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Mental Disorders Commons

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Mental and Social Health

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Articles 121 - 150 of 486

Full-Text Articles in Mental Disorders

Fda Approval Of Zuranolone: A Breakthrough Treatment For Postpartum Depression, Connor Dains, Makayla Eversole, Kiley Devoll, Daniella Egbujor, Marisa Petrunich, Madilyn Paphanchith, Joshua Honaker, Samantha Mccord, Manoranjan D'Souza Dec 2024

Fda Approval Of Zuranolone: A Breakthrough Treatment For Postpartum Depression, Connor Dains, Makayla Eversole, Kiley Devoll, Daniella Egbujor, Marisa Petrunich, Madilyn Paphanchith, Joshua Honaker, Samantha Mccord, Manoranjan D'Souza

Pharmacy and Wellness Review

Postpartum depression (PPD) is a serious medical condition that increases the risk of postpartum mortality and affects the ability of a postpartum individual to take care of their newborn. Until 2023, intravenously-administered brexanolone was the only Food and Drug Administration (FDA)-approved medication for PPD. Brexanolone’s route of administration poses significant barriers to accessibility and convenience. Other treatment options, such as psychotherapy and antidepressants, often require long-term commitment and may not provide rapid relief for severe symptoms. In August 2023, the FDA approved zuranolone as an oral medication for PPD, which enhances treatment accessibility and offers patients a more flexible, outpatient …


Learning To Be An Autistic Therapist: Personal Steps Towards An Autism-Affirming Psychotherapy, Sasha D. Strong Dec 2024

Learning To Be An Autistic Therapist: Personal Steps Towards An Autism-Affirming Psychotherapy, Sasha D. Strong

Ought: The Journal of Autistic Culture

How can Autistic therapists understand and support themselves, and how can this help them support their clients? In this paper, I recount my personal journey of healing and growth as an Autistic psychotherapist, 16 months after self-identification. Here is an overview of conceptual frameworks from #actuallyautistic authors, critical theory, queer theory, and social justice that I have found helpful. I also share some of the therapeutic and wellness approaches that have been important to me, including mindfulness and bodyfulness. Organic knowing has been pivotal for me in discerning between masking and aliveness, and regaining a choice around masking behaviors. This …


Cognitive Behavioral Therapy (Cbt) Interventions For Group Therapy For College Students Experiencing Depression, Ty Ogren Dec 2024

Cognitive Behavioral Therapy (Cbt) Interventions For Group Therapy For College Students Experiencing Depression, Ty Ogren

Dissertations, Theses, and Projects

This group manual was created to support college students struggling with a depressive mood disorder such as Major Depressive Disorder. The instance of mental health concerns, including depression, have increased greatly over the last several years. Depression is the most common mental health concern for college students, and the rate at which they experience depressive symptoms has exceeded that of the general population. Depressive symptoms in college students can lead to many concerns like poor academic achievement, self-isolation, poor diet and nutrition, and suicidal ideation (Liu et al., 2022). This group manual aims to equip college students struggling with depression …


Factors Associated With Cognitive Flexibility In People With Opioid-Use Disorder: A Pilot Study, Paul S. Regier, Thais Costa Macedo De Arruda, Laura Sinko, Anne M. Teitelman, Anna Rose Childress Dec 2024

Factors Associated With Cognitive Flexibility In People With Opioid-Use Disorder: A Pilot Study, Paul S. Regier, Thais Costa Macedo De Arruda, Laura Sinko, Anne M. Teitelman, Anna Rose Childress

College of Nursing Faculty Papers & Presentations

The ability to adapt to changing circumstances has strong survival value. Individuals with substance use disorders tend to get "stuck" over-responding to drug-reward signals and pursuing drugs despite negative consequences. A lack of flexibility may be tied to impairments in neurocognition, including learning, memory, and executive function. However, results are often mixed, potentially due to heterogeneity in factors such as mental health, personality traits, or prior adversity. This study aimed to identify which factors influence neurocognitive variations within the opioid use disorder (OUD) population. Based on prior literature, we hypothesized that individuals with OUD would show deficits (vs. controls) in …


Exploring The Role Of Yoga In Improving The Quality Of Life Among Patients Diagnosed With Schizophrenia And Intellectual Disability, Laura Tolbaños-Roche Dec 2024

Exploring The Role Of Yoga In Improving The Quality Of Life Among Patients Diagnosed With Schizophrenia And Intellectual Disability, Laura Tolbaños-Roche

Journal of Applied Yoga Studies

Background and objectives

There is large evidence of the positive effect of yoga in mental health disorders, mainly anxiety and depression. However, the studies on the role of yoga in schizophrenia and intellectual disability are sparse and inconclusive. The objective of this study is exploring the role of a specific yoga intervention, based on the Gitananda Rishiculture Asthanga Yoga Tradition, in improving the quality of life (QoL) of patients diagnosed with schizophrenia and intellectual disability in a mental health institution of Las Palmas de Gran Canaria (Spain).

Methods

Patients diagnosed with schizophrenia (n=5) and patients diagnosed with intellectual disability (n=4) …


Improving Outcomes Of Patients Being Seen In The Emergency Room For Mental Health Crisis, Kimberly Hudson Dec 2024

Improving Outcomes Of Patients Being Seen In The Emergency Room For Mental Health Crisis, Kimberly Hudson

Doctoral Projects

Mental health is a significant problem, especially in males aged 20 to 50 years old (Omary, 2019). Lack of a primary mental health care provider, lack of proper treatment and follow up appointments for this population, and bottlenecking patients in the emergency room are all factors that contribute to the problem. As a result, these patients experience negative outcomes such as not receiving proper care and/or causing harm to themselves or others. In this doctoral project we will explore the option of patients having better outcomes if seen immediately by a psychiatric health care provider.

Having psychiatric healthcare providers in …


Effect Of Pilot Mental Health On Passenger Willingness To Fly, Isabella L. Deloach, Sara E. Bergamini, Dowon Choi, Brooke Wheeler, Vivek Sharma Dec 2024

Effect Of Pilot Mental Health On Passenger Willingness To Fly, Isabella L. Deloach, Sara E. Bergamini, Dowon Choi, Brooke Wheeler, Vivek Sharma

Aeronautics Student Publications

This study explored how passengers' willingness to fly is affected by the mental health condition of pilots, providing insight into public perception of the mental health condition of pilots. Results showed significant differences between all scenarios except the medication scenario vs. therapy scenario.


Comprehensive Community Medicine, Alexander Walther Dec 2024

Comprehensive Community Medicine, Alexander Walther

Capstone Projects and Master's Theses

Comprehensive Community Medicine (CCM) is a theoretical framework designed to address the complex needs of individuals with dual diagnoses of mental illness and substance use disorders (SUDs). Dual diagnosis is highly prevalent, particularly among populations experiencing homelessness, and is associated with poorer health outcomes and increased healthcare service utilization. Structural inequities, including a fractured healthcare system, exacerbate the challenges faced by this vulnerable group. Research indicates that effective care for dually diagnosed individuals requires a layered approach addressing clinical, systemic, legal, and housing barriers.

The development of CCM has been informed by interviews with local stakeholders, including County EMS board …


Bridging The Gap: Fostering Open Dialogue On Resource Access And Service Needs, Cameron Castillo Dec 2024

Bridging The Gap: Fostering Open Dialogue On Resource Access And Service Needs, Cameron Castillo

Capstone Projects and Master's Theses

This project investigates whether there are additional resources desired by clients or are needed to better support said clients in their recovery at the Interim, Inc. organization. This agency is a nonprofit organization whose sole purpose is to build community connections through providing services to individuals facing mental health and substance use challenges. While there is a wide range of programs available, there may still be clients with unmet needs. The purpose of this project was to identify any service gaps by conducting separate surveys of clients and staff members. Through the use of open-ended questions, the expectation of receiving …


Effectiveness Of Interventions To Address Nursing Students' Mental Health: An Integrative Review, Aimee Dickson, Shelby Carter Nov 2024

Effectiveness Of Interventions To Address Nursing Students' Mental Health: An Integrative Review, Aimee Dickson, Shelby Carter

Master's Projects

Background:

The rigors of the nursing school curriculum are associated with higher levels of stress, anxiety, and depression, resulting in unhealthy habits and ineffective coping strategies that lead to initial difficulties in the academic environment and burnout as professional nurses advance into their careers. This phenomenon further burdens the already taxed workforce, leading to ongoing turnover and compromising care. This integrative review aims to look at what coping strategies have proven most successful in fostering nursing students' well-being, leading to lifelong practices that promote strength while addressing the rigors of academia and, later, the workforce.

Methods:

The literature review search …


Is Warmer Better? Examining Counseling Student Responses To Syllabus Tone, Angela I. Sheely-Moore, Leeann Cardaciotto, Krista Malott, Megan Krell, Carlos A. Flores Nov 2024

Is Warmer Better? Examining Counseling Student Responses To Syllabus Tone, Angela I. Sheely-Moore, Leeann Cardaciotto, Krista Malott, Megan Krell, Carlos A. Flores

Journal of Counselor Preparation and Supervision

Researchers in this quantitative study explored the impact of syllabus tone on master-level counseling students (N = 124). Findings indicate statistically significant differences between students’ reactions to syllabi language, with greater student retention of the content within the warm syllabus condition and more favorable perceptions of the instructor and their grading practices. Implications for counselor educators are included.


The "Ableism'' Behind Mental Health Professionals' Perceptions Of Support, Hideki Muramatsu Nov 2024

The "Ableism'' Behind Mental Health Professionals' Perceptions Of Support, Hideki Muramatsu

Patient Experience Journal

This paper presents the personal narrative of the author, an individual who has experienced personal and clinical recovery from mental health difficulties. Diagnosed with a mental disorder (NEUROTIC; ICD-10) during my university years, I endured cognitive dysfunction, panic disorder, derangement of ego, suicidal ideation, and depression. Despite these challenges, I have actively engaged in social skills training, supervised virtual reality content, led self-help groups, and published papers on my experiences. I will discuss my own experiences as an expert-by-experience and describe the tendencies of professional ableism consciousness that I encountered during my journey of recovery. Through the lens of my …


Psychosis And Personality Changes Following Traumatic Brain Injury, David Hanna, Sonya Priven, Nathan Carroll, Heba Ekladios, Adriana Fitzsimmons Nov 2024

Psychosis And Personality Changes Following Traumatic Brain Injury, David Hanna, Sonya Priven, Nathan Carroll, Heba Ekladios, Adriana Fitzsimmons

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Psychotic disorders following traumatic brain injury (TBI) are a significant concern in psychiatry, with chronic sequelae often overlooked. The pathophysiology of post-TBI psychosis involves neuroplasticity and neuronal remodeling, potentially exacerbating vulnerabilities to chronic psychotic disorders. Differentiating post-TBI psychosis from primary schizophrenia and other psychotic conditions is crucial for appropriate treatment. This case report discusses a 63-year-old male with a history of TBI from a gunshot wound sustained in adolescence, who later developed schizophrenia. The report explores the patient's psychiatric symptoms, cognitive dysfunction, personality changes, and imaging findings. The report examined the complex relationship between TBI and psychotic symptoms, considering genetic, …


Neural Correlates Of Socially Rewarding Memories In Posttraumatic Stress Disorder, Kyle P. Blidy Oct 2024

Neural Correlates Of Socially Rewarding Memories In Posttraumatic Stress Disorder, Kyle P. Blidy

MUSC Theses and Dissertations

Significance. Memory disturbances for emotional content are central to PTSD, yet most research focuses on trauma memories. Recent evidence suggests that enhancing access to positive memories could improve mood, affect regulation, self-esteem, and integration of trauma memories. However, the neurocognitive mechanisms underlying positive memory encoding in PTSD are poorly understood. No study has examined memory for positive social items in PTSD, which is important because PTSD entails social withdrawal and reduced accessibility to positive memory. Additionally, positive memories embedded in a social context have enhanced subjective value and strengthening their accessibility may confer greater benefits to wellbeing compared to non-social …


The Role Of The Basolateral Nuclear Complex & Central Nucleus Of The Amygdala In Fear-Conditioned Responses To External Stimuli And Anxiety Responses, Oluwaseyi A. Adelakun Oct 2024

The Role Of The Basolateral Nuclear Complex & Central Nucleus Of The Amygdala In Fear-Conditioned Responses To External Stimuli And Anxiety Responses, Oluwaseyi A. Adelakun

Senior Theses

This thesis reviews the role of the amygdala, particularly the basolateral nuclear complex (BLA) and central nucleus (CeA), in fear-conditioned responses and generalized anxiety disorder (GAD). By investigating the neurological and physiological mechanisms that influence the amygdala’s fear and anxiety responses, further connections can be made between this region and other notable brain regions, like the prefrontal cortex (PFC). We review both human and rodent models to explore the overlap between the two and explore various therapeutic interventions that regulate amygdalar activity and therefore mitigate anxiety symptoms. Key research into the patient SM, who lacks fear responses due to bilateral …


A Brief Review Of Zuranolone, Aubrey A. Jackson Sep 2024

A Brief Review Of Zuranolone, Aubrey A. Jackson

Transformative Medicine

Zuranolone, a novel analog of allopregnanolone, has been approved by the U.S. Food and Drug Administration (FDA) as the first oral medication approved for the treatment of postpartum depression in adults. Developed by Sage Therapeutics under the brand name Zurzuvae, zuranolone was approved by the FDA on August 4th, 2023.1 Zuranolone is a modified version of brexanolone (sold under the brand name Zulpresso), an intravenously administered allopregnanolone formulation that was previously the only FDA-approved medication for postpartum depression. Zuranolone offers a more accessible treatment option for patients with efficacy established in clinical trials. Its approval expands the …


Providing End-Of-Life Counseling: A Narrative Inquiry, Carol Hecht, Sibyl West Sep 2024

Providing End-Of-Life Counseling: A Narrative Inquiry, Carol Hecht, Sibyl West

Adultspan Journal

This qualitative study aimed to address the gap in the research related to end-of-life counseling by exploring the experiences of counselors working with clients at end of life. While counseling literature and education are lacking regarding end of life, many counselors will work alongside clients approaching death. The purpose of this study was twofold: (a) to better understand the nuanced experiences of counselors providing end-of-life counseling and (b) to explore the supports and preparations helpful for counselors to provide end-of-life counseling. A narrative approach, using the Listening Guide (Gilligan, 2015), was employed to analyze and present the stories of three …


Considerations Of Medicare Telehealth Services With Older Adults, Sonah Kho, Amanda Dediego Sep 2024

Considerations Of Medicare Telehealth Services With Older Adults, Sonah Kho, Amanda Dediego

Adultspan Journal

The onset of the COVID-19 pandemic set in motion a rapid expansion of mental health services offered via telehealth. With this rapid expansion came the need to examine how policy and practice should be shaped in a future where telehealth is considered common in counseling practice. For counselors to understand how to support older adult clients in using telehealth services, they must understand telehealth policy. Following the eligibility of licensed counselors to participate in Medicare, counselors need to stay abreast of regulatory changes regarding restrictions and regulations on use of telehealth for mental and behavioral health services, including video and …


Postpartum Depression Screening In The Neonatal Intensive Care Unit At A Tertiary Pediatric Hospital, Abbie Bates Aug 2024

Postpartum Depression Screening In The Neonatal Intensive Care Unit At A Tertiary Pediatric Hospital, Abbie Bates

Doctor of Nursing Practice Final Manuscripts

POSTPARTUM DEPRESSION SCREENING IN THE NEONATAL INTENSIVE CARE UNIT AT A TERTIARY PEDICTRIC HOSPITAL

By

Abbie Kim Bates

Razel Bacuetes Milo, PH.D. DNP., FNP-C

Background: Postpartum depression (PPD) is a treatable mood disorder with an onset at 1-3 months after childbirth. In the United States, PPD occurs at a rate of 1 in 8 women and as high as 1 in 5 women in parts of the country. In unique populations such as the neonatal intensive care unit (NICU), PPD rates can be as high as 40%. The treatment rate for PPD is 50% with a sizable percentage of …


Adverse Childhood Experiences And Effects On Delinquency, Katherine Lank Aug 2024

Adverse Childhood Experiences And Effects On Delinquency, Katherine Lank

Master of Arts in Human Services

Youth involved in delinquent acts are seen interacting with the juvenile justice system at an alarming rate. Adverse childhood experiences influence the development of behavior and chances of taking risks. Children who grow up in a household with an unfit parent, substance abuse, or mental health disorders are seen turning to delinquent acts for gratification. This can have a higher chance of poor educational performance, unemployment, increased law enforcement interactions, and long-term mental and physical disabilities. Searching literature consisted of finding external factors and their control on brain development and future adult behaviors. Research was conducted on the school-to-prison pipeline, …


Using Fink’S Taxonomy In Counseling Practicum And Internship Courses, Kailey Bradley, Emily Horton Phd Aug 2024

Using Fink’S Taxonomy In Counseling Practicum And Internship Courses, Kailey Bradley, Emily Horton Phd

Journal of Counselor Preparation and Supervision

Fink’s Learning Taxonomy expanded upon Bloom’s Learning Taxonomy to provide concrete suggestions on development of significant learning experiences. Limited research exists on implementation of Fink’s learning Taxonomy in counselor education curriculum. As such, this conceptual article illuminates how the integration of Fink’s Learning Taxonomy could be used by educators to develop significant learning experiences within counseling internship and practicum courses.


Stigma Reduction And Resiliency Training For First Responders (Srrt-Fr): A Feasibility And Initial Efficacy Evaluation, Thalia P. Nicholson Aug 2024

Stigma Reduction And Resiliency Training For First Responders (Srrt-Fr): A Feasibility And Initial Efficacy Evaluation, Thalia P. Nicholson

Electronic Theses and Dissertations

First responders, especially law enforcement, frequently encounter individuals experiencing substance use concerns. Previous research has documented that a greater understanding of substance use disorders promotes a decrease in stigmatizing perspectives. We present a novel approach to training law enforcement officers to improve their interactions with community members exhibiting substance use disorders, while also promoting their professional well-being. The present study sought to evaluate the feasibility and acceptability of the Stigma Reduction and Resiliency Training for First Responders (SRRT-FR) in a sample of law enforcement officers, as well as its efficacy in decreasing stigmatizing perspectives towards substance use disorders and increasing …


Self-Harm In Female Youth With Undiagnosed Adhd: Implementing American Academy Of Pediatrics Screening Guidelines, Roselie M. Woodard Jul 2024

Self-Harm In Female Youth With Undiagnosed Adhd: Implementing American Academy Of Pediatrics Screening Guidelines, Roselie M. Woodard

Dissertations

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. If undiagnosed or untreated, ADHD can lead to severe psychosocial issues such as academic failure, substance abuse, unplanned pregnancy, and incarceration. The financial burden in the U.S. from diagnostic errors creates an immense, rising fiscal impact. Early diagnosis and management are crucial to prevent these complications.

Females with ADHD, particularly those with the inattentive subtype, often face diagnostic challenges due to symptom masking and over-compensation. This results in poorer cognitive functioning and self-esteem compared to males with ADHD. ADHD is linked to autonomic nervous …


A Confirmatory Factor Analysis Of The Psi-4-Sf In Parents Of Children With Autism Spectrum Disorder, Paige Weir Jul 2024

A Confirmatory Factor Analysis Of The Psi-4-Sf In Parents Of Children With Autism Spectrum Disorder, Paige Weir

LSU Doctoral Dissertations

The factor structure of the Parenting Stress Index - Short Form (PSI-4-SF) was evaluated among parents of children with autism spectrum disorder (ASD). Two hypotheses were tested: (1) the original PSI-4-SF model would yield an unsatisfactory fit, and (2) a three-factor alternative model would improve fit compared to the original and other models. A sample of 205 parent-child dyads was analyzed using confirmatory factor analysis (CFA) with the lavaan package in R Studio. Preliminary analyses included descriptive statistics, normality checks, and assessments of skewness and kurtosis. Results supported the first hypothesis, showing poor fit indices for the original PSI-4-SF model. …


Depression Screening And Education For Immigrants To Increase Access To Care, Viktoriya Ivantsova Jul 2024

Depression Screening And Education For Immigrants To Increase Access To Care, Viktoriya Ivantsova

Dissertations

Abstract

Problem: Immigrants are at risk for developing mental health disorders due to multiple factors including social, cultural, or economic factors. This can result in a lower quality of life and an increased chance of further disabilities. Although immigrants are at increased risk for the development of mental health disorders, studies show that utilization of available services and resources are low. Additionally, organizations that provide services to immigrants may not be implementing screening and psychoeducation.

Methods: This quality improvement (QI) project followed a descriptive, observational design along with an educational intervention. Using convenience sampling for recruitment, Russian and/or Ukrainian adults …


Psychosocial And Mental Health Challenges Facing Perinatally Hiv-Infected Adolescents Along The Kenyan Coast: A Qualitative Inquiry Using The Socioecological Model, Stanley W. Wanjala, Moses Nyongesa, Stanley Luchters, Amina Abubakar Jul 2024

Psychosocial And Mental Health Challenges Facing Perinatally Hiv-Infected Adolescents Along The Kenyan Coast: A Qualitative Inquiry Using The Socioecological Model, Stanley W. Wanjala, Moses Nyongesa, Stanley Luchters, Amina Abubakar

Institute for Human Development, East Africa

Background: The advent of antiretroviral therapy has led perinatally HIV-infected (PHI) adolescents to live long, fulfilling lives through lifelong treatment. However, there is limited knowledge about the lived experiences and psychosocial and mental health challenges faced by PHI adolescents in sub-Saharan Africa, where 80% of PHI adolescents reside. To address this gap, we adapted the socioecological model to investigate the challenges and lived experiences of PHI adolescents in rural coastal Kenya.

Methods: Between October and November 2018, a sample of 40 participants (20 PHI adolescents and their 20 primary caregivers) participated in a qualitative study using an H-assessment data collection …


What Are The Psychosocial Effects Of Service Dogs On Handlers With Disabilities, Kylie Kline Jul 2024

What Are The Psychosocial Effects Of Service Dogs On Handlers With Disabilities, Kylie Kline

University Honors Theses

This study looks to explore the psychosocial effects that service dogs have on handlers with disabilities. A cross-sectional survey designed to gather information about this directly from service dog handlers was administered to a sample of 20 participants. Then, a qualitative analysis was conducted on data from the survey using an inductive coding scheme that identified themes in the data as key terms and ideas emerged.

Results revealed many nuances surrounding service dogs' effects on handlers' psychosocial health. Notable results include: 20 of 20 participants (100%) reporting their service dogs have had positive impacts on their quality of life; 19 …


Prenatal Maternal Depression In Canada: Are Current Protocols Adequate?, Britney A. Glasgow-Osment, Farah Wahib, Madeleine Zanin, Shama Kassam Jun 2024

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 …


Who Should Pay The Bill For The Mental Health Crisis In Africa?, Cyprian Mostert, Olivera Nesic Taylor,, Chinedu Momoh, Murad M. Khan Dr., Thomas Thesen, Edna Bosire, Dominic Trepel, Karen Blackmon, Manasi Kumar, Zul Merali Jun 2024

Who Should Pay The Bill For The Mental Health Crisis In Africa?, Cyprian Mostert, Olivera Nesic Taylor,, Chinedu Momoh, Murad M. Khan Dr., Thomas Thesen, Edna Bosire, Dominic Trepel, Karen Blackmon, Manasi Kumar, Zul Merali

Brain and Mind Institute

No abstract provided.


Family Fragments: Pressure And Proximity In First-Episode Psychosis, Cassandra B. Seltman Jun 2024

Family Fragments: Pressure And Proximity In First-Episode Psychosis, Cassandra B. Seltman

Dissertations, Theses, and Capstone Projects

This study explores the value of assuming a position that decenters the identified patient in families with a member with schizophrenia. Instead, a systemic view of the family is taken, as subject to pressures from without and within, and utilizing observable processes for the management and discharge of tension. It attempts the difficult balance of thinking dynamically without sacrificing scientific rigor, considering the social without discounting the biological, and exploring the functionality of the family without collapsing into blame, reductive cause-and-effect thinking, and the search to prioritize one true origin.

When treating family members as discrete units around an identified …