Behavioral Medicine Commons^™

Prevalence Of Sleep Disturbances And Factors Associated Among School Going Children In Uganda, A Cross-Sectional Study, Martha Sajatovic

Faculty Scholarship

Background: Sleep disturbances greatly impact children's academic performance and social well-being. This study set out to determine the prevalence of sleep disturbances and factors associated among school going children in Kawempe division, Kampala, Uganda. Methods: In a community cross-sectional study, 548 study participants using random cluster sampling were enrolled. The children start lessons at 8am and end the days classes at 5pm. Random cluster sampling method was used to select participants from the 19 parishes in Kawempe district. Data was collected using a semi-structured questionnaire and Sleep Disturbance Scale for Children (SDSC). Descriptive statistics and multivariate binary logistic regression were …

Psych Assessment In The Er, Bailey J. Thompson, Addie Cowger, Hailie Hollis

Scholars Week

An immense amount of patients who enter the emergency department, whether for a psychiatric illness or not, struggle with mental health challenges. By creating a standardized routine and checklists for the care of high-risk psychiatric patients, the new quality and consistency can enhance patient experiences. This process will start at the triage stage and continue throughout their stay. Presenting the supportive research to the emergency department staff and introducing these changes gradually will help with staff buy-in and become a more sustainable process. Finally, with a structured approach, psychiatric patient outcomes will benefit significantly.

Resilience Factors And Physical Activity Engagement In Adolescents With Chronic Musculoskeletal Pain: A Cross-Sectional Study., William R. Black, Haley Hart, Jennifer Christofferson, Mark Connelly, Liesbet Goubert, Dustin Wallace, Laura Ellingson-Sayen, Ann M. Davis

Manuscripts, Articles, Book Chapters and Other Papers

Background/Objectives: Chronic musculoskeletal pain (CMSKP) affects up to 40% of adolescents and leads to substantial disability, reduced quality of life, and long-term health risks. Physical activity is central to treatment, but adherence to moderate-to-vigorous physical activity (MVPA) is inconsistent. We evaluated higher-resilience constructs-self-efficacy, pain acceptance, motivational stage, and affect-and hypothesized that higher resilience would be associated with greater objectively measured physical activity, better daily functioning, and higher quality of life in adolescents with CMSKP. Methods: Forty-three adolescents (13-18 years) with CMSKP completed measures of physical activity-specific self-efficacy, acceptance (AFQ-Y), motivational stage (PSOCQ-A), and affect (PANAS-C). Participants wore activPAL …

Housing Insecurity Is Associated With Higher Utilization Of Acute Care Services Among Oregon Health Plan Members With Behavioral Health Conditions, Megan Holtorf, Cat Livingston

Articles, Abstracts, and Reports

No abstract provided.

Opportunities And Barriers To Engaging Caregivers In Firearm Suicide Prevention: Findings From Focus Groups With Caregivers Of Veterans., Katherine Macwilliams, John Marmion, Dee Blascyk, Sharon Urbina, Rachel Moyers, Gala True

School of Medicine Faculty Publications

Background: Firearms are involved in more than 70% of U.S. Veteran suicides. Caregivers, defined as family members or concerned significant others, can play an important role in firearm suicide prevention through initiating conversations about secure firearm storage with Veterans. Our objective was to explore caregivers' experiences with lethal means safety (LMS) conversations and identify perceived barriers to caregivers discussing LMS with healthcare providers and with Veterans. Methods: We conducted focus groups with 32 caregivers with experience caring for a Veteran at risk for suicide. Qualitative data were analyzed using thematic analysis. Results: We identified three primary themes: 1) caregivers recognize …

Complex Factors Impacting Smoking Behavior In Cancer Survivors With Food Insecurity, Madeline C. Castele, Kareena Shah, Avianna Thompson, Jin E. Kim-Mozeleski

Faculty Scholarship

Objectives: Tobacco use remains prevalent among people with social needs, such as food insecurity. In this study, we aimed to understand the complex experiences of low-income cancer survivors with food insecurity who smoke tobacco, to identify the unique smoking cessation needs for this group. Methods: We conducted in-depth, semi-structured qualitative interviews with 40 adults experiencing food insecurity who continued smoking after a cancer diagnosis. Interviews focused on smoking behaviors, cessation interest, cancer experiences, and financial circumstances. We analyzed the data using reflexive thematic analysis. Results: In this sample of cancer survivors (50% female, mean age 42 years, 60% black/African American, …

Screens Are Not The Enemy: Recommendations For Developing Healthy Digital Habits In Youth., Megan B. Bolch, Rachel Moore, Gail Robertson, Meredith J. Scafe, Libby Milkovich

Manuscripts, Articles, Book Chapters and Other Papers

With the rapid and ever-evolving growth of both digital media platforms and mental health concerns in youth, parents and practitioners are faced with the challenge of critically evaluating the effects of digital media use on youth development.1 Despite popular culture's narrow focus on the risks, research has established both positive and negative effects of youth digital media use.2,3 In contrast to interventions primarily focused on screen time limits, the goal of this article is to propose a framework for healthy digital habits rooted in a social-ecological model, called the Multisystemic Model of Digital Habits. This framework considers the intersection of …

Psychosocial Supports For The Physical And Mental Health Of Youth With Autism And Other Neurodevelopmental Disabilities., Melissa Campbell, Elizabeth Hastings, Paige Mcardle, Darren Olsen, Kathryn Benton, Cy Nadler

Manuscripts, Articles, Book Chapters and Other Papers

One in six youth has a neurodevelopmental disability (NDD), and autism diagnostic rates continue to rise. Before and after a diagnosis, families need trusted sources of guidance to navigate co-occurring medical and psychological conditions, and to manage unique stressors including transition to adulthood. However, medical professionals from all specialty areas struggle to identify resources to support the complex psychosocial and healthcare needs of these patients and their families. This primer on psychosocial supports for youth with autism will explore the major mental and physical health stressors faced by affected youth and families, and discuss opportunities for primary care and other …

Binge Eating Disorder: A Clinical Review, Michell Mcdiffett Mshs, Pa-C

Lynchburg Journal of Medical Science

Binge eating disorder (BED) is the most common eating disorder (ED) in the United States (U.S.) and is characterized by recurrent episodes of eating a larger than normal amount of food in a discrete period of time and includes a sense of loss of control over food intake. BED is often comorbid with serious somatic and psychiatric disorders and is associated with reduced quality of life and excess mortality. Some consider BED a public health concern due to frequent co-occurrence with obesity and worse outcomes in those populations. The diagnosis is often delayed due to shame and underreporting of symptoms …

Covid-19 Pandemic Impacts On Behavioral And Emotional Health Of Young Children With Autism., Olivia M. Pokoski, Hayley M. Crain, Sarah M. Furnier, Ronald E. Gangnon, Cy Nadler, Eric J. Moody, Karen Pazol, Maria A. Stanley, Lisa D. Wiggins, Maureen S. Durkin

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To test initial hypotheses that the coronavirus disease 2019 (COVID-19) pandemic was associated with decreases in adaptive behavior and increases in behavioral and emotional problems of children with autism; greater impacts for children who lost specialty services; and greater behavioral and emotional problems for children with autism vs control participants.

METHOD: Eligible participants (N = 1,158) enrolled in phase 3 of the multisite, case-control Study to Explore Early Development (SEED) before March 31, 2020, were between 2 and 5 years old, and completed follow-up assessments between January and July 2021. Caregivers completed a COVID-19 Impact Assessment Questionnaire, Vineland Adaptive …

Neuroanatomical And Morphometric Differences In Children Who Stutter, Mohammad A. Khan

Honors Scholar Theses

Childhood-Onset Fluency Disorder commonly known as stuttering is a neurodevelopmental speech disorder characterized by disruptions in speech fluency. While genetic and neurobiological factors are implicated, the structural brain differences underlying stuttering remain unclear. This study investigated neuroanatomical alterations in children who stutter (CWS) compared to typically fluent children (TFC), focusing on gray matter volume, cortical thickness, and surface area in speech-related regions; the Inferior Frontal Gyrus, Middle Temporal Gyrus, and Pre-motor Operculum. High-resolution MRI data from 100 children (48 CWS, 52 TFC) aged 3–12 years were analyzed using FreeSurfer. Group comparisons revealed no statistically significant differences in cortical thickness, surface …

Mental Health And The Role Of Social Support In The Lives Of Vulnerabilized Sexual Minority Women, Jennifer L. Glick, Megan G. Nguyen, Aimee K. Huang, Kamila A. Alexander, Danielle German

School of Public Health Faculty Publications

Introduction Sexual minority women (SMW; women who self-identify as lesbian, queer, etc., as well as heterosexually-identified women who experience attraction to romantic or sexual partnerships with women) and vulnerabilized women (those marginalized due to structural forces such as housing insecurity, violence, sex exchange, drug use, or HIV positive status) experience a range of mental health challenges compared to their heterosexual and general population counterparts. General populations studies show a positive relationship between social support and mental health; less is known about SMW experiencing intersecting multi-layered vulnerabilities. This study characterizes mental health stressors, identifies social support sources and forms, and explores …

Intersection Of Alcohol Use, Pain Symptoms, And Negative Affect In Total Knee Arthroplasty Patients And People With Hiv, Taylor Fitzpatrick-Schmidt, Vinod Dasa, Claudia Leonardi, Tekeda F. Ferguson, David A. Welsh, Patricia E. Molina, Martin J.J. Ronis, Scott Edwards

School of Medicine Faculty Publications

Alcohol is a well-known analgesic, although excessive alcohol use can lead to hyperalgesia and heightened negative affect. This cross-sectional study examined associations between alcohol use, self-reported pain, and negative affective symptoms in two distinct cohorts of patients vulnerable to chronic pain: individuals undergoing total knee arthroplasty (TKA) surgery and a cohort of people with HIV (PWH). Participants were enrolled in two clinical studies: a retrospective study of patients undergoing TKA and a longitudinal study of PWH, the New Orleans Alcohol Use in HIV (NOAH) cohort. Based on the Alcohol Use Disorders Identification Test – Consumption (AUDIT-C) score, participants in both …

Misused And Misunderstood: Examining The Inappropriate Use Of Stimulant Medications, Connor Dains, Madilyn Paphanchith, Makayla Eversole, Chaehyeon Jin, Minhwan Yang, Joshua Honaker, Samantha Mccord, Kayla Petkus

Pharmacy and Wellness Review

Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder in children, characterized by inattention, hyperactivity, and impulsivity. The American Academy of Pediatrics (AAP) endorses stimulant medications as the first-line treatment option. When combined with behavioral therapy, this pharmacologic class can improve focus, executive functioning, and the overall quality of life. While stimulant prescriptions can have a positive effect when used as directed, there is concern for the potential of provider overprescription and patient misuse related to these medications. Consequently, the Food and Drug Administration (FDA) revised the boxed warning and prescribing information for stimulant medications. Healthcare providers must educate …

Mental Health Diagnoses Amongst Children With Complex Chronic Medical Conditions, Maria Newmaster M.D., Matt Hall, Adrienne Deporre, Molly Krager, Cy Nadler, Laura Plencner, Henry T. Puls

Research Days

Background: Mental health (MH) diagnoses are known to complicate outcomes of underlying medical conditions in pediatrics, but the prevalence of MH diagnoses across the array of medically complex and/or chronic conditions are not well known.

Objectives/Goal: To compare prevalence of MH diagnoses across levels of medical complexity and chronicity, and identify factors associated with MH diagnoses among children with complex chronic conditions (CCC).

Methods/Design: This retrospective cross-sectional study included children ages 5-17 years with at least 11 months of continuous Medicaid enrollment in 2022 from the Merative Marketscan Medicaid Database which collects data from all children with Medicaid in the …

Family-Based Health Promotion To The Early Phases Of Pediatric Acute Lymphoblastic Leukemia Treatment: A Qualitative Review, Anna Van Asselt, Renee Gilbert, Hide Okuno, Ann M. Davis, Keith J. August, Carolyn R. Bates, Robert C. Gibler

Research Days

Introduction: Excessive weight gain during early phases of Acute Lymphoblastic Leukemia (ALL) treatment elevates risk for long-term morbidities, late effects, and secondary cancers. Behavioral factors including physical inactivity and poor diet quality play a significant role in weight outcomes. Existing health behavior and obesity interventions do not address challenges that children and families face during cancer treatment. The current study qualitatively investigated caregiver, child, and multi-disciplinary expert perspectives on health behavior engagement and intervention content for the future adaptation of NOURISH-ALL.

Method: Caregivers (N=11) and youth with ALL (N=6) in the first year of treatment completed semi-structured interviews …

Integrating Positive Psychology And Spirituality To Foster Meaning And Well-Being In Older Adults, Crystal Morris

Adultspan Journal

This perspective article explores the integration of positive psychology interventions (PPIs) and spirituality in therapy to foster meaning and well-being in older adults. It highlights exercises such as the positive introduction, positive legacy, character strengths, mindfulness, mindful-based yoga, and a manifestation prayer journaling. The interventions presented are tools to support older adults that may experience depression, difficult life transitions, and the search for renewed meaning. Therapists who integrate PPIs and spirituality into therapy can promote a holistic, non-pathological approach to treatment.

Beyond Opioids: The Role Of Polysubstance Exposure In Neonatal Abstinence Syndrome Treatment And Hospitalization, Caelyn Harrison

Undergraduate Honors Theses

This thesis explores the impact of prenatal polysubstance exposure, specifically focusing on the need for pharmacological treatment for Neonatal Abstinence Syndrome (NAS) and the duration of their hospital stay. A retrospective analysis of 462 infants, including 121 exposed to polysubstances during pregnancy, showed significant associations between polysubstance exposure and adverse neonatal outcomes. Infants with prenatal polysubstance exposure were more likely to require pharmacological treatment for NAS (52.8%) compared to non-exposed infants (38.7%), as determined by chi-square analysis (χ²(1, N = 462) = 7.36, p = .007). Additionally, infants exposed to polysubstances experienced longer hospital stays on average (M = 14.88 …

The Role Of Ect In Ocd: A 10-Year Review (2014-2024), Mariana Sales, Tainiz Polanco, Amy Nguyen

Rowan-Virtua Research Day

Background: Obsessive-compulsive disorder (OCD) affects up to 2.5% of the population with significant impacts on everyday functioning and relationships. First-line treatment includes selective serotonin reuptake inhibitors (SSRI) and cognitive behavioral therapy; however, studies have found that up to 40-60% of patients do not respond to SSRIs. ECT is an alternative approach that has demonstrated limited efficacy in OCD.

Objective: The current review aims to summarize the results of published work between 2014-2024 to assess the efficacy of ECT in the treatment of OCD.

Methods: A literature review was conducted using eight studies from 2014-2024 to assess the effectiveness of ECT …

How Does Exposure To Early-Life Stressors Shape Eating Behaviors In Adulthood?, Surabhi Panda

Rowan-Virtua Research Day

The objective of this literature review is to explore the relationship between early-life stress and the development of disordered or dysregulated eating in adulthood. A search was conducted across PubMed, CINAHL, Embase, and PsycINFO databases. Results from each study were compared and synthesized. Twelve studies were analyzed including case reports, systematic reviews, cohort studies, and cross-sectional studies. Research indicates that childhood emotional abuse, often more prevalent than other forms of maltreatment, is a significant risk factor for eating pathology, with studies investigating psychological mediators such as anger, anxiety, and dissociation in this relationship. Adverse Childhood Experiences (ACEs) and early life …