing many primary care providers is managing hypertension. Hypertension contributes to cardiovascular disease events. Consequently, the high occurrence of hypertension related visits signifies a clinical practice gap in hypertension management resulting in substandard blood pressure outcomes. The purpose of this clinical scholarship project was to assess the difference of pre and post Quality of Life Scale (QOLS) scores in a hypertensive population.

Methods: This quality improvement project used a longitudinal, observational design with prospective data collection. The sample included newly diagnosed hypertensive adults ages 21 to 64 years old. The sample was administered the World …

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

Dissertations

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

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

Mothers’ Reflections On Cat Ownership For A Child With Autism Spectrum Disorder During Covid-19, Saskia Keville, Sophia De Vita, Amanda K. Ludlow

People and Animals: The International Journal of Research and Practice

Animal- assisted interventions are increasingly used as a complementary therapy in clinical practice to support people with autism spectrum disorder (ASD), with promising outcomes compared to traditional therapies. Less is understood about the therapeutic benefits of more accessible and affordable small pet ownership for families with a child with ASD, alongside the pets’ welfare living in these homes. This study explored the experiences of cat ownership for young people with ASD from the perspective of their mothers during a time of transition generated by COVID-19. Semi-structured interviews were conducted with six mothers and transcripts analyzed using reflexive thematic analysis. Three …

Change In Students’ Peer Evaluations Of Requirements Elicitation Interviews Across The Pre-Pandemic And Pandemic-Affected Semesters, Dmytro Babik, Iryna Babik

Psychological Sciences Faculty Publications and Presentations

Successful development of an information system to solve a business problem depends on the analyst’s ability to elicit system requirements from a user. This complex competency could be trained via critical peer evaluation of the requirements elicitation (RE) interviews. In this study, 294 students across four pre-pandemic and two COVID-19 pandemic-affected semesters evaluated recorded sample RE interviews of low and high quality. A piecewise regression modeling was used to examine the change in students’ evaluations separately for the pre-pandemic and pandemic-affected semesters. Current results showed that students exhibited inflated evaluation scores (relative to instructors’ scores) for the high-quality, but not …

Moral Distress During Covid-19: The Importance Of Perceived Organizational Support For Hospital Nurses, Abigail Latimer, Melanie D. Otis, Gia Mudd-Martin, Debra K. Moser

UK CARES Faculty Publications

Moral distress, or the inability to act congruent with moral beliefs, has been of concern for healthcare professionals especially since the COVID-19 pandemic. Hospital nurses are particularly affected in their roles with mounting administrative pressures and demands. We examined whether general and COVID- specific support in employing healthcare organizations predicted moral distress in a sample of inpatient hospital nurses. A total of 248 nurses completed the Measure of Moral Distress for Healthcare Professionals, Survey of Perceived Organizational Support, COVID Organizational Support survey, and the Hospital Ethical Climate Scale. We found that general and COVID-related organizational support were predictors of moral …

‘Mapping’ Moral Engagement In The Solution-Focused Approach Through Macintyre’S Model Of Practice, Brian K. Jennings

Journal of Solution Focused Practices

I attempt to answer Trish Walsh’s two questions about the ‘maps’ that might exist for moral engagement in the ‘helping’ professions and how these might relate to the Solution-Focused Approach (Walsh, 2010). I seek to do this by exploring the narrative of the emergence of the Solution Focused Approach from the perspective of Alasdair MacIntyre’s concept of a ‘practice’ (MacIntyre, 1985) with the aim of providing the basis for ‘map’ for moral engagement by Solution-Focused Practitioners. To this end I attempt to interpret the Solution Focused Approach as a MacIntyreian ‘practice’ in which virtues (as ‘human qualities’) emerge out of …

J Mich Dent Assoc July 2022

The Journal of the Michigan Dental Association

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

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

10-Minute Ebd: Stimulant Medications, Rampant Caries, And Prevention, Madison Thomas Bs, Nancy Poznick Dds, Melanie E. Mayberry Dds, Ms-Hcm

The Journal of the Michigan Dental Association

The 10-Minute Evidence-Based Dentistry Column illustrates how to implement the evidence-based dentistry search process to quickly identify and apply the best literature to answer a clinical question. Through critical appraisal, the author of this article answers the clinical question of a connection between stimulant medications, rampant caries, and prevention, with a focus on the impact of ADHD medication on oral health. The term "meth mouth" often associated with dental decay is discussed in the context of xerostomia (dry mouth), a common side effect of stimulant medications. The article uses the PICO (Population, Intervention, Comparison, Outcome) system to formulate a research …

The Importance Of Treatment Integrity: Examining The Effect Of Dosage On Intervention Outcomes, Samantha C. Maguire

Theses - ALL

Treatment integrity is a critical component to evaluating the impact of interventions (Collier-Meek et al., 2018). However, one frequently underreported and unacknowledged dimension of treatment integrity is intervention dosage. Determining the amount of treatment (i.e., dosage) necessary to produce desired changes is important to increasing our understanding of the impact of an intervention and the development of a more efficient and precise method of organizing and delivering treatments (Codding et al., 2016). Utilizing data (n = 391) from four individual randomized control trials and three clustered randomized control trials, the purpose of the present study was to descriptively examine the …

Examining The Social Validity Of Parent Training: Post-Participation Parent Perceptions And Reflections Of Group Triple P, Nycole C. Kauk

USF Tampa Graduate Theses and Dissertations

Child behavior problems are highly prevalent and impactful on the child and their family system, bringing both short-term and long-term consequences (Sanders, 2012). Many risk factors for child behavior problems are modifiable via the use of Behavioral Family Interventions, such as behavioral parent training programs (Kazdin, 1991). Behavioral Family Interventions (BFI) modify factors within the family system to minimize modifiable risk factors and engineer protective factors to produce behavior change (Kazdin, 1991). While several manualized behavioral parenting interventions exist, the Triple P parenting program is one of the most researched and effective programs used internationally, particularly the Level 4 package; …

Simulated Owl Predation During Foraging Differentially Alters Choice And Fear Behavior Between Sex In Rats, Meghan M. Olsen

Research Psychology Theses

Existing research on the predator cue circuit has indicated there are observed differences between sexes of animals either directly or indirectly exposed to a predator stimulus. Exposure increases predator directed attention, and overrides other motivational systems (hunger, pain, reproductive behavior). Little research has explored whether exposure to predation is associated with differential responses to non-predator related decision-making across a variety of tasks. Therefore, understanding the prioritization of motivational states when a predator stressor is present can aid in understanding sex differences in these processes in both adaptative and maladaptive conditions. To determine how repeated exposure to a predator stressor differentially …

Associations Of Discrimination With Drinking Behavior In Multiracial College Students: Protective Role Of Racial Socialization, Fatima Dobani

Theses - ALL

Despite the rapid growth of the Multiracial population in the United States, less is known about correlates of their health behaviors. Nascent findings demonstrate elevated rates of drinking behavior among Multiracial college students compared to their monoracial counterparts. Theoretical models posit that racial socialization by primary caregivers may change the magnitude of the relationship of discrimination with drinking behavior among Multiracial individuals. The role of racial socialization, however, has not been tested specifically among Multiracial college students. In this cross-sectional survey study, 193 undergraduate students (Mage = 20 years [SD = 1.33]; 30% male; 33% Greek affiliated) reporting lifetime alcohol …

Cannabis Sleep Aid Use In Daily College Life: An Intensive Longitudinal Assessment Approach, Patricia A. Goodhines

Dissertations - ALL

Objective: Emerging evidence suggests that college cannabis sleep aid use may increase vulnerability to diurnal impairment, despite proximal sleep-related benefits. In contrast, relatively little is known about proximal precipitants of cannabis sleep aid use in daily college life. The identification of modifiable, situational intervention points preceding cannabis sleep aid use in daily college life is critical to accelerate the development of college harm reduction efforts. This 14-night mixed methods study tested temporal associations of THC-based cannabis sleep aid use with cognitive arousal-based precipitants (consistent with cognitive theory of insomnia) and sleep outcomes.

Method: Daily diary (pre-sleep and waking) and actigraphy …

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

Faculty, Staff and Student Publications

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

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

Staff and Researcher Publications

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

Non-Alcoholic Fatty Liver Disease And Depression: Evidence For Genotype × Environment Interaction In Mexican Americans, Eron G. Manusov, Vincent P. Diego, Khalid Sheikh, Sandra Laston, John Blangero, Sarah Williams-Blangero

School of Medicine Publications

This study examines the impact of G × E interaction effects on non-alcoholic fatty liver disease (NAFLD) among Mexican Americans in the Rio Grande Valley (RGV) of South Texas. We examined potential G × E interaction using variance components models and likelihood-based statistical inference in the phenotypic expression of NAFLD, including hepatic steatosis and hepatic fibrosis (identified using vibration controlled transient elastography and controlled attenuation parameter measured by the FibroScan Device). We screened for depression using the Beck Depression Inventory-II (BDI-II). We identified significant G × E interactions for hepatic fibrosis × BDI-II. These findings provide evidence that genetic factors …

The Utilization And Validation Of The Human Factors Intervention Matrix And The Companion Assessment Tool Faces In The Development Of Novel Interventions, Victoria Lew

Doctoral Dissertations and Master's Theses

The purpose of the current project was to utilize and validate the Human Factors Intervention Matrix (HFIX) and the companion assessment tool FACES regarding developing and ranking novel interventions. This was completed by 1. Uncovering whether brainstorming with HFIX generated a higher quantity, quality, and broader breadth of ideas compared to traditional brainstorming, and 2. Seeing whether the modality in which HFIX was utilized affected the quantity, quality, and breadth of ideas generated. This research employed a 2x2 between-subjects experimental design (n = 120) where participants were assigned to groups of three in one of the four conditions. Analyses …

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

HCA Healthcare Journal of Medicine

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

Covid-19 And Mental Health Disparities In The Black American Population, Israel Taylor

HCA Healthcare Journal of Medicine

The current COVID-19 pandemic has amplified health disparities that have long existed for minoritized groups in the United States. There have been disproportionate effects on the mental and physical health of the Black American population, specifically because of longstanding racial, social, and economic injustices. To fully understand the current state of Black mental health and the extent to which COVID-19 has impacted it, we examine historical examples of unjust mental health practices throughout generations. We then explore why depression, suicidality, and other mental illnesses may have a profound effect on a community that has been made vulnerable to socioeconomic shifts. …

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

HCA Healthcare Journal of Medicine

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

Psychological Well-Being In Childhood And Cardiometabolic Risk In Middle Adulthood: Findings From The 1958 British Birth Cohort, Julia K. Boehm, Farah Qureshi, Laura D. Kubzansky

Psychology Faculty Articles and Research

Childhood adversity is linked to poor cardiometabolic outcomes, but less is known about positive childhood factors. Using data from 4,007 members of the 1958 British Birth Cohort, we investigated whether children with greater psychological well-being had lower adulthood cardiometabolic risk. At age 11, participants wrote essays about their future. Two judges rated each essay for nine psychological well-being items (Finn’s r = .82–.91), which were combined into a standardized overall score (Cronbach’s α = .91). When participants reached age 45, nurses assessed their blood pressure, heart rate, lipids, glycosylated hemoglobin, fibrinogen, and C-reactive protein, which were standardized and summed for …

Profession Related Intra-Correlation Satisfaction Levels In Palestinian Physiotherapists: An Exploratory Study, Yousef Al Hamdan, Mosab Amoudi, Wael Abuhassan

Journal of the Arab American University مجلة الجامعة العربية الامريكية للبحوث

Aim of Study: The aim of the present study was to investigate the level of job satisfaction of physiotherapists in Palestine and to how much extent those levels are intra-correlated.

Methods: Researchers used the cross-sectional descriptive analytical approach, where data was collected through a questionnaire. The target population was physiotherapists in Palestine. A sample of 60 physiotherapists was conveniently selected. Program of SPSS was used to analyze data, where means were extracted, in addition to percentages and standard deviations to answer study questions.

Results: The research results showed that the overall mean of the sample responses on …

Homoeopathy As An Add-On Treatment For Schizophrenia - A Case Series, S Karunakara Moorthi, Radhika P, Mohan N. Devasia

Indian Journal of Research in Homoeopathy

Introduction: Schizophrenia is a complex, progressive and severe mental disorder characterised by distortions in thinking, perception, emotions, language, sense of self and behaviour. Conventional medication and cognitive behaviour therapy are used in the treatment of schizophrenia. Homoeopathy can also offer promising results in schizophrenia as evident from the previous studies. Case Summary: Five patients reported at the outpatient department of National Homoeopathy Research Institute in Mental Health, Kerala, India, with symptoms of schizophrenia were treated with individualised homoeopathic medicine as an add-on therapy to conventional medicines. Assessment of the patients was done using three scales: Positive and Negative Syndrome Scale, …