Other Psychiatry and Psychology Commons^™

Acute Agitation Intervention Tool For Reduction Of Polypharmacy, Brooks J. Propst

Dissertations

Introduction: Patients with behavioral health diagnoses are among the highest risk for
aggression. For pediatric patients with behavioral health needs, urgent treatment is
needed for aggressive behavior, due to the potential unwanted outcomes. The purpose of this Quality Improvement (QI) pilot project was to implement an Acute Agitation Intervention Tool that uses the Broset Violence Checklist (BVC) to guide
pharmacological intervention for mild and moderate to severe agitation in pediatric
patients with behavioral health needs ages 8 to 18 to decrease the number of medications that patients are getting per agitation event over a 12-week period.

Methods: This QI included …

Hiv And Early Life Stress On Neuroimaging And Risky Behavior, Paola Garcia Egan

Dissertations

This study examined the interactive effects of early life stress (ELS) and HIV on brain morphometry, diffusion-basis-spectrum-imaging (DBSI), risky decision-making, and sex-risk behavior. 122 people with HIV (PWH) and 113 people without HIV (PWoH), free of major psychiatric illness and neurological confounds, were stratified into high (≥ 3 events) vs. low (< 3 events) ELS [PWoH/low ELS (n = 57), PWoH/high ELS (n =56), PWH/low ELS (n = 43), PWH/high ELS (n = 79)] and underwent structural magnetic resonance imaging, DBSI, neuropsychological, and risky-behavior assessment; all PWH were virologically controlled. Compared to PWoH, PWH had smaller orbitofrontal cortex (OFC), parietal lobes, insula, caudate and anterior cingulate. No ELS effects were detected in volumetric measures. Significant interactions were found between HIV serostatus and ELS on the OFC and on cellularity of the inferior fronto-occipital fasciculus after multiple comparisons adjustment. Specifically, PWH/high ELS exhibited significantly smaller OFC and PWoH/high ELS show significantly larger OFC than the other groups. PWoH/high ELS exhibited higher DBSI cellularity (neuroinflammation proxy) of the inferior-occipital-fasciculus compared to PWoH/high ELS. Regardless of HIV status, executive function moderated the relationship between the OFC and sex-risk behavior such that individuals within the sample who performed above average on a measure of executive function and had a larger OFC reported fewer sex partners in past six months than individuals with smaller volumes. No interaction was found between HIV serostatus and ELS on risky behavior measures. Clustering analyses defined ELS subgroups in PWH that were determined by demographic characteristics, duration of infection, recent CD4+ T-cell count, nadir CD4+ T-cell count and high/low ELS.Even in PWH that are virologically controlled, without major current psychiatric comorbidities, there is evidence of a synergistic impact of ELS and HIV on OFC volumes. Higher volumes in the OFC were detrimental when associated with lower executive function scores or advantageous when associated with higher executive function. Findings suggest that ELS is associated with different brain signatures among PWoH and virally suppressed PWH. However, ELS was not directly associated with risky behaviors, and subgroups in PWH were characterized by demographic variables, past substance use and HIV clinical variables.

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 …

The Life Story Analysis Of Those Suffering From Autoimmune Thyroiditis, Azalea Di Nardi

Dissertations

The purpose of this study was to understand the pervasive impacts of autoimmune thyroiditis, specifically Hashimoto’s and Graves’ disease. To accomplish this, the life story methodology was utilized to gather individual experiences from 11 participants diagnosed with Hashimoto’s or Graves’ disease. The participants completed a background and general health questionnaire and 45- to-100-minute virtual interview disclosing their journey from the onset of symptoms, through diagnosis, to their most recent state. Themes were compiled from the interviews, which allowed identification of the largest areas of impact, needs, and future implications for practitioners and providers. Major themes identified were decreased quality of …

Empowering Nurses Of Minority In The Face Of Incivility And Bullying: Through The Lens Of Phenomenology, Corrine Floyd

Dissertations

Abstract

Up to 85% of nurses have reported exposure to incivility in the workplace (Hunt & Marini, 2012). The often-subtle nature of incivility toward nurses in a minority population may partially explain why it remains a problem. Healthcare organizations realize the need for civility to counter the high turnover rate, staff shortages, and low job satisfaction reported by nurses, but lack understanding of how nurses of a minority population perceive incivility and bullying. This study aimed to answer the research question how do nurses with minority representation experience incivility and bullying versus empowerment in the workplace? A descriptive phenomenological design …

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 …

Bridging The Gap: Understanding Non-Offending Parental Responses To Their Children's Sexual Abuse., Jennifer Latreill, Psy.D.

Dissertations

The parental response to children's disclosure of childhood sexual abuse (CSA) is the most critical and important factor regarding the child's post trauma trajectory and overall trauma resolution. Understanding parental responses and the factors that prompt acceptance versus disbelief among the non-offending parent (NOP) is vital to children's success following disclosure given the weight of the NOPs response and its impact on long-term consequences of CSA. This literature review provides a comprehensive summary of what may deter the NOP from recognizing intrafamilial sexual abuse, factors that may contribute to the NOPs disbelief following disclosure, and possible clinical implications of such …

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 …

Indirect & Displaced Aggression: The Role Of Comparison Based Traits And Cognitive Vulnerabilities, Niki M. Knight

Dissertations

The present study explored the relationships of contingent self-esteem, dispositional envy, and two cognitive vulnerabilities (i.e., anger rumination and fear of negative evaluation) to indirect aggression (IA) and displaced aggression (DA) in a college student sample (N = 346). Despite the theoretical relevance of these personality and cognitive factors to aggression, there is little empirical evidence linking them to the perpetration of IA and DA. Bivariate correlations and hierarchical multiple regression were used to test the utility of these constructs in accounting for unique variance in IA and DA and to assess the potential role of participant gender. Participants …

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 …

The Impact Of Systematically Varying The Duration Of Breath Samples During Infrared-Based Alcohol Breath Testing, Chris C. Clatterbuck

Dissertations

The present study set out to investigate the reliability and performance of the BAC DataMaster®, an infrared-based alcohol breath testing instrument. The focus of this study was to determine: (a) the impact of varying breath sample duration during testing, (b) if Blood Alcohol Concentration (BAC) levels produced by the DataMaster® (BAC_DM) are significantly different from BAC levels produced by analysis of whole blood (BAC_WB), and (c) if the relationship between BAC_DM estimates and BAC_WB is influenced by the amount of alcohol an examinee has ingested. Each of 27 participants was randomly assigned to one …

Comparative Effectiveness Of Therapeutic Strategies On Drug Knowledge And Drug Attitude In Inpatient Psychiatric Substance Abuse Population, Amber Haque

Dissertations

This study examined the effects of instructional strategies on the change of knowledge and attitude scores in mentally ill subjects with a history of substance abuse. Twenty subjects from a state psychiatric hospital were randomly divided into one control and three experimental groups. The study period was ten weeks with each session lasting forty five minutes, twice per week. Subjects studied issues relating to drug abuse outside scheduled sessions as they pleased. Pre- and post-test scores were measured by a drug abuse questionnaire developed at the Pennsylvania State University. Hypotheses formed were: (a) drug education improves knowledge and attitude in …

Using Group Psychotherapy For Enhancing Late Adolescent Selfconcept: Comparing The Effects Of Hypnosis And Rational-Emotive Therapy, James J. Buldas

Dissertations

The purpose of this study was to determine whether university students, classified as late adolescents, could enhance their self-concept as measured by the Tennessee Self-Concept Scale (TSCS) Total Positive Score. Seven hypotheses which stated the null relationship between self-concept enhancement and the treatment modalities of hypnosis and rational-emotive therapy, when compared over an eight week period of time were derived. A review of the literature showed that the belief that low self-concept is etiologic in psychopathology is widespread in the clinical literature.

A sample of university students enrolled in Psychology 100 (N = 54) were pre, post and follow-up tested …