Mental Disorders Commons^™

The Relationship Between Depression And Cognitive Proficiency Index Across Biological Sex, Angela N. Ferdinardo

Dissertations

Depression is a widely studied mood disorder, and understanding its effect on cognitive functioning has become an important area of research. While research has examined relationships among depression, working memory, and cognitive deficits, limited research has explored depressive symptoms and cognitive proficiency across biological sex. Depression manifests similarly in men and women, though men are more likely to experience irritability, impulsivity, and anger, while women tend to experience sadness, stress, and sleep disturbances (Johns Hopkins Medicine, 2023). Women are also more likely to seek treatment and cope differently than men. This study examined the relationship between depression and cognitive proficiency …

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 …

Exploring Primary Care Providers’ Compassionate Care And Their Evidence-Based Practice With Death, Grief, And Loss: Patient Experience And Perspective, Kathryn Krzykala

Dissertations

Research on primary care providers’ (PCPs) education regarding Death, Grief, and Loss (DGL) remains limited. Specifically, data is lacking regarding patients' perceptions and opinions on what they need and expect from their PCPs regarding grief and loss. This exploratory mixed-method study comprised 146 participants who had experienced death and non-death loss. It examined participants' perceptions of 1) PCP compassion, 2) PCP utilization of evidence-based grief and loss practices, 3) their own level of comfort discussing DGL with their PCPs during medical visits, and 4) their personal grief and loss experiences. The findings revealed that PCPs' grief-informed evidence-based treatment, as reflected …

Evaluation Of Neuroplastic Changes In Psychological Intervention And Contemporary Treatments Of Depression, Taylor Severance

Dissertations

Major depressive disorder is one of the most prevalent mental health disorders worldwide. There is a vast range of treatment options for depression, with varying levels of effectiveness. Recent treatments for depression have expanded, increasing alternative treatments, and it is unknown which treatments have the largest impact on depression. This research was designed to examine the treatments of depression, with a focus on psychotherapy and contemporary treatments such as ketamine, psilocybin, and transcranial magnetic stimulation. A literature review was conducted to assess treatment outcomes and neuroplastic changes in these interventions, as well as combinations of the interventions. Data were evaluated …

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 …

A Review Of The Role Of Anxiety In Diagnosis Of Children And Adolescents With Autism Spectrum Disorder: A Paradigm Shift In Conceptualization And Diagnosis, Evan Wahlquist

Dissertations

Early evidence of co-occurring anxiety symptoms in children and adolescents with autism spectrum disorder (ASD) dates back to the first descriptions of ASD by Leo Kanner (1943) and Hans Asperger (Frith & Mira, 1992). While current research has identified anxiety disorders as one of the most prevalent co-occurring disorders in children and adolescents with ASD, little is known about the nature of the relationship between these disorders. In an effort to explain these high prevalence rates, recent research has started to investigate the relationship between these two disorders. To join these efforts, this clinical research project explored the role of …

Hippocampal Volume And The Detection Of Mild Cognitive Impairment In An Older Adult Population: Assessing Performance On Cognitive Screeners Administered In-Person And Electronically, Kristen Fabrizi

Dissertations

The present study investigated how performance on in-person and electronic neuropsychological assessment measures predicted subcortical hippocampal volume and cognitive decline consistent with mild cognitive impairment. It was hypothesized that the Montreal Cognitive Assessment would display better predictive strength than the Cogstate Brief Battery when evaluating subcortical hippocampal volume measured via structural magnetic resonance imaging. It was further hypothesized that the Montreal Cognitive Assessment would be more sensitive to predicting group membership to the diagnostic classification of mild cognitive impairment compared to the Cogstate Brief Battery. The sample included 445 older adult participants selected from the Alzheimer’s Disease Neuroimaging Initiative 3. …

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 …

Anxiety And Agitation In Adult Patients Admitted To An Emergency Room During The Covid-19 Pandemic, Doris L. Asombrado

Dissertations

Purpose: The purpose of this retrospective correlational study was to identify the relationship between COVID-19 status and the prevalence of anxiety-agitation with select sociodemographic and clinical characteristics in adults admitted to the ED during the pandemic (03/01/2020 through 12/31/2020).

Background: COVID-19 infections combined with the WHO and CDC recommendations to mitigate spread have had deleterious psychosocial and economic outcomes with the risk of subsequent COVID-19 related mental illness. Studies indicate one in three adults experience anxiety or depression.

Methods: This retrospective correlational study reviewed 2,572 psychiatric admissions from a Southern California ED during the pandemic from March 1, 2020 through …

Single-Case Pilot Study For Longitudinal Analysis Of Referential Failures And Sentiment In Schizophrenic Speech From Client-Centered Psychotherapy Recordings, Travis A. Musich

Dissertations

Though computational linguistic analyses have revealed the presence of distinctly characteristic language features in schizophrenic disordered speech, the relative stability of these language features in longitudinal samples is still unknown. This longitudinal pilot study analyzed schizophrenic disordered speech data from the archival therapy audio recordings of one patient spanning 23 years. End-to-end Neural Coreference Resolution software was used to analyze transcribed speech data from three therapy sessions to identify ambiguous pronouns, referred to as referential failures, which were reviewed and confirmed by multiple raters. Speech samples were analyzed using Google Cloud Natural Language API software for sentiment variables (i.e., score, …

Lifestyle Choices Related To Food Consumption And Their Relationship To Depression, Steven L. Jennings Jr.

Dissertations

Dieting, or the act of restricting oneself to small amounts or particular kinds of foods on the basis of health, spirituality, lifestyle, and moral decisions, is a practice that dates to 1066 A.D. However, with social media being as influential as it is, one might believe dieting is a new obsession or at least an obsession to which popular culture is returning. Despite this, it is only in recent years that researchers have begun to focus on the health benefits of such behaviors. The present study was designed to take this focus a step further by exploring the potential risks …

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 …

Mental Health Treatment In Juvenile Correctional Facilities: Utilizing Assessment To Inform Treatment, Sarah Riccio

Dissertations

Youth in juvenile correctional facilities face a wide range of mental health difficulties. Over the years, the juvenile justice system has prioritized the need for providing appropriate and effective treatment services to youth throughout their detainment. Despite these ongoing efforts, treatment practices in juvenile correctional facilities continue to fall short. This study will first focus on assessment practices within these facilities and the impact current practices have on diagnosis and subsequent treatment. Emphasis will be placed on the importance of comprehensive evaluations for informing diagnosis and determining the individual treatment needs of detained youth. An integrated approach to assessment will …

Exploration Of Patient Variables And Characteristics Best Suited For Medical Marijuana Treatment For Anxiety And Depressive Disorders, Corey Gazoo

Dissertations

Individuals with posttraumatic stress, anxiety and depressive disorders are currently being prescribed medical marijuana as a treatment in many states across the United States. However, marijuana is still considered a schedule one narcotic by the Drug Enforcement Administration and federal government, which provides several barriers and challenges to conduct research such as approval from the U.S. Food and Drug Administration and following guidelines from the National Institute on Drug Abuse issued by the DEA. Additionally, individuals prescribed medical marijuana for mental health disorders are not always thoroughly instructed on the type of medical marijuana, the dosage, and how frequently to …

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 …

Examining Treatment Acceptability Of An Eight-Week Mindfulness-Based Stress Reduction Protocol, Blake William Palmer

Dissertations

The goal of this study is to examine whether levels of perceived stress, experiential avoidance, personality traits including openness to experience and agreeableness, and demographic variables will predict the treatment acceptability (indicated by responses on the Treatment Acceptability and Adherence Scale) of an eight-week Mindfulness-Based Stress Reduction (MBSR) program. This study collected data in the Spring of 2019. The final number of participants in the study was 116 (40 females, 76 males, Mage = 36, age range: 22-69 years). Participants completed measures including the Perceived Stress Scale (PSS), Acceptance and Action Questionnaire-II (AAQ-II), the agreeableness and openness to Experience domains …

Risk And Protective Factors For Psychological Distress Following A Morally Injurious Event In Combat Veterans, Aaron Keating

Dissertations

Morally injurious events have been shown to increase the likelihood of experiencing anxiety, depressive, and posttraumatic stress symptoms of combat veterans. Research has found that guilt and shame are associated with higher levels of symptomology following morally injurious events. Similarly, individuals who are high in trait proneness to guilt and shame may be at higher risk for developing symptoms following a morally injurious event; however, no research to date has examined this possibility. In addition, acts that go against what one considers morally right bring about cognitive dissonance which then leads to anxiety. In order to reduce anxiety caused by …

Exploration Of Physician Attitudes About Self-Care And Personal Mental Health: Possible Barriers To Physician Well Being, Candich Farrar

Dissertations

The present study was designed to examine physicians’ mental health, attitudes, and behaviors toward self-care and the utilization of mental health services. As the medical field can be very demanding and exhausting, it is believed that many physicians suffer from mental illnesses such as anxiety and depression. However, it was theorized that many physicians do not engage in adequate self-care regimes or seek support and suppress their symptoms, which may further exacerbate their illnesses. A thorough literature review was performed to explore the following: possible barriers to physicians seeking mental health services to address high rates of mental illnesses, physicians …

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 …

The Predictors Of Juvenile Recidivism: Testimonies Of Adult Students 18 Years And Older Exiting From Alternative Education, La Toshia Palmer

Dissertations

Purpose: The purpose of this descriptive, qualitative study was to identify and describe the importance of the predictors of juvenile recidivism and the effectiveness of efforts to prevent/avoid juvenile recidivism as perceived by previously detained, arrested, convicted, and/or incarcerated adult students 18 years of age and older exiting from alternative education in Northern California. A second purpose was to explore the types of support provided by alternative schools and the perceived importance of the support to avoid recidivism according to adult students 18 years of age and older exiting from alternative education.

Methodology: This qualitative, descriptive research design identified …

Impulsive Choice In Unmedicated And Medicated Children Diagnosed With Adhd: Examining The Variables Of Reward Type And Adhd Subtype, Nicole Henriksen

Dissertations

Developmentally inappropriate and impairing impulsive behaviors are often seen in attention-deficit/hyperactivity disorder (ADHD). One method for objectively assessing impulsivity is the Choice-Delay Task (C-DT) which presents repeated opportunities to choose between a smaller, sooner (SS) or larger, later (LL) reward. A preference for the SS reward that results in less total reward is considered impulsive. Many studies have found that participants diagnosed with ADHD choose the SS reward more than typical controls. However, less is known about the effects of different types of rewards, or the comparative performance of certain subgroups, such as children diagnosed with ADHD Predominantly Inattentive Type …

The Intersection Of Depression, Partner Violence And Poverty During The Perinatal Period, Catherine L. Kothari

Dissertations

Problem: Despite the wealth of research documenting the individual links between maternal depression, partner violence, and poverty, important gaps remain regarding their combined interactions, and their variation related to perinatal timing (pregnancy and postpartum). The current dissertation examined the interplay of these phenomena across perinatality.

Methods: This dissertation utilized secondary analysis of telephone survey data from a representative sample of women recruited during their postpartum hospital stay and interviewed four times over the subsequent 18 months. Linear regression was used for predictive modeling of fixed effects, and generalized estimating equation regression was used for multivariate analysis of temporal trends.

Findings: …

Teaching Language To Children With Developmental Disabilities Using Combined Direct Reinforcement And Stimulus-Stimulus Pairing, Brighid Helene Fronapfel-Sonderegger

Dissertations

Several researchers have used stimulus-stimulus pairing (the pairing of speech sounds with established reinforcers) to increase the frequency of specific vocalizations in children with disabilities. However, only a few addressed the utility of stimulus-stimulus pairing to increase functional language, and none combined stimulus-stimulus pairing and direct reinforcement. The present study combined stimulus-stimulus pairing and direct reinforcement to successfully teach 2 to 10 functional mands in 21–49 7-minute sessions with four children with developmental disabilities with low verbal repertoires. Following mand training, two children were taught 10 tacts for pictures using the combined direct reinforcement and stimulus-stimulus pairing procedure in a …

Refugee Experiences Of Trauma And Ptsd Effects On Psychological, Physical, And Financial Well-Being, Karen J. Cusack

Dissertations

No abstract provided.

Analysis Of Factors Involved In Ratings Of Treatment Acceptability For Trichotillomania, Amy J. Elliott

Dissertations

Based on the literature, trichotillomania (or chronic hair pulling) appears to be responsive to behavioral interventions, with habit reversal as the most promising intervention. Habit reversal has been shown effective with children and adults of varying levels of severity, but some have questioned the generality and acceptability of the procedure. Little is known about the acceptability of interventions for habit disorders. These two research studies were designed to answer questions regarding the acceptability of behavioral and pharmacological interventions for trichotillomania and to expand the conceptual knowledge of treatment acceptability.

Study 1 compared the acceptability of four interventions targeting trichotillomania. The …