Mental and Social Health Commons^™

Bowen Informed Therapy Integrated With Gene Keys, Kristen Oliver M.A.

Counseling and Family Therapy Scholarship Review

The mental health professions require innovation in order to advance theory and practice. This article presents reimagined therapeutic work that joins the metaphysical element of Gene Keys with the largely accepted theoretical approach of Bowen Family Systems Theory. We propose the integration of metaphysics as a way to facilitate higher levels of differentiation – particularly in clients who have an expanded worldview inclusive of metaphysics. The reader is asked to stretch their beliefs and perspective as they read through this paper.

Mft Trainee Experiences Of Shame, Self-Criticism, And Self-Compassion In Their First Practicum, Mark Karris , Ph.D., Angela B. Kim Ph.D.

Counseling and Family Therapy Scholarship Review

The purpose of this transcendental phenomenological study was to explore the lived experiences of MFT trainee shame, self-criticism, and self-compassion. Additionally, this study also sought to understand how those experiences may affect a trainee’s clinical work as a first-time practicum student. Interviews were conducted with 15 trainees in a graduate program who were performing therapy at a practicum site. Utilizing Moustakas’ transcendental phenomenology, six essential themes emerged: (1) shame and self-criticism are interrelated and can affect therapeutic presence; (2) self-criticism can have a positive impact on clinical work; (3) trainees use metaphors to describe shame and self-criticism (4) self-compassion …

Using Stories With Families: A Scoping Review, Sam Hadji Cyrous Ph.D. (Candidate), Sofia Valadares Nishiyama Cordeiro, Ana Caroline De Caldas

Counseling and Family Therapy Scholarship Review

This article is the fruit of a systematic scoping review, according to PRISMA precepts. Its objective was to explore the use of stories and other symbolic genre on family therapy settings. Thus, it explains how the researchers made the selection of articles in phases or steps, in a total of six, having a final result of 11 articles, in a time-lapse of 28 years. By the one hand, it was observed a relationship between different techniques that are usually grouped separately and, by the other hand, the disparate way in which the same concepts are confused among researchers, where each …

Notes On Language In The Clinic In A Lacanian Key, Sean J. Carroll

Counseling and Family Therapy Scholarship Review

There is no shortage of therapeutic modalities and interventions at the therapist’s disposal. Psychotherapy, because it claims to treat the individual, is necessarily multifaceted and complex. The dimension of language which structures much of our experience should be considered as a starting point for a psychotherapeutic technique. French psychoanalyst Jacques Lacan developed a theory and technique of the talking cure beginning from this assumption: that language structures our experience. In the early 1950s he sought to recover a linguistic Freud: to re-center psychoanalytic psychotherapy on language itself. In this paper, I sketch the theoretical reasons for this turn in Lacan …

Fertility Counseling For Couples, Brennan Peterson, Kristy Koser

Marriage and Family Therapy Faculty Books and Book Chapters

This chapter addresses the role, and importance, of individual counseling and psychotherapy in providing psychological assistance and support to patients who are struggling with infertility and loss. Depression and anxiety are the two most frequent emotional sequelae of the infertility experience. The chapter therefore speaks not only to what factors contribute to making fertility counselors effective in their work, but also addresses specific treatment approaches that can yield positive outcomes in working with this unique population. These approaches include psychodynamic psychotherapy, cognitive–behavioral therapy (including dialectical behavior therapy and trauma-focused therapy), and supportive counseling. A brief history and description of each …

精神病及癌症照顧者的社會支持及需要研究報告, Chak Kwan, Dickon Chan, Meng Soi, Florence Fong, Mun Yu, Vera Tang, Hiu Tung, Angel Chan, Sheung Wan, Wanda Wong, Mei Ling Lee

APIAS Research Report 研究報告

本研究旨在探討非正式照顧者在照顧60歲或以上受精神病或癌症困擾的家庭成員時遇到的困難、長時間照顧工作帶來的問題和他們的非正式社會支持。同時亦針對他們的需要提出相關建議。受精神問題及癌症困擾的年長患者數字持續上升，這兩類患者的非正式照顧者(下文統稱為照顧者)多面對因患者的情緒起伏和病情轉變化而帶來的巨大壓力。為深入了解他們的現況和為制定相關政策及服務提供參考，研究團隊以半結構性訪談的方法搜集了15位精神病及癌症患者的照顧者和17位服務提供者的意見。

研究結果發現，精神病患者照顧者常遇到的困難包括：缺乏私人空間、經濟壓力大、對相關疾病資訊不了解和因社會的負面標籤不願向外界求助。同時，他們因要長時間照顧患者，人際關係、身體狀況和就業狀況均受到負面影響。對於照顧癌症家屬的照顧者，他們多不了解現有的支援服務，而且需要面對沉重的經濟壓力。由於需要長時間照顧患者，照顧者的日常生活和心理狀況皆受到影響，他們與患者的關係轉差。這兩類照顧者的非正式社會支援網絡主要為家人、朋友及教會會友。

針對照顧者的需要，研究團隊提出了五個建議。一、加強公眾教育以去除社會對精神病患者的負面標籤，減低患者家人及照顧者對尋求外界協助的顧慮。二、增加暫託服務的資源和人手以縮短輪候時間，並推行以地區為本的照顧者「社區保姆」計劃，提供空間予照顧者暫時離開患者，以處理突發或私人事務。三、設立地區性照顧者服務中心，提供輔導服務，推行照顧者技巧培訓、經濟諮詢、喘息活動和「社區保姆」計劃，令到照顧者可以在同一個服務單位獲得所需的服務。四、政府可透過線上資源整合平台為照顧者提供相關照顧資訊，讓照顧者及其家庭更易知悉社會支援服務。對於年長的照顧者，建議政府可以在他們常出現或較容易接觸到的地方擺設攤位街站，派發相關小冊子。五、增加照顧者的經濟支援，提供「喘息及活動津貼」，並且將「照顧元素」融入經濟援助項目，使到綜援申請人和長者生活津貼領取人可獲得一定比率的照顧者津貼金額。

An Evaluation Of Peer-Rated Surgical Skill And Its Relationship With Detrusor Muscle Sampling In Transurethral Resection Of Bladder Tumor, Minh N Pham, Oliver S Ko, Reiping Huang, Amanda X Vo, Kyle P Tsai, Jeremy D Lai, Matthew T Hudnall, Joshua A Halpern, Joshua J Meeks, Jonas Benson, Ricardo Soares, Ronald Kim, Karl Y Bilimoria, Jonah J Stulberg, Gregory B Auffenberg

Faculty, Staff and Student Publications

OBJECTIVE: To assess the reliability of peer-review of TURBT videos as a means to evaluate surgeon skill and its relationship to detrusor sampling.

METHODS: Urologists from an academic health system submitted TURBT videos in 2019. Ten blinded peers evaluated each surgeon's performance using a 10-item scoring instrument to quantify surgeon skill. Normalized composite skill scores for each surgeon were calculated using peer ratings. For surgeons submitting videos, we retrospectively reviewed all TURBT pathology results (2018-2019) to assess surgeon-specific detrusor sampling. A hierarchical logistic regression model was fit to evaluate the association between skill and detrusor sampling, adjusting for patient and …

Exploring Graduate Student Mental Health And Service Utilization By Gender, Race, And Year In School, Mikhila N. Wildey, Meghan E. Fox, Kelly A. Machnik, Deborah Ronk

Peer Reviewed Articles

Objective: The current study explored differences in mental health problems, services utilization, and support of graduate students by gender, race/ethnicity, and year in school.

Participants: Participants consisted of 734 graduate students from a large, Midwestern university.

Methods: Graduate students answered a series of questionnaires in fall 2021 assessing their mental health, services utilization, and perception of services.

Results: Women (vs men) and participants in their second year and beyond (vs first year) reported greater mental health problems, negative impact of the pandemic, and more services utilization. White (vs non-White) participants reported greater negative impact of the pandemic, greater services utilization, …

Long-Term Management Of Generalised Anxiety Disorder With Low-Dose Continuous Infusions Of Flumazenil: A Case Series, Alexander T. Gallo, Stephen Addis, Vlad Martyn, Hishani Ramanathan, Grace K. Wilkerson, Sean D. Hood, Hans Stampfer, Gary K. Hulse

Research outputs 2022 to 2026

Background: Generalised anxiety disorder (GAD) is a common anxiety disorder associated with social and occupational impairment. Recently, a theory was postulated that dysfunctional gamma aminobutyric acid type A receptors (GABAA) are implicated in anxiety symptomology, which could be corrected by flumazenil, an antagonist at the benzodiazepine binding site on the GABAA receptor. Method: Participants had a primary diagnosis of GAD and were treated initially with an eight-day continuous low-dose flumazenil infusion (total 32 mg at a rate of 4 mg/24 h). Some participants were re-treated with a further four- or eight-day infusion. Treatment response was measured as a 50 % …

Patterns Of Suicide And Self-Harm In Pakistan: A Retrospective Descriptive Study Protocol, Nargis Asad, Summaiya Tariq, Asra Qureshi, Mohammad Zaman, Mustafa Aslam, Farhat Mirza, Murad Khan

Brain and Mind Institute

Introduction Suicide is a major global public health problem. Low-income and middle-income countries contribute 78% of all suicidal deaths. Pakistan, a South Asian country, lacks official statistics on suicides at national level. Statistics on suicide are neither collected nationally nor published in the annual national morbidity and mortality surveys. Medicolegal reports on suicides and self-harm are extremely rich and important source of information but greatly underused in Pakistan. We aim to examine the patterns of suicides and self-harm retrospectively in patients who were registered with medicolegal centres (MLCs) in Karachi, during the period January 2017 to December 2021.

Methods and …

Prevalent Multimorbidity Combinations Among Middle-Aged And Older Adults Seen In Community Health Centers, Ana R Quiñones, Steele H Valenzuela, Nathalie Huguet, Maria Ukhanova, Miguel Marino, Jennifer A Lucas, Jean O'Malley, Teresa D Schmidt, Robert Voss, Katherine Peak, Nathaniel T Warren, John Heintzman

Faculty, Staff and Student Publications

BACKGROUND: Multimorbidity (≥ 2 chronic diseases) is associated with greater disability and higher treatment burden, as well as difficulty coordinating self-management tasks for adults with complex multimorbidity patterns. Comparatively little work has focused on assessing multimorbidity patterns among patients seeking care in community health centers (CHCs).

OBJECTIVE: To identify and characterize prevalent multimorbidity patterns in a multi-state network of CHCs over a 5-year period.

DESIGN: A cohort study of the 2014-2019 ADVANCE multi-state CHC clinical data network. We identified the most prevalent multimorbidity combination patterns and assessed the frequency of patterns throughout a 5-year period as well as the demographic …

Tdap-Hpv Vaccination Bundling In The Usa: Trends, Predictors, And Implications For Vaccine Series Completion, Yenan Zhu, Chi-Fang Wu, Anna R Giuliano, Maria E Fernandez, Ana P Ortiz, Cecilia Ganduglia Cazaban, Ruosha Li, Ashish A Deshmukh, Kalyani Sonawane

Faculty, Staff and Student Publications

The Centers for Disease Control and Prevention (CDC) promotes taking a 'bundling approach' (i.e., administering Tetanus, diphtheria toxoids, and acellular pertussis [Tdap] and human papillomavirus [HPV] vaccines in the same way and on the same day) for adolescent vaccinations. Recent trends and patterns in Tdap-HPV vaccination bundling in the USA remain undocumented. In addition, the implications of bundling Tdap-HPV vaccination for HPV vaccine series completion remain unknown. to address these critical knowledge gaps, we performed a retrospective study using a nationwide sample of privately insured adolescents (Optum's de-identified Clinformatics® Data Mart Database). Tdap-HPV vaccination bundling (per 100 Tdap vaccination encounters) …

Rare Genetic Variants Explain Missing Heritability In Smoking, Seon-Kyeong Jang, Luke Evans, Allison Fialkowski, Donna K Arnett, Allison E Ashley-Koch, Kathleen C Barnes, Diane M Becker, Joshua C Bis, John Blangero, Eugene R Bleecker, Meher Preethi Boorgula, Donald W Bowden, Jennifer A Brody, Brian E Cade, Brenda W Campbell Jenkins, April P Carson, Sameer Chavan, L Adrienne Cupples, Brian Custer, Scott M Damrauer, Sean P David, Mariza De Andrade, Carla L Dinardo, Tasha E Fingerlin, Myriam Fornage, Barry I Freedman, Melanie E Garrett, Sina A Gharib, David C Glahn, Jeffrey Haessler, Susan R Heckbert, John E Hokanson, Lifang Hou, Shih-Jen Hwang, Matthew C Hyman, Renae Judy, Anne E Justice, Robert C Kaplan, Sharon L R Kardia, Shannon Kelly, Wonji Kim, Charles Kooperberg, Daniel Levy, Donald M Lloyd-Jones, Ruth J F Loos, Ani W Manichaikul, Mark T Gladwin, Lisa Warsinger Martin, Mehdi Nouraie, Olle Melander, Deborah A Meyers, Courtney G Montgomery, Kari E North, Elizabeth C Oelsner, Nicholette D Palmer, Marinelle Payton, Anna L Peljto, Patricia A Peyser, Michael Preuss, Bruce M Psaty, Dandi Qiao, Daniel J Rader, Nicholas Rafaels, Susan Redline, Robert M Reed, Alexander P Reiner, Stephen S Rich, Jerome I Rotter, David A Schwartz, Aladdin H Shadyab, Edwin K Silverman, Nicholas L Smith, J Gustav Smith, Albert V Smith, Jennifer A Smith, Weihong Tang, Kent D Taylor, Marilyn J Telen, Ramachandran S Vasan, Victor R Gordeuk, Zhe Wang, Kerri L Wiggins, Lisa R Yanek, Ivana V Yang, Kendra A Young, Kristin L Young, Yingze Zhang, Dajiang J Liu, Matthew C Keller, Scott Vrieze

Faculty, Staff and Student Publications

Common genetic variants explain less variation in complex phenotypes than inferred from family-based studies, and there is a debate on the source of this 'missing heritability'. We investigated the contribution of rare genetic variants to tobacco use with whole-genome sequences from up to 26,257 unrelated individuals of European ancestries and 11,743 individuals of African ancestries. Across four smoking traits, single-nucleotide-polymorphism-based heritability ([Formula: see text]) was estimated from 0.13 to 0.28 (s.e., 0.10-0.13) in European ancestries, with 35-74% of it attributable to rare variants with minor allele frequencies between 0.01% and 1%. These heritability estimates are 1.5-4 times higher than past …

Brain-Wide Versus Genome-Wide Vulnerability Biomarkers For Severe Mental Illnesses, Peter Kochunov, Yizhou Ma, Kathryn S Hatch, Si Gao, Neda Jahanshad, Paul M Thompson, Bhim M Adhikari, Heather Bruce, Andrew Van Der Vaart, Eric L Goldwaser, Aris Sotiras, Mark D Kvarta, Tianzhou Ma, Shuo Chen, Thomas E Nichols, L Elliot Hong

Faculty, Staff and Student Publications

Severe mental illnesses (SMI), including major depressive (MDD), bipolar (BD), and schizophrenia spectrum (SSD) disorders have multifactorial risk factors and capturing their complex etiopathophysiology in an individual remains challenging. Regional vulnerability index (RVI) was used to measure individual's brain‐wide similarity to the expected SMI patterns derived from meta‐analytical studies. It is analogous to polygenic risk scores (PRS) that measure individual's similarity to genome‐wide patterns in SMI. We hypothesized that RVI is an intermediary phenotype between genome and symptoms and is sensitive to both genetic and environmental risks for SMI. UK Biobank sample of N = 17,053/19,265 M/F (age = 64.8 …

Brain Structure In Acutely Underweight And Partially Weight-Restored Individuals With Anorexia Nervosa: A Coordinated Analysis By The Enigma Eating Disorders Working Group, Esther Walton, Fabio Bernardoni, Victoria-Luise Batury, Klaas Bahnsen, Sara Larivière, Giovanni Abbate-Daga, Susana Andres-Perpiña, Lasse Bang, Amanda Bischoff-Grethe, Samantha J Brooks, Iain C Campbell, Giammarco Cascino, Josefina Castro-Fornieles, Enrico Collantoni, Federico D'Agata, Brigitte Dahmen, Unna N Danner, Angela Favaro, Jamie D Feusner, Guido K W Frank, Hans-Christoph Friederich, John L Graner, Beate Herpertz-Dahlmann, Andreas Hess, Stefanie Horndasch, Allan S Kaplan, Lisa-Katrin Kaufmann, Walter H Kaye, Sahib S Khalsa, Kevin S Labar, Luca Lavagnino, Luisa Lazaro, Renzo Manara, Amy E Miles, Gabriella F Milos, Alessio Maria Monteleone, Palmiero Monteleone, Benson Mwangi, Owen O'Daly, Jose Pariente, Julie Roesch, Ulrike H Schmidt, Jochen Seitz, Megan E Shott, Joe J Simon, Paul A M Smeets, Christian K Tamnes, Elena Tenconi, Sophia I Thomopoulos, Annemarie A Van Elburg, Aristotle N Voineskos, Georg G Von Polier, Christina E Wierenga, Nancy L Zucker, Neda Jahanshad, Joseph A King, Paul M Thompson, Laura A Berner, Stefan Ehrlich

Faculty, Staff and Student Publications

Background: The pattern of structural brain abnormalities in anorexia nervosa (AN) is still not well understood. While several studies report substantial deficits in gray matter volume and cortical thickness in acutely underweight patients, others find no differences, or even increases in patients compared with healthy control subjects. Recent weight regain before scanning may explain some of this heterogeneity. To clarify the extent, magnitude, and dependencies of gray matter changes in AN, we conducted a prospective, coordinated meta-analysis of multicenter neuroimaging data.

Methods: We analyzed T1-weighted structural magnetic resonance imaging scans assessed with standardized methods from 685 female patients with AN …

Same Day Discharge Following Elective, Minimally Invasive, Colorectal Surgery : A Review Of Enhanced Recovery Protocols And Early Outcomes By The Sages Colorectal Surgical Committee With Recommendations Regarding Patient Selection, Remote Monitoring, And Successful Implementation, Elisabeth C Mclemore, Lawrence Lee, Traci L Hedrick, Laila Rashidi, Erik P Askenasy, Daniel Popowich, Patricia Sylla

Faculty, Staff and Student Publications

BACKGROUND: As enhanced recovery programs (ERPs) have continued to evolve, the length of hospitalization (LOS) following elective minimally invasive colorectal surgery has continued to decline. Further refinements in multimodal perioperative pain management strategies have resulted in reduced opioid consumption. The interest in ambulatory colectomy has dramatically accelerated during the COVID-19 pandemic. Severe restrictions in hospital capacity and fear of COVID transmission forced surgical teams to rethink strategies to further reduce length of inpatient stay.

METHODS: Members of the SAGES Colorectal Surgery Committee began reviewing the emergence of SDD protocols and early publications for SDD in 2019. The authors met at …

Is Antibiotic Prophylaxis Necessary After Endoscopic Ultrasound-Guided Fine-Needle Aspiration Of Pancreatic Cysts?, Seifeldin Hakim, Mihajlo Gjeorgjievski, Zubair Khan, Michael E Cannon, Kevin Yu, Prithvi Patil, Roy Tomas Davee, Sushovan Guha, Ricardo Badillo, Laith Jamil, Nirav Thosani, Srinivas Ramireddy

Faculty, Staff and Student Publications

BACKGROUND/AIMS: Current society guidelines recommend antibiotic prophylaxis for 3 to 5 days after endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of pancreatic cystic lesions (PCLs). The overall quality of the evidence supporting this recommendation is low. In this study, we aimed to assess cyst infection and adverse event rates after EUS-FNA of PCLs among patients treated with or without postprocedural prophylactic antibiotics.

METHODS: We retrospectively reviewed all patients who underwent EUS-FNA of PCLs between 2015 and 2019 at two large-volume academic medical centers with different practice patterns of postprocedural antibiotic prophylaxis. Data on patient demographics, cyst characteristics, fine-needle aspiration technique, periprocedural and …

Outcomes Of Gynecologic Cancer Surgery During The Covid-19 Pandemic: An International, Multicenter, Prospective Covidsurg-Gynecologic Oncology Cancer Study, Christina Fotopoulou, Tabassum Khan, Juraj Bracinik, James Glasbey, Nadeem Abu-Rustum, Luis Chiva, Anna Fagotti, Keiichi Fujiwara, Rahel Ghebre, Murat Gutelkin, Thomas O Konney, Joseph Ng, Rene Pareja, Rajkumar Kottayasamy Seenivasagam, Jalid Sehouli, Shylasree T S Surappa, Aneel Bhangu, Elaine Leung, Sudha Sundar

Faculty, Staff and Student Publications

BACKGROUND: The CovidSurg-Cancer Consortium aimed to explore the impact of COVID-19 in surgical patients and services for solid cancers at the start of the pandemic. The CovidSurg-Gynecologic Oncology Cancer subgroup was particularly concerned about the magnitude of adverse outcomes caused by the disrupted surgical gynecologic cancer care during the COVID-19 pandemic, which are currently unclear.

OBJECTIVE: This study aimed to evaluate the changes in care and short-term outcomes of surgical patients with gynecologic cancers during the COVID-19 pandemic. We hypothesized that the COVID-19 pandemic had led to a delay in surgical cancer care, especially in patients who required more extensive …

The Association Of Human Leukocyte Antigen Genotyping Among Sudanese Patients With Rheumatoid Arthritis: Reference To Ethnicity, Deborah R Young, Benjamin D Hong, Kristina H Lewis, Silvia R Paz, Bhumi B Bhakta, Mayra Macias, Cecelia L Crawford, Adam Drewnowski, Ming Ji, Darren D Moore, Ernest Shen, Sameer B Murali, Karen J Coleman

Faculty, Staff and Student Publications

OBJECTIVE: This study examined the association of weight loss following bariatric surgery with self-reported sleep quality after accounting for other sleep-related factors.

METHODS: Participants were from the Bariatric Experience Long Term (BELONG) study. Participants completed a survey up to 6 months before surgery and approximately 1 year after surgery. The Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality. One-year percentage total weight loss (%TWL) was determined from electronic medical records. Covariates included demographics, Charlson Comorbidity Index, geocoded variables to assess neighborhood quality, and physical activity. The authors assessed the association between %TWL at 1 year and PSQI …

Does Attention-Deficit/Hyperactivity Disorder Increase The Risk Of Minor Blunt Head Trauma In Children?, Murat Pakyurek, Mohamed Badawy, Irma T Ugalde, Paul Ishimine, Pradip P Chaudhari, Kevan Mccarten-Gibbs, Ozra Nobari, Nathan Kuppermann, James F Holmes

Faculty, Staff and Student Publications

PROBLEM: It is unclear if attention-deficit hyperactivity disorder (ADHD) increases the risk of head trauma in children.

METHODS: We conducted a multicenter prospective observational study of children with minor blunt head trauma. Guardians were queried, and medical records were reviewed as to whether the patient had previously been diagnosed with ADHD. Enrolled patients were categorized based on their mechanism of injury, with a comparison of those with motor vehicle collision (MVC) versus non-MVC mechanisms.

FINDINGS: A total of 3410 (84%) enrolled children had ADHD status available, and 274 (8.0%; 95% confidence interval, CI: 7.1, 9.0%) had been diagnosed with ADHD. …