Psychiatry and Psychology Commons^™

Socio-Spatial Patterns Of Suicide Mortality In The United States, Kushagra Tiwari, M. Amin Rahimian, Marie-Laure Charpignon, Philippe J. Giabbanelli, Praveen Kumar

VMASC Publications

Suicides cause more than 49,000 deaths per year in the United States, including 55% associated with the use of a firearm. Across states and counties in the US, suicide mortality exhibits substantial geographical and sociodemographic heterogeneity. However, the role of large-scale social networks in shaping this variation remains underexplored. To assess how both the risk of suicide mortality and the effect of firearm restriction policies propagate through inter-county social ties, we integrate data on county-level suicide mortality (2010–2022) and the Facebook Social Connectedness Index (SCI), a continuous measure of the strength of social ties between counties used to derive weighted …

The Effects Of Stress-Related Hormones On Excitatory Synapse Formation, Autumn C. Garvey

Honors Undergraduate Theses

Stress profoundly influences brain function through neuromodulatory hormones that regulate synaptic plasticity, yet how temporal patterns of hormone exposure shape excitatory synapse formation remains poorly understood. This study investigates how exposure to stress hormones, norepinephrine and cortisol, affects excitatory synapse development. While existing research primarily compares concentration models, real-world stress occurs in variable patterns that may produce distinct neural outcomes. To address this gap, differentiated Neuro2A neuronal cells are exposed to norepinephrine or cortisol under a continuous treatment paradigm designed to model chronic stress conditions. Following treatment, immunofluorescence imaging is utilized to quantify excitatory synapse formation through analysis of presynaptic …

Studying Chronotypes And Their Role In Sleep And Mental Health: A Scoping Review, Evan Nguyen

Honors Undergraduate Theses

Sleep patterns remain a significant public health concern globally, impacting several aspects of life, including mental health. This scoping review examined how chronotype and circadian typology predict mental health, with sleep quality serving as a crucial mediator. While the importance of sleep is widely acknowledged, there is a lack of studies specifically investigating chronotype-aligned interventions to reduce psychological distress. To address the shortage, a comprehensive review of the peer-reviewed literature was conducted, identifying six papers for analysis. These studies mostly utilized cross-sectional designs to assess diverse global groups, including university students, healthcare workers, and military personnel. The results indicate that …

Pillpetz: A Smarter Way To Encourage Medication Adherence In Children, John H. Begley

CMC Senior Theses

Medication adherence is usually framed as a problem of patient behavior, but this thesis argues that it is equally a problem of design. Children who take daily medication face barriers that adults often do not: developing executive function, dependence on caregivers, shifting school and home routines, privacy concerns, and stigma around being perceived as different. The standard prescription bottle, by contrast, was designed primarily for dispensing efficiency, safety, and accidental ingestion prevention—not for sustained daily use by a developing child.

This thesis proposes PillPetz, a smart pill case and digital companion that uses routine, play, dose confirmation, and caregiver-connected support …

Contemporary Approaches To Group Psychotherapy Supervision, Michelle A. Collins-Greene (Ed.), Molyn Leszcz, Nina W. Brown, Ellen Wright, Scott Giacomucci, Les R. Greene, Susan P. Gantt, Leah M. Niehaus, Francis Kaklauskas, Tony L. Sheppard

Counseling & Human Services Faculty Publications

This chapter captures the work of contemporary supervisors of group psychotherapy, all of whom have practiced many years and have trained and supervised innumerable group leaders. They demonstrate the diversity of settings and theoretical orientations that are prominent in the current era. Their essays speak for themselves and provide wonderful illustrations and models for supervisors-in-training and consultation to emulate. They also talk about who influenced, mentored, and supervised them.

Examining The Effects Of Virtual Nature Exposure And Video Immersion On State Hope With Nature Relatedness As A Covariate, Zachary Arneson

All Master's Theses

Previous work in the field of environmental psychology has shown that virtual nature exposure can produce many psychological benefits for the viewer. Within this literature, however, there has been no examination of the effects of virtual nature exposure on levels of state hope, a goal-directed positive psychological construct made up of two types of thought: agency and pathways. Additionally, there has been no direct examination of the effect of immersion level of the virtual nature exposure on psychological measures. To fill this gap in the literature, the current study examined the effects of virtual nature exposure and video immersion on …

Emotionally Healthy Black Men: Guidelines For Supporting Mental Health Treatment For Black Men In Ohio, Eira Nichell Yates

Antioch University Dissertations & Theses

This study examines the barriers that prevent Black men in Ohio from seeking treatment for depression and other mental health conditions and explores strategies to improve engagement and outcomes. Although depression is the most prevalent mental health disorder in the United States, it remains underdiagnosed and undertreated among Black men, contributing to persistent mental health disparities. The limited body of research addressing help-seeking behaviors within this population necessitated the use of a Delphi methodology to obtain expert consensus on key challenges and promising practices. A panel of subject-matter experts in mental health, social services, and culturally responsive care participated in …

Resilience Shields And Grit Intensifies Subjective Cognitive Decline In Middle‐To‐Older Aged Black Americans, Sunkanmi Folorunsho, Maria Clark, Obinna Odo, Yolanda L. Jackson, Candidus C. Nwakasi, Darlingtina K. Esiaka

Behavioral Science Faculty Publications

Background: There is growing interest on the relationship between psychosocial factors and cognitive health trajectories in adulthood. While grit and resilience have been shown to influence health outcomes, their differential effects on subjective cognitive decline (SCD) in Black American adults remain understudied. The purpose of this study is to help fill this gap.

Methods: The study utilized a cross-sectional research design. Black American participants (N = 242; Mean age = 44.32) responded to a survey assessing SCD, grit, resilience, and sociodemographic factors. Linear regression analysis was performed to test the associations between grit and resilience and SCD, and to …

Evidence Of Heterogeneity In The Opioid Withdrawal Syndrome: Spontaneous And Precipitated Withdrawal, Suky Martinez, Jermaine D. Jones, Kelly E. Dunn, Andrew Huhn, Joshua A. Lile, Thomas P. Shellenberg, Laura Brandt

Behavioral Science Faculty Publications

Aims: This study characterized the heterogeneity of opioid withdrawal by comparing naturally occurring withdrawal during opioid abstinence (spontaneous withdrawal) with abrupt, pharmacologically induced naloxone-precipitated withdrawal in adults with Opioid Use Disorder (OUD).   Methods: A secondary analysis was conducted on de-identified data from 86 adults meeting DSM-5 criteria for moderate-to-severe OUD. Participants either presented in spontaneous withdrawal (n = 28) or underwent naloxone challenge to precipitate withdrawal (n = 58). Withdrawal symptoms were rated using the Wang procedure. Principal Component Analysis (PCA) of binary symptom data was performed to identify dominant patterns of symptom co-occurrence. Separate PCAs were then …

Facebook As A Strategy To Deliver A Peer Navigation Intervention For Recently Incarcerated Women With Opioid Use Disorder: A Mixed Methods Descriptive Profile, Martha Tillson, Jaxin Annett, Marguerite A. Webster, Amanda Fallin-Bennett, Mandi Webster, Amber Clemons, Cynthia Robinson, Kevin Crabtree, Casey Baker-Romans, Michele Staton

Center on Drug and Alcohol Research Faculty Publications

Recovery support and treatment linkages are critical during transitions from incarceration to community but can be challenging to deliver to hard-to-reach populations. This paper will examine Facebook contacts between peer navigators (PNs) and women with opioid use disorder (OUD) following jail release to explore women’s use of PN services, including purpose and content of Facebook messages. As part of a larger clinical trial under the Justice Community Opioid Innovation Network (JCOIN), PNs provided OUD treatment navigation and recovery support for 12 weeks following women’s release from jail, using remote options such as Facebook. Facebook Messenger transcripts between PNs and participants …

Evolution Of A Client‐Level Dataset: 20 Years Of National Child Traumatic Stress Network Data Collection, C. A. Purbeck, A. N. Cooke, L. J. Liang, C. Smith, J. Staten, J. Epstein, H. B. Hodgdon, Jessica Eslinger, A. Wells, J. Goodrich, T. H. Bethel, K. Willett, Y. C. Fu, J. A. Fairbank, E. C. Briggs

Center on Trauma and Children Faculty Publications

Objectives: For 20 years, the National Child Traumatic Stress Network's (NCTSN) data collection efforts have been a central mechanism for Clinical Quality Improvement (ClQI). The NCTSN is a federally funded initiative in the United States composed of programs dedicated to raising the standard of care and increasing access to services for children and families who have experienced traumatic events.

Methods: These efforts span three initiatives: the Core Data Set (CDS), the Clinical Improvement through Measurement Initiative (CIMI) Measurement Based Care (MBC), and CIMI Data Sharing (CIMI-DS) that collected and analyzed client-level data to improve care for children and families served …

Genomic Determinants Of Appetite Regulation And Their Role In Obesity Risk, Timothy J. Renier

Dartmouth College Ph.D Dissertations

Over 40% of US adults and 20% of children live with obesity. It is related to increased risks of diseases including type II diabetes and cancer, is a source of harmful stigma, and impairs child development. Appetitive traits describing patterns of food approach and avoidance behaviors may serve as windows into the underlying pathophysiology of obesity. As both obesity and appetitive traits are heritable, common genetic drivers of obesity may lead to phenotypic obesity through appetitive traits as a disease mechanism. Additionally, GLP-1 receptor agonists (GLP-1RAs) have been shown to exert their profound clinical effects in part by modulating appetite. …

Correlates Of Recovery Capital Among Women In Jails: Leveraging A Dimensional Recovery Framework, Amanda Fallin-Bennett, Martha Tillson, Jaxin Annett, Hartley Feld, Michele Staton

Nursing Faculty Publications

Background: Recovery capital encompasses internal and external factors that support recovery from substance use disorder, such as employment, social support, and physical and mental health. There is a need for more research on recovery capital among women who are incarcerated, who often face complex barriers to recovery, such as poverty, unemployment, and histories of trauma.

Methods: Women (N ¼ 900) were recruited from Kentucky jails as part of the broader NIDA-funded Kentucky Justice Community Opioid Innovation Network (JCOIN) cooperative project. Measures from baseline interviews (during incarceration) were selected in alignment with the Substance Abuse Mental Health Service Administration (SAMHSA)’s four …

Clinical And Demographic Characteristics Of Participants In A Hepatitis C Treatment Trial In Rural Kentucky: How Policies Around Treatment Access May Impact Elimination Efforts In The United States, Jennifer R. Havens, Brittney D. Williams, Takako Schaninger, Virginia A. Shepherd-Tackett, Michelle R. Lofwall, Michele Staton, Sharon L. Walsh, Hannah K. Knudsen

Behavioral Science Faculty Publications

Introduction: The advent of curative direct acting antiviral (DAA) drugs to treat those actively infected with the hepatitis C virus (HCV) has allowed for discussion around HCV elimination. Restrictive state-by-state policies for the coverage of DAAs for Medicaid recipients may hamper elimination efforts in the United States by limiting access to these curative treatments. Methods: The purpose of the current analysis was to examine the sociodemographic, drug use and clinical characteristics of participants in the Kentucky Viral Hepatitis C Treatment (KeY Treat) study in the context of Medicaid policies in the United States. The goal of KeY Treat was to …

The Interaction Of Tobacco Retailer Density And Rurality With Tobacco Use Prevalence In Kentucky, Shyanika W. Rose, W. Jay Christian, Judy Van De Venne, Delvon T. Mattingly, Bethany Shorey Fennell, Saber Feizy, Mary Kay Rayens

Behavioral Science Faculty Publications

Purpose: Tobacco retailer density is a key correlate of tobacco use prevalence in the United States, but this relationship has typically been examined in urban areas. We examined the relationship between retailer density and tobacco use across Kentucky counties, a state with high smoking rates and a substantial rural population.

Methods: We obtained a list of tobacco retailers from the 2021 Kentucky Synar program, used for minor’s access inspections. We merged these data with county-level prevalence estimates for cigarette and smokeless tobacco use for each county in Kentucky, calculated using pooled 3-year estimates (2017-2019) of Kentucky Behavioral Risk Factor Surveillance …

Acceptability And Appropriateness Of Harm Reduction Vending Machines Compared To Syringe Service Programs In Appalachian Kentucky, Hannah K. Knudsen, Jennifer R. Havens, April M. Young

Behavioral Science Faculty Publications

Objective:

Many rural people who inject drugs do not use syringe service programs (SSPs). In addition, people who use drugs but do not inject may perceive that SSPs are not intended for their use. Harm reduction vending machines (HRVMs) may be preferred by some individuals. This study examines attitudes and preferences regarding HRVMs to consider possibilities for enhancing the reach of harm reduction services. Method:

Structured surveys were conducted with 712 people who use drugs in two rural Appalachian counties in Kentucky. Participants rated the acceptability/appropriateness of SSPs and HRVMs; HRVM preference was the difference between the two scales. Linear …

Perceived Neighborhood Disadvantage And Current Nicotine Pouch Use Among U.S. Youth, Delvon T. Mattingly, Meman Diaby, Jing Zhang, Juhan Lee, Melinda J. Ickes

Behavioral Science Faculty Publications

Introduction: Nicotine pouches (NPs) are emerging nicotine products that appeal to youth due to their discreet use, tobacco-free formulation, and flavor availability. However, given their recent introduction to the market, little is known about how neighborhood environments may influence US youth NP use.

Methods: We imputed cross-sectional data from the 2023 National Youth Tobacco Survey (n = 22,069, ages 9 + years) and developed a neighborhood risk score (range: 1–4) by averaging 10 items related to neighborhood disorder, safety, and disadvantage. To estimate associations between the risk score and current (past 30-day) NP use, we fit logistic regression models adjusted …

Beyond Weak Ties In Prison: An Investigation Of Core Support Networks Of Incarcerated Persons, Siyun Peng, Martha Tillson, Maria Rockett, Marisa Booty, Carrie B. Oser

Behavioral Science Faculty Publications

Tie formation has been a core interest of network researchers. However, most existing research on tie formation in prisons has focused on weak ties, assuming that a core network approach is less applicable within total institutions such as prisons. Drawing on egocentric network data from 389 incarcerated individuals and 1352 named network members, this study demonstrates that relationships between incarcerated persons can be examined using a core support network framework. We find that about 20 % of participants include at least one incarcerated peer in their core support networks, with these ties providing both practical and emotional support comparable to …

Decreasing Prevalence In Youth Depressive Episodes: Evidence From The 2021-2024 National Survey On Drug Use And Health, R. Andrew Yockey, Aminul Apu, Timothy Grigsby, Jacob Bleasdale, Delvon T. Mattingly, Rachel Hoopsick

Behavioral Science Faculty Publications

Background: Major depressive disorder (MDD) is a leading contributor to the global burden of disease and commonly develops during adolescence. The COVID-19 pandemic was linked to significant increases in depressive symptoms among youth, but less is known about whether these increases have continued in recent years.

Objective: Using the first four consecutive years of methodologically comparable national data since the pandemic, we examined changes in past-year major depressive episode (MDE) among U.S. adolescents aged 12–17 years from 2021 to 2024 and evaluated demographic and substance use factors.

Methods: We analyzed pooled, cross-sectional data from the 2021–2024 National Survey on Drug …

Differences In The Use Of Smokeless Tobacco, Alcohol, And Co-Use Among U.S. High-School Students: Analysis Of National Youth Risk Behavior Survey Data, Ganna Kostygina, Yoonsang Kim, Alex Kresovich, Simon Page, Shyanika W. Rose, Sherry L. Emery

Behavioral Science Faculty Publications

Introduction: This study was aimed to examine the bidirectional relationships and patterns of concurrent smokeless tobacco and alcohol use among U.S. high-school students, investigating whether demographic characteristics and behavioral factors differentially predict concurrent versus single substance use of smokeless tobacco or alcohol (referred to as either-alone use in the remaining parts of this paper).

Methods: Analysis of nationally representative Youth Risk Behavior Survey data was perfomed, combining 3 cross-sectional surveys (2019, 2021, 2023) from 39,164 students in Grades 9–12. Logistic regression examined the bidirectional smokeless tobacco–alcohol associations, whereas multinomial models compared the characteristics of concurrent users, users of smokeless tobacco …

An Exploratory Study To Determine The Feasibility And Processes Needed To Implement The Immunization Neighborhood To Increase Hpv Vaccination Among African American Adolescents And Adolescents In The General Population: A Multi-Partner Perspective, Jennifer Cunningham-Erves, Freneka Minter, Pamela C. Hull, Amanda F. Dempsey, Alexandria Demons, Mariya Chalise, Consuelo H. Wilkins

Behavioral Science Faculty Publications

Limited education and healthcare access are major contributors to Human Papillomavirus (HPV) vaccination disparities among African American adolescents. The Immunization Neighborhood (IN) involves enhanced communication and collaboration among providers to address people’s needs by expanding access points and education to increase vaccination. Because needs of immunization providers and parents to effectively collaborate are unknown, this study explored the feasibility of and processes needed for IN utilization across key partners: pediatricians, pharmacists, school nurses, health department staff, and African American parent–child dyads. We conducted a semi-structured interviews in a qualitative, descriptive study with a purposive sample of 30 African American parent–child …

Extended-Release Vs Sublingual Buprenorphine In Pregnancy Through 12 Months Post Partum: A Randomized Clinical Trial, T. John Winhusen, Michelle R. Lofwall, Frankie Kropp, Daniel Lewis, Marcela C. Smid, Jessica L. Young, Candace Hodgkins, Elizabeth E. Krans, Zachary Hansen, Elisha M. Wachman, Davida M. Schiff, Constance Guille, Vania Rudolf, Tara Chowdhury, Lawrence Leeman, Mitra Lewis, Abigail G. Matthews, Gerald Cochran, Jacquie King, Christine Wilder, Carmen Rosa

Behavioral Science Faculty Publications

Importance: Treating opioid use disorder (OUD) in pregnancy with sublingual buprenorphine is an evidence-based practice, but it has disadvantages that could be addressed with an extended-release formulation.

Objective: To evaluate the effectiveness and safety of extended-release buprenorphine vs sublingual buprenorphine for OUD in pregnancy through 12 months post partum.

Design, Setting, and Participants: This 2-group, open-label, noninferiority, randomized clinical trial was conducted between July 2, 2020, and October 30, 2024, among adults with OUD and a singleton pregnancy of 6 to 30 weeks’ gestational age at 13 outpatient cross-disciplinary peripartum OUD treatment sites.

Interventions: Randomization to sublingual or extended-release buprenorphine …

Feeding The Family—A Food Is Medicine Intervention: Preliminary Baseline Results Of Clinical Data From Caregivers And Children, Gabriela Drucker, Christa Mayfield, Elizabeth T. Anderson Steeves, Sara Maksi, Tabitha Underwood, Julie Brown, Marissa Frick, Alison Gustafson

Behavioral Science Faculty Publications

Background/Objectives: Food is Medicine (FIM) programs have been shown to be effective at addressing food and nutrition insecurity among individuals. However, more evidence is needed to determine effective interventions at the household level and their impact on child health outcomes. Feeding the Family is a randomized controlled trial which aims to determine whether the amount of food provided and the ability to select foods in FIM interventions have an incremental effect on child and caregiver clinical outcomes relative to nutrition counseling alone. The objective of this paper is to describe the population at baseline among those enrolled in Feeding the …

Frequent Police Contact And Nonfatal Overdose Among People Who Use Drugs In Rural Appalachia, Javier A. Cepeda, Talia Loeb, Zach R. Salazar, Brittney D. Williams, Brooke Hiltz, Brandon Del Pozo, Eileen V. Pitpitan, Leo Beletsky, April M. Young, Jennifer R. Havens

Behavioral Science Faculty Publications

Introduction: Police contact shapes subsequent health practices and outcomes among people who use drugs (PWUD). However, the relationship between police encounters with overdose remains under-researched. We evaluated how police stop-and-search was associated with nonfatal overdose and identified correlates of frequent police contact among PWUD in rural Kentucky.

Methods: From May 2023– April 2024, 774 PWUD were enrolled in the Social Networks of Appalachian People and KyOSK studies. The exposure of interest was self-reported police stop-and-search in the past 6 months (0, 1–3, ≥4 times). The primary outcome was self-reported nonfatal overdose in the past 6 months. We evaluated the association …

Social Engagement Moderates The Relationship Between Cognitive Functioning, Depressive Symptoms, And Restless Sleep In Older Black Adults, Sunkanmi Folorunsho, Olufunmilola Abraham, Darlingtina K. Esiaka

Pharmacy Practice and Science Faculty Publications

INTRODUCTION: Older Black adults face higher dementia risk, but it is unclear whether social engagement offsets the effects of depression and restless sleep.

METHODS: We analyzed 1,905 Black adults aged 50+ from the 2016-2020 Health and Retirement Study (HRS). Linear mixed-effects models tested how depressive symptoms, restless sleep, and social engagement predicted baseline cognition and cognitive decline.

RESULTS: Higher depressive symptoms and restless sleep were associated with lower baseline cognition (about 0.2 and 0.5 points lower) and faster decline (β×time ≈ −0.07 and −0.05). Greater social engagement predicted higher baseline cognition (about 0.6 points higher) and slower decline (β×time ≈ …

Quick Improvement In Delirium In A Patient With Parkinson's Disease Through Rectally Administered Carbidopa/Levodopa: A Case Report, Emil Philip, Carol Elsakr, Tyler Kilgore

South Atlantic Division GME Research Days 2026

No abstract provided.

The Effects Of Childhood Maltreatment On Executive Functioning: The Difference Between Cumulative Trauma, Abuse Severity, And Neglect, Kelly Krehbiel

Master's Theses or Doctor of Nursing Practice

Childhood maltreatment is prevalent in the United States with around 558,899 children being victims of abuse in 2022 (U.S Department of Health & Human Services, 2024). Neglect is the most common form of abuse with around 74 percent of abused children being neglected; however, neglect tends to be the least researched form of abuse. Childhood maltreatment has long-term effects on a person’s mental, physical, and cognitive health. Previous research suggests that childhood maltreatment leads to severe deficits in executive functioning skills such as working memory and cognitive flexibility. Executive functioning skills are important for almost every aspect of life including …

Hungarian Validation Of The Pelvic Floor Distress Inventory - 20 (Pfdi-20) Questionnaire And The Pelvic Floor Impact Questionnaire - 7 (Pfiq - 7), Barbara Kozma, Bence Kozma, Peter Takacs, Dávid Rátonyi, Nelli Farkas, Attila G. Sipos, Balint Farkas

Department of Obstetrics & Gynecology Faculty Publications

Introduction and Hypotheses

Pelvic floor disorders (PFDs) affect women's quality of life through physical, psychological, and social domains. The Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7) are validated tools for assessing symptom severity and quality of life impact. The current study aim to investigate the reliability and validity of the Hungarian versions of these questionnaires in women with PFD symptoms.

Methods

This validation study was carried out at the University of Debrecen among women with clinically confirmed pelvic floor disorders. The PFDI-20 and PFIQ-7 questionnaires were translated into Hungarian using independent native English speaker in …

Prenatal Exposure To Nicotine And Postpartum Depression: A Systematic Review And Meta-Analysis, Reem Sharaf-Alddin, May Salama, Denise Mckinney, George Saade, Qi Zhang

Health Behavior, Policy & Management Faculty Publications

Purpose: Postpartum Depression (PPD) is the most common mental health complication of childbirth, and has short-term and long-term consequences for mother, child, and the entire family. PPD is a function of several factors. Prenatal exposure to nicotine (PEN) by Active Tobacco Smoking (ATS), Secondhand Smoking (SHS), or Electronic Nicotine Products (ENPs) is a major potential risk factor. This systematic review and meta-analysis aim to summarize and evaluate all evidence regarding the association between PEN and PPD.

Methods: We searched the following databases, PubMed, Medline, Cochrane, EMBASE, and CINHAL, for studies published between Jan.1st ,2000&Sep.19th ,2024, with the outcome PPD. Studies …

Cognitive Load Classification Using Functional Near-Infrared Spectroscopy, Pratham Shah

Theses and Dissertations (Comprehensive)

This thesis investigates the classification of cognitive load using functional near-infrared spectroscopy (fNIRS) signals recorded during an N-back working memory task. The study introduces a novel short-channel correction layer designed to suppress superficial physiological noise adaptively, addressing limitations of traditional General Linear Model (GLM) based regression. A single participant dataset comprising 69 validated sessions was analyzed using both conventional machine learning and deep learning approaches. Traditional classifiers: Linear Discriminant Analysis (LDA), Support Vector Machines (SVM), Random Forests, and Gradient Boosting were first evaluated using statistical features (mean, variance, peak, and slope). Among these, Gradient Boosting achieved the highest accuracy (55.6%), …