Psychiatry and Psychology Commons^™

Undifferentiated Embryonal Sarcoma Of Liver In A Child : A Case Report, Neha Devendra Bhongale, Sumeet Baheti, Poonam Wade, Omkar Khandkar, Meenakshi Balasbramanian

Digital Journal of Clinical Medicine

Background: Undifferentiated Embryonal Sarcoma of liver (UESL) is a rare malignancy of liver originating from primary mesenchymal tissue with overall poor prognosis. Around 220 pediatric cases of UESL have been reported in the literature. The lack of characteristic clinical manifestations, laboratory tests and imaging studies pose a diagnostic challenge and the preoperative misdiagnosis rate is high. Historically, treatment was limited to surgical resection with poor survival rate. In recent times, combination of chemotherapy and surgical resection has improved survival.

Case Presentation: We report a case of undifferentiated embryonal sarcoma of liver in a 6 years old boy who presented …

Hungry Minds: Analyzing The Impact Of Food Insecurity And Food Assistance Programs On Neurocognitive Development And Childhood Mental Health, Kayla A. Davenport

Senior Theses

Introduction: Food insecurity affects millions of children in the United States and is increasingly recognized as a significant risk factor for poor nutritional intake and adverse health outcomes. However, less is known about how the experience of food insecurity disrupts healthy development and well-being, particularly among American youth. This thesis had two aims: (1) to examine the relationship between household food insecurity and children’s neurocognitive and mental health outcomes and (2) to evaluate how major food assistance programs address, or fail to address, these developmental risks.

Methods: This thesis uses a mixed-methods approach, integrating a narrative literature review, a cross-sectional …

Measurement-Based Care For Depression In Youth: Practical Considerations For Selecting Measures To Assess Depression, Associated Features And Functioning, Cynthia Garza, Diana Chapa, Catherine Hernandez, Hayley Aramburu, Taryn L. Mayes, Graham J. Emslie

School of Medicine Publications

Identification and management of major depressive disorder (MDD) in children and adolescents remains a significant area of public health need. The process for identifying depression (e.g. screening) and management (e.g. measurement based care [MBC]) is substantially enhanced by utilization of clinical measures and rating scales. Measures can be self- or caregiver reported or clinician rated. They can aid recognition of at-risk individuals for future assessment and assist in clinical diagnosis and management of depression. In addition to assessing symptoms of depression, rating scales can be used to assess important associated features (e.g. anxiety, trauma) and functional outcomes (e.g. quality of …

Is Bedtime Use Of Kratom (Mitragyna Speciosa) A Sleep Aid Or Disruptor? Examining Its Daily Effects And Individual Differences, Chung Jung Mun, Patricia Timmons, Leigh V Panlilio, Christopher D Verrico, Ynhi T Thomas, C Austin Zamarripa, David H Epstein, Kirsten E Smith

Faculty, Staff and Students Publications

Kratom (Mitragyna speciosa) is a psychoactive botanical native to Southeast Asia increasingly used in the U.S. for various self-reported benefits, including sleep improvement. However, empirical evidence concerning kratom’s effects on sleep is limited. Here, we examined the association between bedtime kratom use and self-reported sleep outcomes in naturalistic settings across consecutive days, while also exploring sex and chronic pain status as potential moderators. A secondary analysis was conducted using the data from a 15-day ecological momentary assessment (EMA) study of 357 U.S. adults who reported regularly using kratom. Participants made daily reports of their bedtime kratom use and …

Faktor-Faktor Yang Berhubungan Dengan Gejala Depresi Pada Pasien Insomnia Usia Lanjut Di Rawat Jalan, Amalia Nur Pratiwi, Edy Rizal Wahyudi, Profitasari Kusumaningrum, Hamzah Shatri, Ikhwan Rinaldi, Rino Alvani Gani, Ika Prasetya Wijaya, Adityo Susilo, Kaka Renaldi

Jurnal Penyakit Dalam Indonesia

Introduction. The elderly population is increasing globally, including in Indonesia, where 10.7% of the population in 2020 were elderly. Insomnia is a common health issue among older adults and has been identified as a predictor of depression. This study aims to identify factors associated with depressive symptoms in elderly outpatients with insomnia.

Methods. This cross-sectional study was conducted in 2024 on patients aged ≥60 years at the outpatient unit of Cipto Mangunkusumo Hospital (RSCM), Jakarta, Indonesia, using consecutive sampling to select participants. Elderly patients were screened using the Pittsburgh sleep quality index (PSQI), and those with a score …

Plastic Makes Perfect: An Analysis Of Plastic Surgery As Rehabilitation In Early To Late 20th Century Prison Populations, Jack West

The Ozark Historical Review

As early as 1910, journalists from around the United States reported on the cause-and- effect relationship between a criminal’s physical appearance, their offenses, and the plastic surgeons willing to help them. These surgeons were interested in changing the physical “causes” of criminality to sever the mental roots of crime, inferiority, and anti-social attitude. This paper examines the use of plastic surgery programs as reform in prison through the lens of popular newspaper and journal articles and argues that public perception and reaction revealed in these articles shaped the prison program’s journey from its underground beginning to its eventual demise.

Psychiatric Associations With Barriers To Use Of Mental Health Services In Medical Students, E. Cadence Rarity, Nora Newcomb, Aishwarya Vuppala, Jade Brunicardi, Kim Van, Amelia C. Phillips

Journal of Wellness

Introduction: Medical students experience stress, anxiety, and depression at rates greater than those of the general population. Medical students also underutilize mental health services. There exists a need for a comprehensive, multivariate analysis of the reasons medical students do not pursue mental health services, and the undesirable mental health outcomes that are associated with these barriers. This study associates psychiatric phenomena of stress, anxiety, and depression within the context of barriers to use of mental health services in medical students.

Methods: In this cross-sectional study, medical students (N = 128) from the University of South Florida engaged with …

Opportunities And Barriers To Engaging Caregivers In Firearm Suicide Prevention: Findings From Focus Groups With Caregivers Of Veterans., Katherine Macwilliams, John Marmion, Dee Blascyk, Sharon Urbina, Rachel Moyers, Gala True

School of Medicine Faculty Publications

Background: Firearms are involved in more than 70% of U.S. Veteran suicides. Caregivers, defined as family members or concerned significant others, can play an important role in firearm suicide prevention through initiating conversations about secure firearm storage with Veterans. Our objective was to explore caregivers' experiences with lethal means safety (LMS) conversations and identify perceived barriers to caregivers discussing LMS with healthcare providers and with Veterans. Methods: We conducted focus groups with 32 caregivers with experience caring for a Veteran at risk for suicide. Qualitative data were analyzed using thematic analysis. Results: We identified three primary themes: 1) caregivers recognize …

Neurofilament Light (Nfl) Chain Levels Predict Clinical Decline In Alzheimer’S Disease: A Systematic Review And Meta-Analysis, Kim Thomas, Paul Spin, Nikita Sir, Kevin Hou, Nicholas J. Ashton, Henrik Zetterberg, Sonya Miller, Carol Pringle, Richard G. Stefanacci, Claude M. Wischik, Serge Gauthier

College of Population Health Faculty Papers

BACKGROUND: Regulatory approval of new investigational Alzheimer's disease (AD) therapies could be accelerated if reasonably likely surrogate endpoints could be used. Neurofilament light chain (NfL) has potential utility as a prognostic biomarker of neurodegeneration in AD.

OBJECTIVE: To synthesize available evidence on the relationship between baseline NfL levels and longitudinal clinical decline.

METHODS: A systematic literature review identified 19 eligible studies, contributing 37 longitudinal statistical models evaluating the association between baseline NfL (plasma or cerebrospinal fluid [CSF]) with subsequent clinical decline based on validated clinical scales including Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale-Cognitive Subscale, and Clinical Dementia Rating. …

Associations Between Individual And Structural Level Discrimination And Psychological And Physiological Stress Indicators During Pregnancy, Özlü Aran, Melissa Nevarez-Brewster, Kimberly D'Anna-Hernandez, Julia Dmitrieva, Curt A. Sandman, Laura M. Glynn, Elysia Poggi Davis

Psychology Faculty Articles and Research

In the United States (U.S.) pervasive health disparities in prenatal care disproportionately impact marginalized individuals. The present study investigates whether discrimination at the individual and structural levels are associated with indicators of psychological and physiological stress among pregnant Latinx people living in the U.S., including both U.S. and foreign-born individuals. Pregnant participants (n = 109) reported on birthplace, lifetime experiences of racial and ethnic discrimination, perceived levels of stress, acculturation, social support, and provided residential address data and hair samples for cortisol analysis. Regression analysis revealed that individual level discrimination was linked to higher psychological stress during pregnancy ( …

Retracted: Idea Density And Grammatical Complexity As Neurocognitive Markers, Diego Iacono, Gloria Feltis

Department of Neurology Faculty Papers

Language, a uniquely human cognitive faculty, is fundamentally characterized by its capacity for complex thoughts and structured expressions. This review examines two critical measures of linguistic performance: idea density (ID) and grammatical complexity (GC). ID quantifies the richness of information conveyed per unit of language, reflecting semantic efficiency and conceptual processing. GC, conversely, measures the structural sophistication of syntax, indicative of hierarchical organization and rule-based operations. We explore the neurobiological underpinnings of these measures, identifying key brain regions and white matter pathways involved in their generation and comprehension. This includes linking ID to a distributed network of semantic hubs, like …

Prevalence Of Helmet Use In Skateboarders: A Systematic Review And Narrative Synthesis, Katherine Hunzinger, Ricker Adkins, Stevie Chen, Thomas Li, Lujie Chen

Department of Exercise Science Faculty Papers

Introduction: Helmet adoption remains low among skateboarders, but the specific prevalence remains unclear. The purpose of this study was to summarize available evidence on helmet-use prevalence among skateboarders. Methods: A systematic search of PubMed and Web of Science was conducted using the search terms: skateboard, skateboarding, protective gear, protective equipment, pads, or helmet. Articles were included if they were in English with specific data on helmet use among skateboarders. Articles excluded were those representing reviews or conference abstracts/presentations; or if helmet use prevalence for skateboarders could not be ascertained. Data extraction and quality assessment were performed independently by two reviewers, …

Grit, A Component Of Resident Well-Being, Nathan W. Olson, Kelly Williamson, Nicholas Hartman, Navneet Cheema, Adriana S. Olson

Journal of Wellness

Introduction: Trainees experiencing burnout, depression, or career dissatisfaction challenge educators and may have patient care consequences. Grit, defined as the “perseverance and passion for long-term goals,” buffers against hopelessness and quantifies an aspect of personality shown to predict fewer career changes. Higher grit has been associated with positive outcomes in physicians, including lower burnout rates. Our objective was to determine the correlation between emergency medicine (EM) resident Short Grit Scale (Grit-S) scores and components of well-being: burnout, a positive depression screen, and career satisfaction.

Methods: This was a prospective, multicenter trial involving ten urban/suburban EM residencies. The subjects …

Examining Domain-Specific Neuropsychological Differences Across Cognitive Status Groups In Utrgv South Texas Alzheimer’S Disease Research Center Cohort, Andrea Ramirez, Estrella Palomo, Rosa Pirela, Hector Rodriguez, Roberto Reyes, Eron Manusov, Ney Alliey-Rodriguez, Jesus D. Melgarejo, Gladys E. Maestre, Silvia Mejia-Arango

Research Colloquium

Background: The Uniform Data Set 3.0 Neuropsychological Battery (UDS3NB) is a standardized tool for assessing cognitive function in aging populations. Factor analytic studies on the UDS 3 have shown that performance across cognitive domains, such as memory, attention, executive function, language, and visuospatial abilities, can differentiate between cognitive status groups, cognitively normal (CN), mild cognitive impairment (MCI), and dementia. Understanding how specific cognitive domains relate to diagnostic categories, CN, MCI, and dementia, is essential for early identification. Additionally, socioeconomic and health factors may influence cognitive outcomes and should be considered alongside cognitive performance. The aims of this study are to: …

Efficacy Of Psychedelics Therapy Across Psychiatric Disorders: An Umbrella Review Of Meta-Analyses, Alissa A. Lopez, Ihsan Salloum, Juan C. Lopez-Alvarenga

Research Colloquium

Background: Psychedelics are gaining renewed scientific interest as a treatment for mental health conditions such as major depression, post-traumatic stress disorder (PTSD), anxiety, and addiction. Numerous clinical trials and meta-analyses suggest these substances may produce significant therapeutic effects. However, there is currently no high-level synthesis comparing how different psychedelic compounds perform across a range of psychiatric conditions. A quantitative umbrella review is needed to clarify whether psychedelics broadly improve mental health outcomes, and whether certain compounds are more effective for specific diagnoses.

Methods: The aim of this study is to conduct an umbrella review (meta-analysis of meta-analyses) to assess the …

The Potential Benefits Of Co-Design In Dog-Assisted Treatment Programs For Veterans Seeking Mental Health Care, Parvin (Pary) Bahmanyari, Pauleen Bennett, Tiffani Howell

People and Animals: The International Journal of Research and Practice

Veterans are more likely than the general population to experience a range of mental health problems. While many veteran mental health support programs are available, veterans may struggle to access and engage with these services for various reasons (e.g., a stigmatized perception of mental health disorders, mistrust). Animal-assisted services have become more popular in civilian and military health care settings where traditional therapies (e.g., cognitive behavioral therapy) may not always be effective. Assistance dogs, for example, which live with veterans to provide disability support, have been successfully employed for veteran mental health. Unfortunately, a subgroup of veterans may miss out …

Metagenomic Characterization Of Gut Microbiota In Children With Autism Spectrum Disorder: Microbial Signatures And Modulation By Anti-Inflammatory Diet And Probiotics, Marysol Valencia-Buitrago, Rodrigo Dias Oliveira-Carvalho, Valbert Cardoso, Jessica Triviño-Valencia, Luisa Matilde Salamanca-Duque, Vanessa Martínez-Díaz, Jovanny Zabaleta, Narmer Fernando Galeano-Vanegas, Carlos Andrés Naranjo-Galvis

School of Medicine Faculty Publications

Background: Autism Spectrum Disorder (ASD) is increasingly associated with alterations in gut microbiota, intestinal permeability, and immune dysregulation. However, integrative studies exploring these mechanisms in Latin American populations are lacking. Objective: To characterize gut microbiota profiles in Colombian children with ASD and evaluate the effects of two microbiota-targeted interventions, an anti-inflammatory diet and a probiotic formulation, on microbial diversity and taxonomic composition. Methods: In a two-phase study, shotgun metagenomic sequencing was performed on fecal samples from 23 children with ASD and 7 typically developing (TD) controls. In the second phase, 17 children with ASD were randomized to receive a 12-week …

Study Of Clinical And Bacteriological Profile Of Culture-Positive Neonatal Sepsis At A Tertiary Care Hospital, Qudsiya Ansari, Vaibhav Pawar, Kailas Randad, Poonam Wade

Digital Journal of Clinical Medicine

Background: Neonatal sepsis is a significant global health challenge, leading to substantial morbidity and mortality among neonates. Its clinical manifestations and causative agents show regional and temporal variations, necessitating localized studies to guide effective management. This study aimed to assess the clinical features, bacteriological profile, and antimicrobial resistance patterns in culture-positive neonatal sepsis at a tertiary NICU. Methods: This retrospective observational study analyzed records of 131 inborn neonates with culture-proven sepsis admitted between April 2019 and March 2020. Data on demographic characteristics, clinical presentations, causative organisms, and treatment outcomes were examined. Antibiotic susceptibility patterns were also evaluated. Results: Of the …

Association Between Climate Change Awareness And Depression & Anxiety: Findings From A U.S. Sample, Stanley Nkemjika, Colvette Brown, Henry Onyeaka, Srikanta Banerjee, Jennifer Oliphant

Department of Psychiatry and Human Behavior Faculty Papers

BACKGROUND: Exploring the connection between climate change awareness and overall well-being is crucial, particularly in how it impacts both the environment and mental health. The mental health consequences of climate change and its awareness have not been thoroughly examined, especially in the U.S. In this study, the relationship between awareness of climate change and depression or anxiety among U.S. adults was explored. Similarly, the role of climate change awareness has not been explored in relation to mental health concerns.

METHODS: Based on the HINTS-6 dataset, a nationally representative, cross-sectional survey conducted by the National Cancer Institute, a variety of statistical …

Sex-Specific Associations Between Early Life Unpredictability And Trajectories Of Body Mass Index From Infancy To Adolescence, Emily M. Melnick, Lilybelle K. Deer, Jenalee R. Doom, Hal S. Stern, Curt A. Sandman, Laura M. Glynn, Elysia P. Davis

Psychology Faculty Articles and Research

Objective:

Unpredictability in early life is an understudied aspect of early life adversity that provides important signals to the child about their environment. Recent work shows the predictability of patterns of parental signals on a moment-to-moment timescale sculpts the developing brain during sensitive windows, offering a potential pathway through which early life experiences shape child development. Both experimental non-human animal models and observational human research show sex-specific links between early life exposure to unpredictable patterns of parental sensory signals and aberrant offspring development. The impact of predictability of sensory signals on physical health outcomes, such as BMI, remains unknown. Here …

Reasons For Maintaining The Classification Of Esmethadone As An Investigational Uncompetitive Nmdar Antagonist Rapid Antidepressant: Reply To Ferré And Michaelides, Sara De Martin, Stefano Comai, Andrea Mattarei, Thomas R Kosten, Frank J Vocci, Charles W Gorodetzky, Marco Pappagallo, Paolo L Manfredi

Faculty, Staff and Students Publications

No abstract provided.

Dynamical Regulation Of Blood Pressure And Cognitive Function, Joshua Sweigert, Tara Gruenewald, Margie Lachman, Teresa Seeman, Maxine Weinstein, Tse-Hwei Choo, Martina Pavlicova, Ramakrishna Mukkamala, Richard P. Sloan

Psychology Faculty Articles and Research

BACKGROUND

Blood pressure (BP) is not steady. It varies over intervals from months to consecutive cardiac cycles, and this variation contains meaningful information beyond mean BP. Variability over multiple clinic visits (VVV-BP) and during 24-h ambulatory monitoring (ABPV) is positively related to risk of stroke and coronary artery disease and negatively associated with cognitive performance. Beat-to-beat BP variation, often quantified as low frequency variability (0.04–0.15 Hz, LF-BPV), is less well-studied. Here, we examine the relationship between LF-BPV and cognitive outcomes in 1953 participants from the Midlife in the US study.

METHODS

Participants completed the Brief Test of Adult Cognition by …

Neonatal Striatal Volume Is Associated With Infant Anhedonia, Melissa Nevarez-Brewster, Catherine H. Demers, Jessica L. Irwin, Laura M. Glynn, Martin A. Styner, Mercedes Hoeflich Haase, M. Camille Hoffman, Diego A. Pizzagalli, Benjamin L. Hankin, Elysia Poggi Davis

Psychology Faculty Articles and Research

Anhedonia is increasingly recognized as a transdiagnostic risk factor for psychopathology. New evidence demonstrates that anhedonia is present in infancy and early childhood. Structural variability in striatal regions involved in reward processing and pleasure seeking is concurrently linked to anhedonia, yet few studies have examined whether striatal differences presage anhedonia, and none have examined prospective associations before middle childhood. The present study examined whether neuroanatomical markers that confer risk for anhedonia can be detected as early as the neonatal period. Specifically, we tested whether the volume of striatal regions in neonates predicted the emergence of infant anhedonic behaviors at six …

Use Of Eagala Model–Based Psychotherapy For Youth Psychological Disorders, Kimberley D. Ryan, Tammy L.B. Mckenzie

People and Animals: The International Journal of Research and Practice

Global youth psychological disorder prevalence has increased exponentially. Therefore, a drastic increase in mental health care utilization is expected. Since traditional approaches to the treatment of adult psychological disorders are ineffective with youth, alternative approaches to treatment of youth psychological disorders must be considered. One such approach is equine assisted psychotherapy (EAP), a person-centered, experiential approach using horses during the treatment of psychological disorders and the basis of the Equine Assisted Growth and Learning Association (Eagala) model–based programming. This article presents the quantitative research findings of a study investigating the effectiveness of the Eagala model–based EAP programming in the treatment …

Childhood Loneliness And Cognitive Decline And Dementia Risk In Middle-Aged And Older Adults, Jinqi Wang, Danyang Jiao, Xiaoyu Zhao, Yixing Tian, Haibin Li, Xia Li, Chen Sheng, Lixin Tao, Hui Chen, Zhiyuan Wu, Xiuhua Guo

Research outputs 2022 to 2026

Importance: Adult loneliness has been linked to cognitive decline and dementia risk, but the long-term implications of childhood loneliness remain underexplored. Objectives: To investigate whether childhood loneliness is associated with cognitive decline and dementia risk and whether adult loneliness mediates or modifies these associations. Design, Setting, and Participants: This cohort study used data from the China Health and Retirement Longitudinal Study, a nationally representative cohort study conducted between June 1, 2011, and December 31, 2018, with a maximum follow-up of 7 years. Data analyses were performed from October 1, 2024, to January 15, 2025. Exposure: Childhood loneliness was defined as …

Learning In Virtual Environments With Varying Levels Of Sensory Information, Maryam Derayati Far

Psychology Theses and Dissertations

The sensory environment plays a critical role in shaping learners’ attention, engagement, and retention. This thesis investigates how varying levels of sensory input in virtual reality (VR) classrooms influence learning for two age groups—children and young adults—and explores how individual differences in sensory processing moderate these effects. Using immersive VR technology to simulate classroom settings, two experimental studies were conducted. Study One involved 60 children aged 6–15 years, recruited primarily through a university-run summer camp. Study Two included 57 undergraduate students aged 18–36 years, recruited through a research participation pool. In both studies, participants were randomly assigned to either a …

Knowledge, Attitude, And Practice Towards Cervical Cancer Screening Among Women Aged 20 Years And Above In Mysuru, India, Sneha Manosh Kumar, Rashmi S, Amogha Shree

Digital Journal of Clinical Medicine

Background: Cervical cancer remains the fourth most common cancer among women globally and a leading cause of cancer-related mortality in India. Despite being largely preventable through screening, uptake remains suboptimal due to socio-cultural and systemic barriers.

Methods: A community-based cross-sectional study was conducted among 300 women aged ≥20 years residing in urban and rural areas of Mysuru. Data were collected using a pre-tested, semi-structured questionnaire and analyzed with SPSS version 30.

Results: Awareness of cervical cancer was reported by 90% of participants and of screening methods by 80%. However, only 21% had ever undergone screening and 17% within the preceding …

Prevalence And Factors Associated With Depression, Anxiety And Post-Traumatic Stress Disorder Among Healthcare Workers From Sub-Saharan Africa: Systematic Review, Ezra Too, Peninah Wachira, Solomon Njenga, Sabina Odero, Eunice Ndirangu, Amina Abubakar

Institute for Human Development, East Africa

Background: Depression, anxiety and post-traumatic stress disorder (PTSD) are prevalent among healthcare workers (HCWs), including those from sub-Saharan Africa (SSA). However, there are limited summary data on the burden and factors associated with these disorders in this region. We conducted this systematic review (registration no. CRD42022349136) to fill this gap.

Aims: The aim of this review was to systematically summarise the available evidence on the prevalence and factors associated with depression, anxiety and PTSD, or their symptoms, among HCWs from SSA.

Method: We searched African Index Medicus, African Journals Online, CINAHL, PsycINFO and PubMed for articles published, from database inception …

Understanding Why Individuals Maltreated As Children Do Not Retrospectively Self-Report, Kristin S. Lynch

Dissertations, Theses, and Capstone Projects

Individuals with documented histories of childhood maltreatment who do not retrospectively self-report these childhood experiences demonstrate better emotional and psychological outcomes in adulthood. Understanding why these individuals do not retrospectively self-report is important for the development of effective interventions focused on mitigating the long-term consequences of maltreatment. The current study compared maltreated individuals who did not retrospectively self-report (O-R group) to those who did retrospectively self-report (O+R group) to examine theoretical explanations related to intentional nondisclosure (i.e., social desirability and discomfort during the interview) and memory processes (i.e. infantile amnesia, use of mental health services, avoidant coping …

Mechanisms Of Sleep Regulation In Drosophila Melanogaster, Anfal A. Abuhilal

Dissertations, Theses, and Capstone Projects

Sleep is a fundamental biological need, and sufficient sleep is required for physical and mental well-being. Sleep is regulated by two biological mechanisms: sleep-wake homeostasis and circadian rhythm. Circadian rhythms are near 24-h rhythms in behavior and physiology that are generated by endogenous mechanisms. In mammals, the suprachiasmatic nucleus (SCN) is the central circadian pacemaker, which is known to receive a significant amount of serotonergic input that likely modulates sleep rhythms. In addition to circadian modulation, sleep is subject to homeostatic regulation. Several neuromodulators have been proposed as mediators of sleep homeostasis. Serotonin has been implicated in sleep drive and …