Behavior and Behavior Mechanisms Commons^™

Technology-Enabled Behavioral Health Integration Decreases Emergency Department Utilization, Adam Pardes, Rachelle Rene, Phansy Chun Chun, Mollie Cherson

Jefferson Hospital Staff Papers and Presentations

Background:

Behavioral health integration allows for patient-centered care, leads to higher levels of provider-patient engagement, and is key to improving patient outcomes. However, behavioral health integration is administratively burdensome and therefore is often not adopted. Technology presents opportunities to increase care team efficiency and improve patient outcomes. The goal of this study was to retrospectively compare clinical outcomes and emergency department utilization in patients using a technology platform compared to patients receiving treatment as usual.

Methods:

The technology platform, NeuroFlow, was deployed to deliver technology-enabled behavioral health integration in 30 clinics, and 598 electronic health records were analyzed.

Results:

In …

How Did The Dietary Habits Of Patients With Chronic Medical Conditions Change During Covid-19?, Sahil K. Patel, Adarsh Gupta

Rowan-Virtua School of Osteopathic Medicine Departmental Research

CONTEXT: Previous studies have examined the changes in the dietary habits of general populations during the COVID-19 pandemic but have not focused on specific populations such as those with chronic medical conditions (CMCs). Prior to major vaccination efforts, 96.1% of deaths were attributed to patients with preexisting CMCs, thus it is important to examine how this population has endured changes.

OBJECTIVES: The purpose of this study was to identify differences in dietary habits, lifestyle habits, and food attitudes between those with CMCs compared to the populations without chronic medical conditions (non-CMCs) since the beginning of the COVID-19 pandemic.

METHODS: An …

Suicide Numbers During The First 9-15 Months Of The Covid-19 Pandemic Compared With Pre-Existing Trends: An Interrupted Time Series Analysis In 33 Countries, Jane Pirkis, David Gunnell, Sangsoo Shin, Marcos Del Pozo-Banos, Vikas Arya, Pablo Analuisa Aguilar, Louis Appleby, S. M. Yasir Arafat, Ella Arensman, Murad Khan

Department of Psychiatry

Background: Predicted increases in suicide were not generally observed in the early months of the COVID-19 pandemic. However, the picture may be changing and patterns might vary across demographic groups. We aimed to provide a timely, granular picture of the pandemic's impact on suicides globally.
Methods: We identified suicide data from official public-sector sources for countries/areas-within-countries, searching websites and academic literature and contacting data custodians and authors as necessary. We sent our first data request on 22nd June 2021 and stopped collecting data on 31st October 2021. We used interrupted time series (ITS) analyses to model the association between the …

A Survey Study Of Speech-Language Therapists’ Experiences With Teletherapy At The Onset Of The Covid-19 Crisis, Jason A. Rosas

Dissertations, Theses, and Capstone Projects

The present study aimed to understand how delivering pediatric treatment services via ‘teletherapy’ affected speech-language therapists (SLTs) during the initial outbreak of the COVID-19 pandemic crisis in 2020. SLTs reported on their experiences with the change from in-person to remote service delivery via two national surveys distributed at the start of the pandemic between April 2020 and July 2020. To explain SLTs’ survey responses, this dissertation introduced the Professional Adaptation Model (PA Model). The PA Model facilitated evaluation of the SLTs’ professional environment and the psychological constructs of their professional identity believed to influence the transition to speech-language teletherapy. Specifically, …

Explicit And Implicit Emotion Processing In The Cerebellum: A Meta‑Analysis And Systematic Review, Jordan E. Pierce, Marine Thomasson, Philippe Voruz, Garance Selosse, Julie Péron

Center for Brain, Biology, and Behavior: Faculty Publications

The cerebellum’s role in affective processing is increasingly recognized in the literature, but remains poorly understood, despite abundant clinical evidence for affective disruptions following cerebellar damage. To improve the characterization of emotion processing and investigate how attention allocation impacts this processing, we conducted a meta-analysis on task activation foci using GingerALE software. Eighty human neuroimaging studies of emotion including 2761 participants identified through Web of Science and ProQuest databases were analyzed collectively and then divided into two categories based on the focus of attention during the task: explicit or implicit emotion processing. The results examining the explicit emotion tasks identified …

Digitized Thought Records: A Practitioner-Focused Review Of Cognitive Restructuring Apps, Drew Erhardt, John Bunyi, Zoë Dodge-Rice, Martha Neary, Stephen M. Schueller

All Faculty Open Access Publications

Mental health (MH) apps can be used as adjunctive tools in traditional face-To-face therapy to help implement components of evidence-based treatments. However, practitioners interested in using MH apps face a variety of challenges, including knowing which apps would be appropriate to use. Although some resources are available to help practitioners identify apps, granular analyses of how faithfully specific clinical skills are represented in apps are lacking. This study aimed to conduct a review and analysis of MH apps containing a core component of cognitive behaviour therapy (CBT)-cognitive restructuring (CR). A keyword search for apps providing CR functionality on the Apple …

Us Helping Us: The Evolution Of A Peer Support Group For Formerly Incarcerated People, Will Boles, Thad Tatum, Jarrod Wall, Lauren Nguyen, Alexandria Van Dall, Claire Mulhollem, Anna Sacks, Ashley Wennerstrom, Bruce Reilly, Anjali Niyogi

School of Medicine Faculty Publications

Introduction: Physical, psychological, and emotional trauma experienced while incarcerated influences subsequent mental health outcomes. Upon release, there is a fragmented landscape of mental health services and many of the existing services do not account for the root causes of challenges faced by formerly incarcerated people (FIP). To address the unmet social, psychological, behavioral, and emotional needs of FIP in Louisiana, the Formerly Incarcerated Peer Support (FIPS) Group developed a twelve-unit curriculum in 2019. Methods: We detail the evolution, development, and evaluation of the FIPS Group program. Additionally, we describe the community-driven process for developing the curriculum. Results: The FIPS Group …

The Effects Of Consumer Loan Application Formats And Advertised Terms On Consumer Borrowing Decisions, Alicia M. Johnson

Graduate Theses and Dissertations

Consumers continue to demonstrate a willingness to accrue more debt. They are also more accepting of increased repayment risk via the acceptance of longer loan terms. Extant research on consumer borrowing consists primarily of experiments designed to assess consumer choices and understand how consumers evaluate loan attributes in relation to one another within consumer borrowing contexts (Kamleitner, Hoelzl, and Kirchler 2012; Ranyard et al., 2006). Thus, prior research examines consumer responses to loan information rather than the generation of loan parameters at the time of financing. With important implications for consumers, marketers of financial products, academic researchers, and federal regulators, …

Discrete Choice Experiments In Agricultural And Food Economics: Two Essays On Information Provision Modalities, Uncertainty Adjustment, And Hypothetical Bias, Monsoïa Arsène Juste Agossadou

Graduate Theses and Dissertations

Stated discrete choice experiments are extensively used in applied economics to study preferences and valuation for new products, as well as costs and benefits of new policies and programs. Moreover, information provision experiments widely use the method to examine information effects on different outcomes. This thesis explores two methodological issues in discrete choice experiments: (i) information provision modalities and (ii) hypothetical bias. The first study examines the effect of information modality by testing the effect of using combined text script and audio clip (treatment) versus only text script (control) to convey information in discrete choice experiments. Specifically, the study elicits …

Church, Country, Culture: How Three Aspects Of Authoritarianism Predict Support For Donald Trump, Trenton Leslie

Graduate Theses and Dissertations

In the American bipartisan system, ideologies and beliefs create political views that sort voters between two groups. Political sorting increases polarization based on cultural preferences for an in-group that become ethnocentric views, which develop into ethnocentric cultural politics. I present an augmented concept of authoritarianism in America that encompasses sorting based on aspects of political belief, encapsulating sources of polarization and cultural attachments to political associations.

I develop the argument that authoritarianism is the result of political attachment to identities that feed off one another as individuals identify with an in-group, such as a party platform. My central theory is …

An Evaluation Of The Convergent Construct Validity Of The Boldness Inventory Of Psychopathy Using A Five-Minute, 10% Carbon-Dioxide-Enriched Air Challenge, Morgan Alexandra Hill

Graduate Theses and Dissertations

Psychopathy is a constellation of maladaptive interpersonal, affective, and behavioral features, including grandiosity, manipulativeness, emotional detachment, and impulsivity (Hare, 2003). Fearlessness, immunity to stress, self-assurance, and social dominance are considered to be adaptive features of psychopathy. Patrick and colleagues (2009) sought to reconcile differences between opposing conceptualizations of psychopathy by formulating a triarchic model of the condition. One core construct in this model, boldness, captures an ability to remain calm in the face of threat, an appetite for dangerous or risky activities, and an increased tolerance for uncertainty and danger. Boldness is believed to originate from differences in the brain’s …

Mentors In Violence Prevention: Differential Impacts On Adolescent Bystander Intentions About Bullying, Dating Violence, And Sexual Harassment, Ayla Mapes

Graduate Theses and Dissertations

Bystander approaches are promising interventions that can engage bystanders as prosocial allies to intervene in interpersonal violence situations among youth within school settings. The Mentors in Violence Prevention (MVP) bystander intervention program targets interpersonal violence using a peer-to-peer mentoring model to engage students in a discussion about violence prevention. Research on the MVP program is promising but limited. The current study examined the specificity of MVP intervention effects in two high school samples. The first was a pre/post-test design that included a smaller sample of high school students who participated in the MVP program in the 2013-2014 academic year. The …

The Influence Of Technostress On Hotel Guests, Samuel Lee

UNLV Theses, Dissertations, Professional Papers, and Capstones

The implementation of technology in the hospitality sector is rapidly growing. Although there are practical, economic, and experiential benefits of hospitality technology, the increased adoption of guest service technologies such as digital room keys, check-in kiosks, and service robots can also introduce friction points in a guest’s hotel experience. Technostress is any form of stress induced by the usage of technology and this study is among the first to apply this concept to consumer behavior. Based on the transactional model of stress and coping and social cognitive theory, this dissertation examined the effects of technostress on hotel guests, using a …

Three Essays About Preventing Mental And Behavioral Disorders, Snehal Lopes

All Dissertations

Prevention efforts in the public health field operate at various levels, including primary prevention among those without a disease of interest, secondary prevention among persons at high risk or showing early signs of the disease, and tertiary prevention among persons with the disease. The three essays presented in this dissertation are centered around the theme of prevention, and taken together, have implications for prevention at the primary, secondary, and tertiary levels. Specifically, the essays focus on the prevention of depressive disorders and the prevention of behavioral and mental health correlates for depression in the context of various populations (general adult, …

Examining P3 And N2 Amplitudes Following Social Exclusion And Provocation In College Students With High And Low Narcissistic Traits, Kathleen Ramsey

Dissertations

Adults with narcissistic traits are prone to reacting aggressively following provocation due to elevations in emotional reactivity and perceived threat to their grandiose self-views. Prior studies have examined event-related potentials (ERPs) measures in college students with narcissistic traits in the context of risky decision making and facial emotion processing; however, no known studies have examined how those with narcissistic traits react to rejection and provocation at the neurophysiological level during an externally valid social rejection task (i.e., Cyberball). For the purposes of this study, it was predicted that participants with higher levels of narcissistic traits (both total narcissism and grandiose …

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 …

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 …

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 …

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 …

Norepinephrine Regulation Of Spatial Memory Using The Barnes Maze In Male And Female Rats, Serena Simpson, Ali Gheidi Phd, Nareen Sadik, Cameron J. Davidson Phd, Shane A. Perrine Phd

Medical Student Research Symposium

The role of norepinephrine (NE) in learning and memory has been extensively studied, yet its contribution remains to be clarified. This study aimed to investigate the role of NE on spatial learning and memory in female and male rats using a Barnes maze assay. We used N-(2-chloroethyl)-N-ethyl-2-bromobenzylamine (DSP-4), a specific noradrenergic neurotoxin that can cross the blood brain barrier, to deplete NE stores. We hypothesized that brain NE ablation would attenuate spatial learning and memory in rats. Loss of NE by DSP-4 was determined by measuring NE (and dopamine and serotonin) levels in several brain regions using HPLC. For the …

The Role Of Reported Affective Symptoms And Anxiety In Recovery Trajectories After Sport-Related Concussion, Bernadette A. D'Alonzo, Abigail C. Bretzin, Douglas J. Wiebe, Ivy League–Big Ten Epidemiology Of Concussion Study Investigators, Arthur C. Maerlender, Cary R. Savage

Center for Brain, Biology, and Behavior: Faculty Publications

Background: There is growing awareness and clinical interest in athletes with affective symptoms after sport-related concussion (SRC), as these symptoms may contribute to overall symptoms and represent a modifiable risk factor of longer recovery. However, evidence of their effects on the entire return-to-play (RTP) trajectory, particularly among women and men, is limited.

Purpose/Hypothesis: To examine the relationship between affective symptom reporting and RTP progression after SRC among a cohort of Division 1 student-athletes. We hypothesized that those endorsing affective symptoms, specifically nervous-anxious symptoms, spend more time in RTP progression and recovery.

Study Design: Cohort study; Level of evidence, 3.

Methods: …

Age-Dependent White Matter Disruptions After Military Traumatic Brain Injury: Multivariate Analysis Results From Enigma Brain Injury, Heather C. Bouchard, Delin Sun, Emily L. Dennis, Mary R. Newsome, Seth G. Disner, Jeremy Elman, Annelise Silva, Carmen Velez, Andrei Irimia, Nicholas D. Davenport, Scott R. Sponheim, Carol E. Franz, William S. Kremen, Michael J. Coleman, M. Wright Williams, Elbert Geuze, Inga K. Koerte, Martha E. Shenton, Maheen M. Adamson, Raul Coimbra, Gerald Grant, Lori Shutter, Mark S. George, Ross D. Zafonte, Thomas W. Mcallister, Murray B. Stein, Paul M. Thompson, Elisabeth A. Wilde, David F. Tate, Aristeidis Sotiras, Rajendra A. Morey

Center for Brain, Biology, and Behavior: Faculty Publications

Mild Traumatic brain injury (mTBI) is a signature wound in military personnel, and repetitive mTBI has been linked to age-related neurogenerative disorders that affect white matter (WM) in the brain. However, findings of injury to specific WM tracts have been variable and inconsistent. This may be due to the heterogeneity of mechanisms, etiology, and comorbid disorders related to mTBI. Non-negative matrix factorization (NMF) is a data-driven approach that detects covarying patterns (components) within high-dimensional data. We applied NMF to diffusion imaging data from military Veterans with and without a self-reported TBI history. NMF identified 12 independent components derived from fractional …

Effects Of Chronic Stress On Safety Processing And Physiology In The Medial Prefrontal-Amygdala-Basal Forebrain Circuit, Itamar S. Grunfeld

Dissertations, Theses, and Capstone Projects

Chronic stress increases generalization of fear to non-threatening cues, a key symptom in numerous psychiatric mood disorders. However, the mechanisms through which stress impacts safety learning remain poorly understood. To probe the relationship between stress and safety learning, this dissertation employed multiple behaviors, in conjunction with in-vivo multisite physiology during explicit safety and fear discrimination learning. In Chapter 1, I outline the role of chronic stress in driving neurological adaptations that result in generalized fear and highlight how this occurs because of impaired safety cue encoding. In Chapter 2, I show that chronic stress in the form of social defeat …

Utility Of The Motivation To Change Lifestyle And Health Behaviors For Dementia Risk Reduction Scale (Mclhb-Drr) Based On A North American Sample, Angelina E. Witbeck

Dissertations

As the population ages, the prevalence rates of dementia continue to increase. Without a cure or promising treatment for dementia, the best course of lowering the prevalence rates of dementia is through preventative measures. Through an electronic survey, the study utilized the MCLHB-DRR scale to determine whether (1) gender, age, educational background, and socioeconomic status will impact the motivational factors to change lifestyle and health behaviors to reduce the risk of developing dementia and (2) direct experiences with individuals that have a dementia diagnosis are likely to impact one's motivational factors to change lifestyle and health behaviors to reduce the …

Implementation Of Nola Pender’S “Clinical Assessment For Health Promotion Plan” To Increase Patient Self-Efficacy, Weight Loss And Health Promoting Behaviors Such As Improving Nutrition And Increased Physical Activity In Obese Women In A Weight Loss Clinic, Christine Ngwazini

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to review research-based studies on Nola Pender’s Health Promotion Model for weight loss and implement the evidence. The goal was to increase patient self-efficacy, weight-loss, and health promoting behaviors such as improved nutrition and increased physical activity among obese women in a weight loss clinic.

Background: Obesity leads to an increased risk of heart disease, stroke, type 2 diabetes, cancer, and premature death (CDC, 2020). From 2016 to 2017, 42.4% of people in the United States were obese (2020). Worldwide, over 650 million people were obese …

The Significance Of Sonic Branding To Strategically Stimulate Consumer Behavior: Content Analysis Of Four Interviews From Jeanna Isham’S “Sound In Marketing” Podcast, Ina Beilina

Student Theses and Dissertations

Purpose:
Sonic branding is not just about composing jingles like McDonald’s “I’m Lovin’ It.” Sonic branding is an industry that strategically designs a cohesive auditory component of a brand’s corporate identity. This paper examines the psychological impact of music and sound on consumer behavior reviewing studies from the past 40 years and investigates the significance of stimulating auditory perception by infusing sound in consumer experience in the modern 2020s.

Design/methodology/approach:
Qualitative content analysis of audio media was used to test two hypotheses. Four archival oral interview recordings from Jeanna Isham’s podcast “Sound in Marketing” featuring the sonic branding experts …

How To Survive The Apocalypse: Using Film, Television, And Video Games As Gateways To Self-Analysis, Braeden Raymer

Theses - ALL

This thesis serves as an investigation on the use of film, television, and video games as access points for personal analysis in imagined scenarios. When creating a fictional world, characters' motivations and behaviors are often based on real-life experiences. In the apocalypse genre, understanding how a character might behave in such an extreme circumstance can be difficult to predict, considering few have lived through comparable conditions. To supplement personal experiences and observations, a creator might use other stories as gateways to self-examination. The investigation begins in film, exploring how stories provide a viewer with new experiences that they can then …

Comorbidity Burden And Covid-19 Vaccination Intention: Application Of The Health Belief Model, Michael Raymond

Honors Theses

The COVID-19 pandemic impacted many aspects of American’s lives causing over 79 million cases and over 950,000 deaths. Existing research shows severity of COVID-19 infection may be linked to number of underlying health conditions, known as comorbidities. The objective of this study was to determine if comorbidity burden was associated with intention to vaccinate against COVID-19. This relationship was looked at through the Health Belief Model (HBM) and its mediating variables of perceived susceptibility, perceived severity, perceived benefits, and perceived barriers. Our sample was compromised of 350 individuals recruited from an online platform who were not already vaccinated against COVID-19. …

Effects Of Waterborne Benzo[A]Pyrene Embryonic Exposure On Development, Behavior, Reproduction, And Mitochondrial Bioenergetics In Zebrafish, Megha Patel

Honors Theses

Benzo[a]pyrene (BaP) is a polycyclic aromatic hydrocarbon (PAH) that is a known carcinogen leading to adverse effects in the development of both humans and animals. BaP is also continuously present in the environment leading to regular exposure via inhalation or ingestion. Because organisms’ early life stages can be more susceptible to contaminant exposure, our focus was on BaP’s adverse impacts on survival, length, weight, behavior, bioenergetic state, and fecundity following developmental exposures. To study BaP’s impacts, zebrafish (Danio rerio) were used as a model organism. BaP is a ligand for the aryl hydrocarbon receptor (AHR in humans; Ahr in …

Reflective Journaling Intervention To Impact Self-Awareness, Professional Health, And Overall Well-Being In Nurses, Brittany M. Langan, Katherine Keppen

Doctor of Nursing Practice Projects: College of Nursing

Background. Burnout among nurses has been on the rise and was exacerbated with the pandemic. Reflective journaling after work may be a strategy to decrease feelings of burnout. Reflective journaling, as an intervention, has been shown to improve self-awareness, compassion fatigue, and burnout among nurses. The purpose of this study was to pilot a 4-week reflective journaling intervention in hospital-based nurses and describe participant professional quality of life, self-awareness, and overall well-being.

Theoretical Framework. The Theory of Reasoned Action (TRA) was chosen as the theoretical framework because it identifies the belief that performing a particular behavior will lead to a …