Mental Disorders Commons^™

The Primary Care Brief Intervention Competency Assessment Tool (Bi-Cat): Examining Reliability And Validity, Arielle Guillod

Dissertations

Within primary care, the Primary Care Behavioral Health (PCBH) model integrates behavioral health services into medical settings through brief, population‑based interventions delivered by behavioral health consultants (BHCs). Although effective performance in this role requires competencies distinct from traditional mental health practice, few psychometrically sound tools exist to assess clinical skills in primary care. The Brief Intervention Competency Assessment Tool (BICAT) is commonly used for this purpose but lacks published evidence supporting its reliability and validity. This dissertation examined the psychometric properties of the BICAT across two studies. Study 1 evaluated factor structure, internal consistency, and construct validity in a heterogeneous …

Silent Struggles: A Qualitative Study On Mental Health Stigma And Help- Seeking Among African Individuals In The U.S, Ololade Ekwere

Dissertations

Approximately one-third of African Americans and Caribbean Blacks who require mental health services seek and utilize them (Evans & Sheu, 2019). Research has shown that stigma surrounding mental health treatment contributes to lower rates of professional help-seeking among Black Americans (Pederson, 2023). Despite the growing diversity within the Black community, limited research exists on how stigma influences professional mental health help-seeking among Africans living in the United States.

The purpose of this qualitative descriptive study was to explore the effect of public stigma on the mental health help-seeking behaviors of Africans living in the United States. Demographic data were collected, …

Screening For Depression And Anxiety In Women With Polycystic Ovarian Syndrome, Nicole M. Bondurant

Dissertations

Background: Polycystic Ovarian Syndrome (PCOS) is a multifaceted endocrine disorder that affects up to 20% of women of reproductive age and is associated with an increased prevalence of psychiatric conditions, particularly depression and anxiety. Despite international guidelines recommending routine screening for these mental health conditions in women with PCOS, consistent implementation in clinical practice remains limited.

Methods: This quality improvement (QI) pilot project aimed to address this gap by developing and implementing a standardized screening protocol for depression and anxiety within a suburban concierge OB-GYN clinic specializing in women’s reproductive and sexual health using validated tools—the Patient Health Questionnaire-8 (PHQ-8) …

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 …

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 …

The Revolutionary St. Louis Insane Asylum, Julia Talbert

Undergraduate Research Symposium

Even with its grand structure on Arsenal Street towering over the city below, few residents of St. Louis and surrounding areas are aware of the grand history or even existence of the St. Louis Insane Asylum. The building is over 150 years old and was a place of hope, failure, strife, and empathy. The asylum had a large impact on St. Louis and provided revolutionary outlooks, unique perspectives, and curious therapies.

Missed And Prior Diagnoses In Children Later Diagnosed With Autism, Maire Diemer

Dissertations

Awareness of autism is rising, yet social determinants of health continue to impact rates, ages of diagnosis, and diagnostic load. Different psychiatric labels carry stigmas; unequal rates of diagnoses may indicate biases in the healthcare system. This study investigates six prior diagnoses (ADHD, disorders of conduct, adjustment, anxiety, mood, and intellectual disability) assigned to children who are later diagnosed with autism. The study investigates how race, sex, and geographic factors were associated with age of diagnosis and diagnostic load. This study utilized a sample of 13,850 children aged 2-10 who were diagnosed with autism on Missouri Medicaid between 2015 and …

Visualizing Depressive Symptom Improvement: Implementing The 17-Item Hamilton Depression Rating Scale, Briana Raterman

Dissertations

Visualizing Depressive Symptom Improvement: Implementing the 17-Item Hamilton Depression Rating Scale

Abstract

Problem

Depression, a mental health diagnosis, has affected about 18.5% of adults (Villarroel & Terlizzi, 2020). Ketamine, a medication initially used as an anesthetic, has improved depressive symptoms in individuals struggling with treatment-resistant depression.

Method

This quality improvement (QI) project used the 17-item Hamilton Depression Rating Scale questionnaire to assess depressive symptom changes in patients receiving intramuscular ketamine for treatment-resistant depression. The questionnaire was administered to patients pre-and post-intramuscular ketamine administration. The data was collected on injections one, three, and six on each participant’s set schedule of injections …

Life Matters, Marina Fischer

Dissertations

Problem: One of the challenges facing many primary care providers is managing hypertension. Hypertension contributes to cardiovascular disease events. Consequently, the high occurrence of hypertension related visits signifies a clinical practice gap in hypertension management resulting in substandard blood pressure outcomes. The purpose of this clinical scholarship project was to assess the difference of pre and post Quality of Life Scale (QOLS) scores in a hypertensive population.

Methods: This quality improvement project used a longitudinal, observational design with prospective data collection. The sample included newly diagnosed hypertensive adults ages 21 to 64 years old. The sample was administered the World …

Implementing A Depression Screening In A Pediatric Acute Care Setting For Adolescents With Type 1 Diabetes, Kelcie Marler

Dissertations

Problem: Depression among adolescents with Diabetes Mellitus type 1 (DM 1) is three times more prevalent than adolescents without chronic disease. Diagnosis of depression has been found to negatively affect the quality-of-care management, quality of life, and results in an increase in hospital admissions with hypoglycemia or hyperglycemia events.

Methods: A depression screening, the patient health questionnaire 9 (PHQ-9), a validated screening tool for use among adolescents was implemented in this quality improvement (QI) project. It was the first cycle of a plan-do-study-act (PDSA) cycle for in a pediatric ICU. Adolescents between the ages of 12 – 18, were …

Historical Trauma Response Scores As A Function Of Unresolved Grief And Substance Use Disorder In American Indian Populations, Andrew R. Saunders

Undergraduate Research Symposium

Abstract

Researchers are interested in the outcomes of interventions, specifically, measuring historical trauma (HT) among American Indian/Alaska Native communities and the long-term distress and substance abuse as a result of historical trauma response (HTR). Previous literature has implicated limitations in the clinical conceptualization of the relationship between intergenerational transfer of HTR and substance abuse. The aim of the current study is to examine treatment efficacy of 50 homosexual, American Indian males randomized to a culturally-adapted juxtaposition of (1) Group Interpersonal Psychotherapy (IPT), (2) Cognitive Processing Therapy (CPT), and (3) Historical Trauma and Unresolved Grief Intervention (HTUG), or (4) waitlisted on …

Improving Access To Mental Health Care With Nurse Practitioners, Jessica Whelan

Dissertations

Problem: Over 40% of those with mental illness are untreated since the supply of psychiatrists does not meet the demand. The psychiatric mental health nurse practitioner (PMHNP) may be an adjunct in providing those services. The purpose of this quality assurance study was to evaluate outcomes of care between a PMHNP and a psychiatrist (medical doctor [MD]).

Methods: An observational, descriptive design with a retrospective medical record review of adult patients over a six-month period in a suburban, Midwestern, privately owned psychiatric practice.

Results: A total of 787 individual patients encountered at least one visit (N=787) although 3,679 …

The Influence Of Stressful Life Events On The Development Of Type 2 Diabetes, Joshua Minks

Dissertations

This study examined the relationship between distress and the development of Type 2 diabetes mellitus (T2DM) in the presence of established risk factors. Distress secondary to mental health disparities, stressful life events, and work conditions has been shown to promote insulin resistance and the development of T2DM.

Subjects (N=79) diagnosed with T2DM within the previous six months were recruited from SSM Health Centers and VA Medical Centers in the greater St. Louis area. They completed the Recent Life Changes Questionnaire, ENRICHD Social Support Instrument, and a demographic survey and analyses were conducted to determine differences between the veteran …