Medicine and Health Commons^™

Competency To Stand Trial Evaluations: Using Vignettes With Patients Who Lack Insight, Katelyn Fuller

James Madison Undergraduate Research Journal (JMURJ)

In the United States, an attorney may request a competency to stand trial evaluation if they are concerned that their client is not mentally fit to adequately participate in their case and defense. Patients found incompetent must undergo treatment for restoration of competency, regardless of their willingness. Clinicians and psychiatrists may use vignettes, or hypothetical scenarios, to help restore competency if the patient lacks insight into their mental illness. While vignettes have been well documented in studying attitudes and awareness, decision making, and identifying mental illness, there is little to no research into their use in psychiatric hospitals due to …

Exploring The Experience Of Healthcare-Related Epistemic Injustice Among People With Myalgic Encephalomyelitis / Chronic Fatigue Syndrome, Joanne Hunt, Jessica Runacres, Daniel Herron, David Sheffield

The Qualitative Report

Myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) is a chronic, disabling yet clinically “contested” condition, previously theorised through a lens of epistemic injustice. Phenomena conceptually close to epistemic injustice, including stigma, are known to have deleterious consequences on a person’s health and life-world. Yet, no known primary studies have explored how people with ME/CFS experience healthcare through a lens of epistemic injustice, whilst a dearth of research explicitly exploring healthcare-related injustice from a patient perspective has been noted. This qualitative study seeks to address this gap. Semi-structured interviews and interpretative phenomenological analysis (IPA) were used to explore the experiences of …

Broken Promises: Prolonged Diminished Quality-Of-Life Among Liberian Ebola Survivors Half A Decade After The 2014-16 West African Outbreak, Jessi Hanson-Defusco, Decontee Davis, Meghana Bommareddy, Zainab Olaniyan

Journal of Social, Behavioral, and Health Sciences

The 2014–2016 Ebola outbreak left thousands of Liberian survivors with severely diminished quality of life. Applying a social determinants framework, this mixed method study investigates to what extent Ebola virus disease (EVD) survivors suffer long-haul psychosocial stress, diminished quality-of-life factors, and the impact of EVD-related service provisions on their ongoing healing. We present the results of a quantitative analysis survey of data collected from 19 Liberian EVD survivors in 2022 using snowball sampling. Additionally, a qualitative analysis of survivor statements helps triangulate key statistical findings and inform causal mechanisms. Survivors report experiencing 5.25 of a total of 7 ongoing stressors …

The Impact Of The Covid-19 Pandemic On The Well-Being Of People Incarcerated In United States Prisons, Kimberly Rivera

Department of Sociology: Dissertations, Theses, and Student Research

The COVID-19 pandemic has negatively impacted the population as a whole. However, the incarcerated population (which also experiences a variety of health disparities) has been disproportionately affected by the pandemic. Due to overcrowding, poor ventilation, and lack of resources, the incarcerated population already is at a heightened risk for negative health outcomes, made worse by the recent pandemic. To adapt to the rapidly changing conditions during the pandemic in 2020 and into 2022, new safety measures were implemented, but the unintended consequences associated with the implementation of these procedures have yet to be examined empirically. I conducted a qualitative content …

Laughing Through The Pain: An Analysis Of Dark Humor In Trauma-And-Crisis-Centered Occupations, Zoe R. Potter

University Honors Theses

The use of dark, or "black" humor by professionals in trauma-and-crisis-centered occupations is common, with fields such as healthcare, crime, emergency response, and social work reporting frequent use of dark humor on the job. Using a literature review approach, peer-review articles were examined to understand the function that dark humor plays in trauma-and-crisis-centered fields. The findings suggest that dark humor acts as a coping mechanism, and contributes to various group dynamics between colleagues. The literature was also reviewed for the effects that dark humor has on patients or people in contact with trauma-and-crisis personnel. While some preliminary findings point to …

Problem Gambling In Chile: A Comparison Between Pre And Post Pandemic Behavior 2018-2022, Juan Oyanedel Dr., Mariela Huenchumilla Ms

International Conference on Gambling & Risk Taking

The COVID-19 Pandemic involved several behavioral changes in the world’s population. Extended periods of isolation were one of its most defining features of it. These changes affected people's relationship with gambling, both in terms of access and socialization processes associated with it. Asocial gambling is one of the features of problematic gambling, and it was particularly fit to grow in the framework of long periods of isolation.

The article reports the differences in the prevalence of problem gambling in the general Chilean population as well as the changes in the characteristics of gamblers between 2018 and 2022. The study uses …

The Development Of The Holistic Pastoral Wellbeing Assessment: A Mixed Methods Study, Timothy Captain

Dissertations

Some pastors are clearly in crisis. Research has indicated that clergy struggle to cope with the stressors of their profession. While pastoral work is overtly spiritual in nature, day-to-day tasks include interactions with God, themselves, congregants, and the world at large. Without multi-dimensional tools to consider their wellbeing, specifically assessments that reflect their worldview and role, pastors may remain unaware of dangerously low levels of wellbeing until they reach a place of crisis. Therefore, in this mixed methods study, the Holistic Pastoral Wellbeing Assessment (HPWA) was developed and tested to offer a validated, useful tool for pastors and those who …

Examining The Use Of Expressive Arts Therapies In Neurorehabilitation Treatment Planning, Rebecca J. Horner

Expressive Therapies Capstone Theses

Those undergoing neurorehabilitation after stroke and traumatic brain injury report a diminished sense of overall wellness. This paper examines the conceivable benefits of introducing expressive arts therapies, which is the therapeutic use and combination of the visual arts, movement, drama, music, writing and other intermodal creative processes, into physical therapy and neurorehabilitation treatment planning. Expressive arts therapies have the capacity to engage with an individual’s physical, emotional, social and spiritual states concurrently. They simultaneously offer the ability to promote an increased sense of well-being, address mind-body disconnects, and process trauma non-verbally.

The sections of this narrative literature review focus on …

The Last Of Us In Therapy: How Mind-Controlling Fungi And Gut Bacteria Affect Your Mental Health, Anastasia Lyon

Journal of Pharmacology & Nutritional Sciences

The "psilocybiome" represents the mutually beneficial relationship between ourselves, our bacteria, and psychedelic drugs. This short review briefly discusses the benefits and limitations surrounding the potential for psychedelic therapy to synergize with gut bacteria to help regulate and maintain proper balance in the immune system, diet, and stress levels. Psychedelic therapy is a novel treatment strategy that has the potential to improve patient mental health, and, by identifying the types of gut bacteria present in patients, it can aid in personalizing medicine by determining how well their "psilocybiome" may respond.

Moral Injury To Inform Analysis Of Post-Traumatic Stress Disorder, Amanda Julia Manea

Senior Theses

Post-traumatic stress disorder (PTSD) is a mental health condition that almost one out of ten veterans struggle with. Although the National Center for PTSD has made extensive progress in characterizing and developing new treatments for PTSD, most veterans still experience symptoms of PTSD following treatment. Novel avenues of investigation, such as developing algorithms to review electronic health record (EHR) data and better understanding moral injury, are being pursued to address the gap that still exists when it comes to treating veterans. Moral injury is the individual evaluation of exposure to a potentially morally injurious event (PMIE) and can lead to …

Experiences Of Covid-19-Related Racism And Impact On Depression Trajectories Among Racially/Ethnically Minoritized Adolescents, Sabrina R. Liu, Elysia Poggi Davis, Anton M. Palma, Hal S. Stern, Curt A. Sandman, Laura M. Glynn

Psychology Faculty Articles and Research

Purpose

In 2020, racially/ethnically minoritized (REMD) youth faced the “dual pandemics” of COVID-19 and racism, both significant stressors with potential for adverse mental health effects. The current study tested whether short- and long-term trajectories of depressive symptoms from before to during the COVID-19 pandemic differed between REMD adolescents who did and did not endorse exposure to COVID-19-era-related racism (i.e., racism stemming from conditions created or exacerbated by the COVID-19 pandemic).

Methods

A community sample of 100 REMD adolescents enrolled in an ongoing longitudinal study of mental health was assessed before and during the COVID-19 pandemic. Participants were 51% girls, mean …

Skin Stories And Family Feelings: The Contradictions Of Skin Picking In Mother And Daughter, Katrina Jacinto

Crossings: Swarthmore Undergraduate Feminist Research Journal

Skin picking, otherwise known as dermatillomania, is considered to be a medical disorder by the DSM-5. However, the embodied experiences of skin picking in myself and my mother do not align with the neat definitions offered by psychiatry. Through autoethnographic material and an ethnographic interview with my mother, I argue that skin picking is a bodily technique that is pathologized through stigma. In particular, I suggest that skin picking reveals the body as a polyvalent entity, in which the same features and practices take on different meanings in different bodies. This frames the discrepancies between mine, and my mother's, experiences. …

Addiction And Liberty, Matthew B. Lawrence

Faculty Articles

This Article explores the interaction between addiction and liberty and identifies a firm legal basis for recognition of a fundamental constitutional right to freedom from addiction. Government interferes with freedom from addiction when it causes addiction or restricts addiction treatment, and government may protect freedom from addiction through legislation empowering individuals against private actors’ efforts to addict them without their consent. This Article motivates and tests the boundaries of this right through case studies of emergent threats to liberty made possible or exacerbated by new technologies and scientific understandings. These include certain state lottery programs, addiction treatment restrictions, and smartphone …

Integrating Feminist Approaches In Counseling Work With Adult Women, Kristen M. Toole

Adultspan Journal

The scope of ‘women’s issues’ in counseling is an ever-evolving landscape. Recent events such as the reversal of Roe v. Wade and the disproportionate impact of COVID-19 on women serve as powerful reminders of the necessity of this focus while underscoring a deep-rooted history of oppressive patriarchal structures. Therefore, counselors must remain informed of the unique considerations surrounding adult women in counseling and acquire proficiency in versatile techniques to meet this population’s nuanced needs. This article examines the complexity of contemporary womanhood and explores the fundamentals of Feminist Counseling Theory (FCT), a holistic, multiculturally conscious, social justice theory in counseling. …

Assessing The Relationships Between Direct And Vicarious Exposure To Healthcare Discrimination And Erasure, Mistrust In Healthcare, And The Healthcare Utilization Behaviors Among Transgender And Gender Independent Individuals, Kyle L. Mason

Theses and Dissertations

Healthcare inaccessibility through direct exposure (i.e., personal) to myriad forms of gender identity-related discrimination and erasure among the Transgender and Gender Independent (TGI) population has been documented by prior studies. The myriad barriers that individuals who embody TGI identities encounter to accessing healthcare are associated with the underutilization of healthcare, which may further exacerbate the health disparities that exist between this population and cisgender individuals in the United States (U.S.). Although the impacts of the harm that direct exposure to healthcare discrimination and erasure may have on TGI individuals are known, their exposure to such harm vicariously (i.e., through observation …

The Impact Of Having Foreign Domestic Workers On Informal Caregivers Of Persons With Dementia: Findings From A Multi-Method Research In Singapore, Qi Yuan, Yunjue Zhang, Ellaisha Samari, Anitha Jeyagurunathan, Tee Hng Tan, Fiona Devi, Peizhi Wang, Harish Magadi, Richard Goveas, Li Ling Ng, Mythily Subramaniam

Research Collection School of Social Sciences

Background: Informal caregivers of persons with dementia (PWDs) sometimes engage foreign domestic workers (FDWs) to support their caregiving journey. However, there has not been much research to establish if this is really beneficial. The current study aims to investigate whether engaging FDWs specifically for caregiving of PWDs truly moderates caregiver stress and to explore caregivers’ experiences of engaging FDWs. Methods: A multi-method study design with a quantitative and qualitative sub-study was adopted. For the quantitative sub-study, 282 informal caregivers of PWDs were recruited. Propensity score matching analysis was used. For the qualitative sub-study, 15 informal caregivers with FDWs were interviewed. …

Assessing Treatment Access, Medication Use, Caregiver Strain And Emergency Service Use In Families Of Youth With Autism, Emmaline Thorpe

Psychological Science Undergraduate Honors Theses

Background: Families with autistic youth utilize emergency services (e.g., police, emergency department) at greater rates than neurotypical peers. While research has recently explored this phenomenon, unknowns remain in how pharmaceutical, therapeutic, family (e.g., caregiver strain), and child factors (concurrent challenging behaviors) may influence the likelihood of this population resorting to emergency care. Method: The current study recruited caregivers (N = 55) of youth with autism and co-occurring challenging behaviors (ages 2 – 22) to complete an online survey regarding their use of emergency services, child medication and therapy, and caregiver strain. Caregivers were compensated for their time. Results: Outcomes revealed …

Surveying The Stigma: How The Plhiv Stigma Index Acts As A Validated Framework To Measure Healthcare Discrimination And How It Can Be Adapted To Quantify Mental Health Stigma, Keeley Lariviere

Independent Study Project (ISP) Collection

The PLHIV Stigma Index is an ongoing, international study conducted by and for people living with HIV to measure the stigmatization that people living with HIV experience. As a model that has been proven successful in translating to targeted advocacy campaigns, this paper theorizes on how this Stigma Index could be broadened to capture other aspects of healthcare discrimination. With a growing demand for mental health support and a critically underdeveloped mental healthcare framework, understanding the stigma and discrimination that exist for people living with depression is a good place to start. Using mixed methods analysis from existing literature and …

The Social Determinants Of Ideal Cardiovascular Health: A Global Systematic Review, Farah Qureshi, Kelb Bousquet-Santos, Sakurako S. Okuzono, Elaine Tsao, Scott Delaney, Anne-Josie Guimond, Julia K. Boehm, Laura D. Kubzansky

Psychology Faculty Articles and Research

This systematic review synthesizes research published from January 2010-July 2022 on the social determinants of ideal cardiovascular health (CVH) carried out around the world and compares trends in high-income countries (HICs) to those in low- and middle-income countries (LMICs). 41 studies met inclusion criteria (n = 28 HICs, n = 13 LMICs). Most were from the United States (n = 22) and cross-sectional (n = 33), and nearly all evaluated associations among adults. Among studies conducted in LMICs, nearly all were from middle-income countries and only one was carried out in low-income country. Education (n = …

A Qualitative Exploration Of Social Support In Males And Females Experiencing Issues With Infertility., Maya Pinzon, Shawna Rotoli

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

INTRODUCTION: The purpose of this study was to qualitatively investigate and compare male and female experiences of infertility in the context of social support.

METHODS: A Qualtrics survey (Qualtrics, Provo, Utah, United States) was posted to online fertility support groups and the responses were thematically analyzed. Only participants that completed the qualitative component of the survey were included in the study. Responses were subsequently thematically analyzed.

RESULTS: A sample of 110 participants (13 males and 97 females) were included in the present study. Thematic analyses revealed that isolation and loneliness, stigma, sentiments of misunderstanding, insensitive reactions, and others' unhelpful attempts …

Our Bodies, Our Stories: Mental And Physical Self Connection As A Protective Factor In Sexual And Gender Minorities, Emerson A. Todd

Electronic Theses and Dissertations

The mind and body connection has been actively examined in neuroscience and developmental psychology backgrounds. Sociological theorists posit ways that individuals develop a sense of self through mind, body, and the social world. While research on the connection between the mind and body in disabled and aging populations is common, less is known of the everyday impact of these connections for other minority populations. The present study uses mixed-methods research to explore the relationship between mind and body and the impacts on internal and social life. The quantitative aspect of the study found significant relationships between physical and mental health …

The Politics Of The Self: Psychedelic Assemblages, Psilocybin, And Subjectivity In The Anthropocene, Joshua Falcon

FIU Electronic Theses and Dissertations

This dissertation examines how psychedelic substances become drawn into particular sociohistorical and political arrangements, and how psychedelic experiences with psilocybin ‘magic mushrooms’ are used as tools of subjectivation. Guided by literatures in philosophy, critical theory, and the social sciences that focus on subjectivity, assemblage theory, and critical posthumanism, I argue that psychedelics are drawn into variegated assemblages, each of which conceptualizes the nature of psychedelics in highly specific ways that reflect implicit conceptions of the world and the self. In developing the concept of psychedelic assemblages, this research provides a window onto the politics of the self in the Anthropocene. …

Early Integration Of Palliative Care With Curative Oncology Treatment For Patients With Advanced Cancer: Implications For Clinical Nursing Practice, Rhea Rughani

Honors Projects

Palliative care, though clinically established to improve health-related quality of life measures for patients with advanced illness, remains underutilized and largely limited to end of life care. This project aims to inform oncology nursing practice through the analysis of literature supporting the early integration of palliative care with standard curative oncology treatment for patients with clinically advanced cancer. Informed by relevant research, clinical practice guidelines, and improved specialty palliative care training, oncology nurses and nurse practitioners are ideally situated to advocate for and initiate early palliative care integration, to holistically improve the standard approach to complex cancer care.

Pornography: Social, Emotional And Mental Implications Among Adolescents, William K. Canady

National Youth Advocacy and Resilience Conference

This presentation will explain the historical development of pornography. It will highlight four segments: 1- Porn’s impact on brain development of reward pathways, ultimately increasing the appetite for more porn. 2- Porn can be a false substitute for real intimacy, resulting in decreased sexual satisfaction with a real person and increased verbal and physical aggression. 3- Porn promotes sex trafficking, promotes multiple sex partners and reduced STD prevention. 4- A review of interventions available to assist clients in navigating a lifestyle away from pornography.

Intergenerational Risk And Resilience Pathways From Discrimination And Acculturative Stress To Infant Mental Health, Sabrina R. Liu, Curt A. Sandman, Elyssia Poggi Davis, Laura M. Glynn

Psychology Faculty Articles and Research

Preconception and prenatal stress impact fetal and infant development, and women of color are disproportionately exposed to sociocultural stressors like discrimination and acculturative stress. However, few studies examine links between mothers’ exposure to these stressors and offspring mental health, or possible mitigating factors. Using linear regression, we tested associations between prenatally assessed maternal acculturative stress and discrimination on infant negative emotionality among 113 Latinx/Hispanic, Asian American, Black, and Multiethnic mothers and their children. Additionally, we tested interactions between stressors and potential pre- and postnatal resilience-promoting factors: community cohesion, social support, communalism, and parenting self-efficacy. Discrimination and acculturative stress were related …

Disability And Health In African Americans: Population Research And Implications For Occupational Therapy Community-Based Practice, Emily Schulz, Debarchana Ghosh, Eddie M. Clark, Beverly R. Williams, Randi Williams, Lijing Ma, Crystal L. Park, Cheryl L. Knott

The Open Journal of Occupational Therapy

Background: Population-based research and community-based interventions are integral to occupational therapy’s scope of practice, yet they are underdeveloped in actual implementation. Therefore, this paper focuses on some health challenges facing the African American population, guided by the Person-Environment-Occupation-Performance Model.

Method: Using data from an observational cross-sectional nationwide telephone survey of African American adults, we examined differences between African Americans who are receiving disability payments (RDP) and those who are employed full time (FTE) on several physical health behaviors and psychosocial health indicators. We further compared the differences between African Americans RDP versus those FTE on those physical health …

Healing Racial Injustice With Mindfulness Research, Training, & Practice, Danielle "Danae" Laura

Mindfulness Studies Theses

This thesis offers a collection of authors and studies in support of improved research, training, and practice connecting mindfulness with racial justice through intergroup applications. The paper identifies barriers at work (e.g., colorblindness, spiritual bypass, white fragility, and implicit bias) in contemplative science, Western Buddhist communities, and secular mindfulness centers, which block the sizeable contributions possible in studying the intergroup application of mindfulness practice—specifically Lovingkindness Meditation, among others—when used as an intervention with anti-racist aims. Through secondary qualitative research, I reviewed six key works from Black authors on mindfulness and race, as well as six sample studies on the prosocial …

Adult-Onset And Adolescent-Limited Suicidal Ideation: A Developmental Approach To Suicide, Brent Teasdale, Michelle N. Harris, Mindy Bradley, Suraiya H. Shammi, Jerreed D. Ivanich

The Journal of Sociology & Social Welfare

Suicidal thoughts and actions have typically been studied from an eventsbased perspective. Some emerging studies, however, have begun to examine suicide and related behaviors through a longitudinal perspective, specifically focusing on establishing trajectories of suicidal behavior. In general, this work produces three-class trajectories of suicide attempts among adolescents, including groups such as: (1) no or low suicidal behavior; (2) moderate suicidal behavior; and (3) high suicidal behavior. Less is known about potential trajectory patterns of suicidal ideation associated with later stages of the life course. Moreover, identifying a low-, moderate-, and high-risk group does not inform the developmental processes that …

A Technology-Based, Mixed Methods Approach To Examining The Psychosocial Determinants Of Maternal Health Disparities, Hannah M. Ming

Theses and Dissertations

Background: Exposure to racism and discrimination in the U.S. increases Black women’s risk for experiencing maternal health disparities. Additionally, racism and discrimination affect maternal psychosocial well-being, creating evidence for a biopsychosocial relationship between racism and maternal health outcomes. However, current research does not define the psychosocial Black maternal self well. Given the dynamic relationship between racism, psychosocial well-being, and Black maternal health outcomes, research must comprehensively examine the Black maternal self. The operationalization of a comprehensive construct for Black maternal psychosocial well-being can improve understanding of the relationship between racism, psychosocial well-being, and Black maternal health outcomes.

Purpose: …

Awareness And Knowledge Of Aging And Hiv-Associated Neurocognitive Disorder: Service User And Provider Perspectives And Experiences In Southern Nevada, Renato M. Liboro, Brandon Ranuschio, Sherry Bell, Jenna Despres, Trinity Puno, Aruna Sedere, Nadia Sheik Yosef, Esmeralda Villalobos, Janelle Wackens, Lianne Barnes

Psychology Faculty Research

This community report presents the findings and analysis of a survey that was part of the quantitative stage of a mixed-method Community-Based Participatory Research (CBPR) project dedicated to examine the awareness and knowledge of racially and ethnically diverse, middle-aged and older people living with HIV/AIDS, and their healthcare and service providers from Southern Nevada, on aging, brain health, HIV/AIDS, and the condition known as HIV-Associated Neurocognitive Disorder. The CBPR project was conducted in collaboration with community partners such as the LGBTQIA+ Community Center of Southern Nevada, Southern Nevada Health District’s Ryan White Program, Community Counseling Center of Southern Nevada, and …