Psychiatry and Psychology Commons^™

The Prevalence Of Moral Injury Among Veterans Diagnosed With Post-Traumatic Stress Disorder (Ptsd): Analyses By Combat Exposure, Gender, Age Group, And Military Service, Carl B. Forkner

Doctoral Dissertations and Projects

The attacks on the United States on September 11, 2001, and the ensuing wars in Afghanistan and Iraq, heralded in a new concept affecting our combat and support military personnel. This concept is known today as moral injury. Military personnel were already familiar with post-traumatic stress disorder (PTSD), whether from personal experience or from reading and training on the subject, but no training addresses the prevalence or effects of moral injury. The term moral injury (MI) was first coined by psychiatrist Jonathan Shay and his colleagues based on feedback from military and veteran patients in 1998; however, it remains that …

Predictors Of Elevated Borderline Personality Disorder And Pai-Bor Scores: The Role Of Psychological, Trauma, And Treatment Factors, Isabel Avendano Gil

Electronic Theses and Dissertations

Borderline Personality Disorder (BPD) is a complex and multifaceted mental health condition that significantly affects individuals' emotional, cognitive, and interpersonal functioning. BPD is characterized by impulsivity, emotional dysregulation, unstable relationships, and self-destructive behaviors, and often results in significant impairment across multiple life domains. Previous research has consistently identified Adverse Childhood Experiences (ACEs), particularly sexual abuse (SA), as key contributors to the development of BPD. These early traumas are closely associated with core features of the disorder, including affective instability, identity disturbance, impulsivity, and maladaptive interpersonal patterns.

Psychotherapeutic interventions, such as Dialectical Behavior Therapy (DBT) and Cognitive Behavioral Therapy (CBT), have …

Stigma And Barriers To Seeking Mental Health Care Among Emergency Department Providers – A Mixed Methods Study, Shannon C. White, Charlotte H. Harris, Ravindra Gopaul, Joshua M. Smyth

Student Papers, Posters & Projects

High levels of psychological distress and depression are common among clinicians working in US emergency departments [ED], yet treatment-seeking remains rare, contributing to burnout and negative well-being. Reluctance to seek care often reflects concerns about negative consequences (e.g., stigma, negative professional impact). We sought to characterize the availability of mental health resource availability, beliefs about seeking care, and barriers faced by emergency department healthcare providers. A sequential mixed-method design was employed. Phase 1 included a survey of ED physicians, advanced practice providers (APPs; i.e., nurse practitioners and physician assistants) and medical residents at an academic medical center. The survey assessed …

Lack Of Relationships Between Ketamine Treatment And Peripheral Neurotrophic And Inflammatory Factors In A Randomized Controlled Ketamine Trial Of Major Depressive Disorder, Manivel Rengasamy, Benjamin Panny, Zakary Hutchinson, Anna Marsland, Tessa Kovats, Angela Griffo, Crystal Spotts, Robert H Howland, Meredith L Wallace, Sanjay J Mathew, Shabnam Hossein, Rebecca B Price

Staff and Researcher Publications

Background: Ketamine is a rapid-acting treatment for treatment-resistant depression (TRD), though mechanisms related to ketamine's effects remain unclear. Blood-based neurotrophic and inflammatory factors (NIFs; e.g., brain-derived neurotrophic factor, interleukin-6) have emerged as markers potentially linked to ketamine and ketamine treatment response.

Methods: In this secondary analysis of a randomized controlled trial (RCT), 133 adults with TRD received a single-dose infusion of ketamine (n = 89; 0.5 mg/kg) or saline (n = 44) and provided measures of peripheral blood NIF levels and depression severity across a five-day post-infusion period. Differences between ketamine and saline groups were examined for (1) NIF levels, …

The Promise Of Psilocybin-Assisted Therapy For Opioid Use Disorder, Craig Kimble, Alberto Coustasse

Management Faculty Research

The opioid epidemic presents a profound and escalating public health and economic crisis in the United States. According to the CDC, the economic burden of opioid use disorder and fatal opioid overdose in the U.S. reached an estimated $1.02 trillion in 2017 alone, encompassing healthcare costs, lost productivity, criminal justice expenditures, and premature mortality. While current pharmacologic treatments—such as methadone, buprenorphine, and naltrexone—have proven efficacy, they are not without limitations, including high relapse rates, issues with compliance, stigma, and insufficient engagement in long-term recovery. These shortcomings necessitate an exploration of innovative, cost-effective interventions. One such promising alternative is psilocybin-assisted therapy. …

From Trauma To Treatment: Chronic Neurobehavioral Consequences And Emerging Treatments, Moriah E. Mcguier

Dartmouth College Ph.D Dissertations

Severe trauma exposure related to traumatic brain injury (TBI) or psychiatric disorders like post-traumatic stress disorder (PTSD) leads to neurobehavioral and physiological impairments that reduce the quality of life of individuals and remain difficult to treat with current therapeutic options. Further, these conditions are highly comorbid, notably in PTSD with blast-traumatic brain injury (bTBI) commonly experienced by military members via explosive forces, leading to complex and heterogenous outcomes. To address this, preclinical models have been developed to recapitulate aspects of TBI and PTSD. This thesis utilizes two such models in rats, bTBI and the single prolonged stress (SPS) model for …

Beyond Opioids: The Role Of Polysubstance Exposure In Neonatal Abstinence Syndrome Treatment And Hospitalization, Caelyn Harrison

Undergraduate Honors Theses

This thesis explores the impact of prenatal polysubstance exposure, specifically focusing on the need for pharmacological treatment for Neonatal Abstinence Syndrome (NAS) and the duration of their hospital stay. A retrospective analysis of 462 infants, including 121 exposed to polysubstances during pregnancy, showed significant associations between polysubstance exposure and adverse neonatal outcomes. Infants with prenatal polysubstance exposure were more likely to require pharmacological treatment for NAS (52.8%) compared to non-exposed infants (38.7%), as determined by chi-square analysis (χ²(1, N = 462) = 7.36, p = .007). Additionally, infants exposed to polysubstances experienced longer hospital stays on average (M = 14.88 …

Childhood Trauma Affects Romantic Relationships In Adulthood, Rhianna Vranka

D.U.Quark

Childhood trauma is when a child experiences sexual, emotional, or physical abuse or neglect. Trauma’s causes aren’t limited to just those factors and can result from a variety of experiences. Childhood trauma makes children more vulnerable to developing issues in adulthood because they are at a critical point in their development. There is insignificant knowledge on why childhood trauma affects romantic relationships in adulthood. Knowledge of warning signs and accurate diagnosis is essential to prevent violence stemming from the psychological effects exhibited by those with childhood trauma in relationships. More research is required to understand how to treat the psychological …

Assessment, Decision, Adaptation, Production, Topical Experts-Integration, Training, And Testing (Adapt-Itt) Framework To Tailor Evidence-Based Posttraumatic Stress Disorder Treatment For People With Hiv To Enhance Engagement And Adherence: Qualitative Results From A Feasibility Randomized Controlled Trial, Cristina M. Lopez, Angela D. Moreland, Stephanie Amaya, Erin Bisca, Christin Mujica, Tayler Wilson, Nathaniel Baker, Lauren Richey, Allison Ross Eckard, Patricia A. Resick, Steven A. Safren, Carla Kmett Danielson

School of Medicine Faculty Publications

BACKGROUND: Individuals with co-occurring posttraumatic stress disorder (PTSD) and HIV are at high-risk for negative HIV-related outcomes, including low adherence to antiretroviral therapy, faster disease progression, more hospitalizations, and almost twice the rate of death. Despite high rates of PTSD in persons with HIV (PWH) and poor HIV-related health outcomes associated with PTSD, an effective evidence-based treatment for PTSD symptoms in PWH does not exist. OBJECTIVE: This study aimed to describe the adaptation and theater testing of an evidence-based intervention designed for people with co-occurring PTSD and HIV. METHODS: The Assessment, Decision, Adaptation, Production, Topical experts-integration, Training, and Testing (ADAPT-ITT) …

Postpartum Depression In Adolescent Mothers: Evaluating The Effectiveness Of Screening Tools, Social And Cultural Interventions, Ysabella M. Co

Nursing | Senior Theses

Background: Pregnancies among adolescents is often an outcome of improper sex education and understanding. It is vital to provide mothers with the proper medical care and resources throughout their pregnancy and postpartum period to prevent any risks or harm from occurring. With the complexities and stressors of pregnancy at such a young age, it is important for healthcare to provide resources regarding postnatal depression diagnoses and interventions, especially to a population that is at risk for mental health issues. Objective: To provide adolescent mothers thorough medical care and lessen the risk of experiencing postpartum depression. By providing frequent …

Using Mindfulness To Manage Moral Injury In Veterans: Feasibility And Satisfaction Of A Pilot Randomized Controlled Trial, Michelle L. Kelley, Adrian J. Bravo, Elizabeth E. Burgin, Susan A. Gaylord, Christine Vinci, Megan Strowger, Jeffrey M. Gabelmann, Joseph M. Currier

Psychology Faculty Publications

Objective

The present study assessed program feasibility and satisfaction among recent-era veterans who participated in Mindfulness to Manage Moral Injury (MMMI), a live facilitated web-based 7-week mindfulness-based program targeting moral injury among veterans.

Method

In total, 56 post-9/11 veterans were recruited with 28 randomized to the MMMI condition and 28 to the Education and Support (ES) condition. Most participants identified as being White (71.4%), male (66.1%), and had a reported mean age of 41.50 years (Median = 39.50, SD = 9.26).

Results

Among the 56 participants, 82.1% attended at least one treatment session and 44.6% completed all seven sessions. There …

Digital Health Intervention For Children With Adhd To Improve Mental Health Intervention, Patient Experiences, And Outcomes: A Study Protocol, Nancy Herrera, Franceli L. Cibrian, Lucas M. Silva, Jesus Armando Beltran, Sabrina E. B. Schuck, Gillian R. Hayes, Kimberley D. Lakes

Engineering Faculty Articles and Research

Background

Attention Deficit Hyperactivity Disorder (ADHD) is the most prevalent childhood psychiatric condition with profound public health, personal, and family consequences. ADHD requires comprehensive treatment; however, lack of communication and integration across multiple points of care is a substantial barrier to progress. Given the chronic and pervasive challenges associated with ADHD, innovative approaches are crucial. We developed the digital health intervention (DHI)—CoolTaCo [Cool Technology Assisting Co-regulation] to address these critical barriers. CoolTaCo uses Patient-Centered Digital Healthcare Technologies (PC-DHT) to promote co-regulation (child/parent), capture patient data, support efficient healthcare delivery, enhance patient engagement, and facilitate shared decision-making, thereby improving access to …

Psychiatric Polygenic Risk Scores: Experience, Hope For Utility, And Concerns Among Child And Adolescent Psychiatrists, Amanda R Merner, Page M Trotter, Lauren A Ginn, Jason Bach, Katherine J Freedberg, Takahiro Soda, Eric A Storch, Stacey Pereira, Gabriel Lázaro-Muñoz

Center for Medical Ethics and Health Policy Staff Publications

Recent advances in psychiatric genetics have enabled the use of polygenic risk scores (PRS) to estimate genetic risk for psychiatric disorders. However, the potential use of PRS in child and adolescent psychiatry has raised concerns. This study provides an in-depth examination of attitudes among child and adolescent psychiatrists (CAP) regarding the use of PRS in psychiatry. We conducted semi-structured interviews with U.S.-based CAP (n=29) who possess expertise in genetics. The majority of CAP indicated that PRS have limited clinical utility in their current form and are not ready for clinical implementation. Most clinicians stated that nothing would motivate them to …

General Psychology 2e, Will Stutterheim

All Open Educational Resources

General Psychology 2e offers an insightful exploration into the complexities of the field of psychology and all that it has to offer. This book provides a thorough introduction to the foundational principles of psychology, covering essential theories, research findings, and applications that illustrate the intricate workings of the mind.

The text begins with a historical overview of psychology, tracing its evolution from philosophical roots to its establishment as a scientific discipline. It then delves into essential topics regarding stress and mental health disorders and concludes with therapy and treatment approaches. It then covers research in psychology, biopsychology, consciousness, and perception. …

Prenatal Maternal Depression In Canada: Are Current Protocols Adequate?, Britney A. Glasgow-Osment, Farah Wahib, Madeleine Zanin, Shama Kassam

Master's in Interdisciplinary Medical Sciences Graduate Program

Throughout pregnancy, maternal and fetal health are influenced by a multitude of factors. Prenatal maternal depression is one such factor. It is well documented that prenatal maternal depression causes negative pregnancy outcomes for both the mother and baby, including irregular placental function, psychological distress, and pre-term birth, among others. In Ontario, the incidence of prenatal maternal depression is alarmingly high, at 10.3%.As such, the current tools for managing prenatal maternal depression must be effective, efficient, and comprehensive. We hypothesized that the current protocols for screening and treating prenatal maternal depression in Canada are inadequate. To investigate this, a literature review …

The Dry Bloodletting: A History Of The Diagnosis And Treatment Of Posttraumatic Stress Disorders In Military Service Members, Kevin Johnson

Masters Theses, 2020-current

This work is a close look at how veterans of war have been treated medically for ailents of the mind. This work looks closely at the many therapies and pharmaceutical remedies that have been perscribed to veterans with the advent of the field of psycology at the trun of the century. Sources included the Diagnostic and Statistical Manual (DSM), multiple clinical trials and white papers, records from the VA, etc. The reader should walk away with a better understanding of how the path towards healing invisble wounds has been mired with revictimization and controversy.

Over The Counter Overdose: A Case Of Tylenol Toxicity, Swet M. Patel, James A. Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 51-year-old man presenting to the Emergency Department (ED) with suicidal ideations (SI) endorsing an intentional overdose of acetaminophen. Just as important is the clinical presentation; it is equally important to obtain a detailed history of patient's presentation leading to the ED visit when evaluating a suicide attempt. Tylenol (acetaminophen) is a common over the counter (OTC) medication available to the public. Management of Tylenol overdose follows a standard outline of things to observe and intervene on. In this case, we discuss how Tylenol overdose is managed in a clinical setting through a patient who …

Examining The Relationship Between Anxiety Severity And Autism-Related Challenges During Cognitive Behavioral Therapy For Children With Autism, Madeleine N Fuselier, Andrew G Guzick, Jafar Bakhshaie, Jeffrey J Wood, Philip C Kendall, Connor M Kerns, Brent J Small, Wayne K Goodman, Eric A Storch

Faculty, Staff and Students Publications

PURPOSE: Using data from a randomized clinical trial evaluating cognitive behavioral therapy (CBT) for children with autism and co-occurring anxiety, this study examined the relationship between autism features and anxiety symptoms throughout CBT.

METHODS: Two multilevel mediation analyses were run which examined the mediating role of changes in anxiety for changes in two core features of autism, (a) repetitive and restrictive behaviors (RRBs) and (b) social communication/interaction impairments, between pre- and post-treatment.

RESULTS: Indirect effects between time and autism characteristics were significant for both models, indicating that as anxiety changes, so do RRBs and social communication/interaction as the outcomes respectively. …

Medication Assisted Therapy And First Episode Psychosis: Evaluating Treatment And Readmission Rates, Kayla Sherea Williams Bsn, Rn, Hannah Lee Brenner Bsn, Rn, Madison Makenzie Yount Bsn, Rn, Jacqueline Sharp Dnp, Aprn, Pmhp-Bc

Doctor of Nursing Practice Projects

Background The Centers for Disease Control and Prevention (CDC) found that each day more than 140 U.S. residents die from drug overdoses, specifically due to opioids. Due to this, alternatives were created to reduce overdoses and ensure safety. Medication assistance therapy (MAT) is an effective form of treatment for people with substance use disorders and is defined as the use of medication in conjunction with counseling or therapy for the treatment of substance use disorders. The efficacy of MAT is used adjunctively with psychotropic medications compared to using no MAT and using psychotropic medications alone with individuals who are experiencing …

Telehealth: A Rising Intervention For Latina Mothers Experiencing Prenatal And Postpartum Depression, Britney Gutierrez

Nursing | Student Research Posters

Abstract: Background: Postpartum depression (PPD) is high among Latina women but often goes unrecognized and untreated. Recognition and management of PPD in this population is crucial as PPD contributes to negative health effects on the mother and infant. Purpose: This research aims to look into telehealth to improve screening methods and treatment for Latina mothers through a Spanish mobile health application that will provide screening and education on PPD. Method: This mixed-method quality improvement study will include 300 participants from an OB-GYN and Pediatrics community clinic, > 18 years old, of Hispanic/Latino ethnicity, Spanish speaking, currently pregnant, or had a child …

Telehealth: A Rising Intervention For Latina Mothers Experiencing Prenatal And Postpartum Depression, Britney Gutierrez

Nursing | Senior Theses

Background: Postpartum depression (PPD) is high among Latina women but often goes unrecognized and untreated. Recognition and management of PPD in this population is crucial as PPD contributes to negative health effects on the mother and infant. Purpose: This research aims to look into telehealth to improve screening methods and treatment for Latina mothers through a Spanish mobile health application that will provide screening and education on PPD. Method: This mixed-method quality improvement study will include 300 participants from an OB-GYN and Pediatrics community clinic, > 18 years old, of Hispanic/Latino ethnicity, Spanish speaking, currently pregnant, or had a child within …

Screening Incarcerated Women For Opioid Use Disorder, Michele Staton, Martha Tillson, Mary M. Levi, Matthew Webster, Carrie B. Oser, Carl Leukefeld

Behavioral Science Faculty Publications

The overall aim of the present study is to examine the utility of the DSM OUD Checklist and the NM-ASSIST screening tools to identify symptoms consistent with OUD among incarcerated women in county jails. This study contributes to the existing literature because research on screening and assessment approaches for incarcerated women has been limited. The focus of the current study is to describe the screening procedures and study recruitment for a larger parent study focused on increasing treatment linkages. Study findings indicate a positive correlation between indicators of OUD using the two screening tools, as well as a high degree …

Specialized Support For Queer Women With Postpartum Depression, Dan-Tam Pham

Nursing | Student Research Posters

Queer women face disproportionately high rates of postpartum depression compared to heterosexual and cisgender individuals. Studies showed that queer women face heightened mental health challenges, including higher rates of depression and anxiety due to factors like discrimination, limited support systems, and negative healthcare experiences. There is a need for culturally competent, LGBTQ+ affirming interventions to improve maternal mental health outcomes; despite the health disparities faced by this population, research on specialized postpartum interventions is limited, revealing gaps in effective mental health care for queer mothers. The key search terms for the articles used in the study included: postpartum depression, queer …

Clinical Practice Guideline For The Management Of Depression In Primary Care, Estrella Catherine Villarreal

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: The prevalence of depression poses a significant challenge in primary care, emphasizing the urgent need to address this issue during patient visits. Primary care providers are at the forefront of managing depression, yet they encounter difficulties in screening, diagnosing, assessing, and treating this complex condition. Clinical guidelines serve as valuable tools for primary care providers and practices, offering support in identifying and addressing depression effectively. An evidence-based approach to treating depression in primary care, with a focus on collaborative interventions with behavioral health to enhance depression management for American Indian/Alaskan Native (AI/AN) communities.

Methods: The descriptive analysis was conducted …

Stepped-Care Cognitive Behavioral Therapy In Children On The Autism Spectrum With Co-Occurring Anxiety, Eric A Storch, Sophie C Schneider, Sean M Olsen, Ana C Ramirez, Leandra N Berry, Robin P Goin-Kochel, Morgan Mcneel, Abigail E Candelari, Andrew G Guzick, Sandra L Cepeda, Saira Weinzimmer, Robert G Voigt, Troy Quast, Wayne K Goodman, Alison Salloum

Faculty, Staff and Students Publications

This trial examined stepped-care cognitive-behavioral treatment (CBT) among 96 autistic youth with co-occurring anxiety. Step 1 included an open trial of parent-led, therapist-guided bibliotherapy. Step 2 was family-based CBT for those who did not respond to Step 1 or maintenance for those who did. Eighteen participants (28%) who completed Step 1 responded. Responders reported significantly lower pre-treatment anxiety, internalizing symptoms, and functional impairment than non-responders. After Steps 1 and 2, 80% of completers (55% intent-to-treat) were responders. Anxiety, impairment, and ASD-related impairments significantly improved. Youth in maintenance experienced faster improvement through post-treatment, though there were no group differences at 3-month-follow-up. …

Pharmacotherapies Targeting Gaba-Glutamate Neurotransmission For Treatment-Resistant Depression, Courtney M Vecera, Alan C Courtes, Gregory Jones, Jair C Soares, Rodrigo Machado-Vieira

Faculty, Staff and Student Publications

Treatment-resistant depression (TRD) is a term used to describe a particular type of major depressive disorder (MDD). There is no consensus about what defines TRD, with various studies describing between 1 and 4 failures of antidepressant therapies, with or without electroconvulsive therapy (ECT). That is why TRD is such a growing concern among clinicians and researchers, and it explains the necessity for investigating novel therapeutic targets beyond conventional monoamine pathways. An imbalance between two primary central nervous system (CNS) neurotransmitters, L-glutamate and γ-aminobutyric acid (GABA), has emerged as having a key role in the pathophysiology of TRD. In this …

Effectiveness Of Amiodarone, Propafenone And Synchronized Electrical Cardioversion For Conversion Of Atrial Fibrillation Paroxysm To Sinus Rhythm In Rigas Stradins University Hospital Department Of Emergency Medicine., Mihails Tracevskis

Digital Journal of Clinical Medicine

Abstract

Introduction: Atrial fibrillation remains a pervasive global health concern, contributing significantly to the incidence of stroke, heart failure, sudden death, and overall cardiovascular morbidity.

Materials and methods: The present study undertook a retrospective analysis involving a meticulous examination of 127 patients, representing a diverse cohort of individuals encompassing 73 men (with a median age of 62 and a range of 37-75) and 54 women (with a median age of 60 and a range of 42-78) duration of atrial fibrillation 48 hours or less.

Results: The results highlighted amiodarone's remarkable efficiency, as it successfully converted 81.2% of cases (56 …

Characterizing The Influence Of Exposure To Military Sexual Trauma And Intimate Partner Violence On Mental Health Outcomes Among Female Veterans, Carrie Esopenko, Nicola De Souza, Elisabeth A Wilde, Kristen Dams-O'Connor, Ellen Teng, Deleene S Menefee

Faculty, Staff and Students Publications

Military sexual trauma (MST) has deleterious long-term psychological consequences. Among female U.S. military members, MST is associated with increased risk for future interpersonal victimization, such as experiencing intimate partner violence (IPV). Few studies have investigated the implications of the cumulative effects of IPV and MST on psychological functioning. This study examined rates of co-exposure to MST, IPV, and their cumulative impact on psychological symptoms. Data were collected from 308 female Veterans (FVets; age:

Psychosocial Characteristics Of Gambling Addicts – Does It Matter When They Start Their Treatment?, Neven Ricijas Phd, Dora Dodig Hundric Phd, Sabina Mandic Ma, Sanja Radic Bursac Ma, Davor Bodor Phd

International Conference on Gambling & Risk Taking

Abstract:

Gambling disorder is well known as a hidden addiction and therefore is subjected to a prolonged time in seeking treatment. During the development of addiction, the psychosocial functioning is more openly or covertly disrupted, and gambling addicts manifest various problems and risky behaviors. At the same time, motivational mechanism for seeking professional help are complex and influenced by different individual circumstances.

This study was conducted with N=315 patients in the Daily Clinic for Gambling Addiction. The psychosocial functioning of the patients is assessed at the beginning of the treatment, while a specific aim of this paper is to explore …

Strategic Use Of Wellness Ambassadors To Increase Attendance Of Initial Mental Health Appointments, Kaitlyn Blair, Mirna Law, Bettina Bernstein

Research Day

Background

Many adults and children with mental health conditions in the US do not receive treatment, and in Philadelphia alone, there were 174 suicide deaths in 2017. The shortage of mental health professionals and long wait times are significant barriers to accessing mental health care. Executive function difficulties can make it challenging for individuals to maintain a schedule for mental health appointments. A study found that reminder phone calls result in an increased rate of mental health appointment keeping. The goal of this project is to increase attendance of first mental health appointments by patients referred to mental health services …