Mental and Social Health Commons^™

Demographic And Symptomology Differences Among Sexually Assaulted Children With Posttraumatic Stress Disorder, Kathleen Bethel-Pracht

Walden Dissertations and Doctoral Studies

Trauma due to sexual assault becomes a life changing event during a child's critical developmental years. Bronfenbrenner's ecological systems theory outlines the process of understanding an individual's environment and how disruptions in one level may affect other levels. This study determined if gender and ethnicity among sexually traumatized children diagnosed with post-traumatic stress disorder (PTSD) predict symptom severity as measured by the Trauma Symptom Checklist for Children (TSCC) after controlling for the socioeconomic level and home environment. The population consisted of 126 children aged 8 through 16 with at least a second-grade reading level. Multiple regression examined whether male and …

Lived Experiences Of Caregivers For Individuals With Serious Mental Illness In Rural Communities, Jennifer Way

Walden Dissertations and Doctoral Studies

More than ten million American adults live with a serious mental illness (SMI). Given the deinstitutionalization of psychiatric facilities, caregivers and family members are often needed to care for these individuals. Due to SMI individuals’ extensive needs, caregivers frequently face unique challenges and experiences. Although research has been conducted on caring for individuals with SMI, less information exists about the experiences of rural caregivers of SMI individuals. The purpose of this study was to fill this gap in research by exploring the lived experiences of caregivers of SMI individuals in rural areas with the intention of understanding this population’s unique …

Examining Motivational Interviewing's Effect On Confidence And Commitment Using Daily Data, Alexis Kuerbis, Kevin Lynch, Sijing Shao, Jon Morgenstern

Publications and Research

Mechanisms of behavior change (MOBC) within Motivational Interviewing (MI) are thought to operate via both relational and technical elements. These elements are hypothesized to increase client motivation and self-efficacy for change and subsequently decrease drinking. Only partial support for this causal chain exists, particularly when using within-session change talk as the primary intervening variable. This study explored whether commitment to moderate or abstain from drinking and confidence to moderate drinking in the next day measured via ecological momentary assessment (EMA) provided alternative support for the theory. Data were from a pilot randomized controlled trial testing active ingredients of MI. Problem …

Is Acupuncture Effective In Reducing Opioid Cravings In Detoxifying Opioid Abusing Adults?, Sarah Kish

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is acupuncture effective in reducing opioid cravings in detoxifying opioid abusing adults?”

STUDY DESIGN: A review of three RCTs published in English, each of which was published in 2009, 2013 and 2014 respectively.

DATA SOURCES: Three randomized controlled trials (RCTs) published in peer-reviewed journals that evaluate the effectiveness of acupuncture to reduce opioid cravings found via PubMed and ScienceDirect.

OUTCOMES MEASURED: Opioid cravings via 100 millimeter analog scale score, the Maudsely craving score consisting of five-point Likert scales and withdraw symptoms as measured by a 4-point …

Is Gabapentin Effective In Reducing Heavy Drinking And Alcohol Related Insomnia In Alcohol Dependent Patients?, Benjamin Michalsky

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is gabapentin effective in reducing heavy drinking and alcohol related insomnia in alcohol dependent patients?”

STUDY DESIGN: Review of three English language primary studies, one published in 2008 and two others in 2013.

DATA STUDIES: Three double blind, randomized controlled trials (RCTs) analyzing the effects of gabapentin therapy in attempting to reduce heavy drinking and alcohol related insomnia in alcohol dependent patients were found via PubMed and Cochrane databases.

OUTCOMES MEASURED: The reduction in alcohol consumption and improvement in alcohol related insomnia were measured through the …

Is Acupuncture A Beneficial Therapy For The Treatment Of Alcohol Dependence?, Jamie E. Mcginn

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not acupuncture is a beneficial therapy for the treatment of alcohol dependence.

STUDY DESIGN: Review of three randomized controlled trails (RCTs) which were published in 2007, 2015, and 2016.

DATA SOURCES: All articles were presented in English and taken from peer reviewed journals found on PubMed.

OUTCOMES: The various symptoms of alcohol dependence; from withdrawal, cravings, and use were assessed through various methods. Alcohol withdrawal symptoms were assed using the alcohol-withdrawal syndrome scale, alcohol craving was assed using a Visual Analogue Scale, and alcohol use was measured …

Is Sublingual Buprenorphine Treatment Effective And Efficient When Compared To Traditional Neonatal Opium Solution (Morphine) In Treating Newborns With Neonatal Abstinence Syndrome?, Abigail G. Stefanides

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether sublingual buprenorphine treatment is effective and efficient when compared to traditional neonatal opium solution (morphine) in treating newborns with neonatal abstinence syndrome (NAS).

Study Design: Review of one randomized active-control clinical trial, one randomized doubleblind, double-dummy clinical trial, and one retrospective cohort analysis.

Data Sources: All articles were published in English between the years of 2011 and 2017. Articles were obtained from peer-reviewed journals and databases using PubMed and Embase.

Outcomes: Outcomes measured were length of stay using the neonates birth date and hospital discharge date as well …

How Coping Process Relates To Eating Behaviors Among Military Veterans With Posttraumatic Stress Disorder, Debra Kimberlin

Graduate Research Theses & Dissertations

Posttraumatic stress disorder (PTSD) is a mental health condition faced by many veterans, and veterans with PTSD have higher rates of poor health and obesity than civilians. Evidence suggests mental health issues such as PTSD may be associated with disordered eating behaviors. In addition, veterans with PTSD may select a variety of coping behaviors to manage stress and emotions, some of which may negatively impact their health. This study explored the relationships between coping process, emotion- and stress-related eating, and eating disorder risk among a sample of veterans with PTSD (n = 239) who were recruited through veteran service organizations …

Internet Addiction, Smartphone Addiction, And Hikikomori Trait In Japanese Young Adult: Social Isolation And Social Network, Masaru Tateno, Alan R. Teo, Wataru Ukai, Junichiro Kanazawa, Ryoko Katsuki, Hiroaki Kubo, Takahiro A. Kato

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: As the number of internet users increases, problems related to internet overuse are becoming more and more serious. Adolescents and youth may be particularly attracted to and preoccupied with various online activities. In this study, we investigated the relationship of internet addiction, smartphone addiction, and the risk of hikikomori, severe social withdrawal, in Japanese young adult.

Methods: The subjects were 478 college/university students in Japan. They were requested to complete the study questionnaire, which consisted of questions about demographics, internet use, the Internet Addiction Test (IAT), the Smartphone Addiction Scale (SAS)–Short Version (SV), the 25-item Hikikomori Questionnaire …

Exploring The Extent Of The Hikikomori Phenomenon On Twitter: Mixed Methods Study Of Western Language Tweets, Pereira-Sanchez, Miguel Angel Alvarez-Mon, Angel Asunsolo Del Barco, Melchor Alvarez-Mon, Alan R. Teo

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Hikikomori is a severe form of social withdrawal, originally described in Japan but recently reported in other countries. Debate exists as to what extent hikikomori is viewed as a problem outside of the Japanese context. Objective: We aimed to explore perceptions about hikikomori outside Japan by analyzing Western language content from the popular social media platform, Twitter. Methods: We conducted a mixed methods analysis of all publicly available tweets using the hashtag #hikikomori between February 1 and August 16, 2018, in 5 Western languages (Catalan, English, French, Italian, and Spanish). Tweets were first classified as to whether they described …

Impacts Of An Opioid Overdose Prevention Intervention Delivered Subsequent To Acute Care, Caleb J. Banta-Green, Phillip O. Coffin, Joseph O. Merrill, Jeanne M. Sears, Chris Dunn, Norbert D. Yanez, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background Opioid overdose is a major and increasing cause of injury and death. There is an urgent need for interventions to reduce overdose events among high-risk persons.

Methods Adults at elevated risk for opioid overdose involving heroin or pharmaceutical opioids who had been cared for in an emergency department (ED) were randomised to overdose education combined with a brief behavioural intervention and take-home naloxone or usual care. Outcomes included: (1) time to first opioid overdose-related event resulting in medical attention or death using competing risks survival analysis; and (2) ED visit and hospitalisation rates, using negative binomial regression and adjusting …

Relative Wealth, Subjective Social Status, And Their Associations With Depression: Cross-Sectional, Population-Based Study In Rural Uganda, Meghan L. Smith, Bernard Kakuhikire, C. Baguma, Justin D. Rasmussen, David Bangsberg, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Depression is a leading cause of disability worldwide, and has been found to be a consistent correlate of socioeconomic status (SES). The relative deprivation hypothesis proposes that one mechanism linking SES to health involves social comparisons, suggesting that relative SES rather than absolute SES is of primary importance in determining health status. Using data from a whole-population sample of 1,620 participants residing in rural southwestern Uganda, we estimated the independent associations between objective and subjective relative wealth and probable depression, as measured by the depression subscale of the Hopkins Symptom Checklist (HSCLD). Objective relative wealth was measured by an asset …

Portrayals Of Mental Illness, Treatment, And Relapse And Their Effects On The Stigma Of Mental Illness: Population-Based, Randomized Survey Experiment In Rural Uganda, Justin D. Rasmussen, Bernard Kakuhikire, C. Baguma, Scholastic Ashaba, Christine E. Cooper-Vince, Jessica M. Perkins, David Bangsberg, Alexander C. Tsai

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background

Mental illness stigma is a fundamental barrier to improving mental health worldwide, but little is known about how to durably reduce it. Understanding of mental illness as a treatable medical condition may influence stigmatizing beliefs, but available evidence to inform this hypothesis has been derived solely from high-income countries. We embedded a randomized survey experiment within a whole-population cohort study in rural southwestern Uganda to assess the extent to which portrayals of mental illness treatment effectiveness influence personal beliefs and perceived norms about mental illness and about persons with mental illness.

Methods and findings

Study participants were randomly assigned …

Barriers And Facilitators To Recruitment And Enrollment Of Hiv-Infected Individuals With Opioid Use Disorder In A Clinical Trial, Kim Hoffman, Robin Baker, Lynn Elizabeth Kunkel, Elizabeth Needham Waddell, Paula J. Lum, Dennis Mccarty, P. Todd Korthuis

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background

The CTN-0067 CHOICES trial tests implementation of extended-release naltrexone (XR-NTX) versus treatment-as-usual (TAU) for opioid use disorders (OUD) in HIV clinics to improve HIV viral suppression. The study team investigated recruitment strategies to elucidate the barriers and facilitators to recruitment and enrollment in the study.

Main text

Methods: Semi-structured, in-depth, digitally recorded interviews were completed with study recruitment-related staff and medical providers (n = 26) from six participating HIV clinics in the fall of 2018. Interviews probed 1) factors that might prevent prospective participants from engaging in study recruitment and enrollment procedures and 2) strategies used by study …

Trace Amine-Associated Receptor Gene Polymorphism Increases Drug Craving In Individuals With Methamphetamine Dependence, Jennifer M. Loftis, Michael Lasarev, Xiao Shi, Jodi Lapidus, Aaron Janowsky, William Hoffman, Marilyn Huckans

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Methamphetamine (MA) is a potent agonist at the trace amine-associated receptor 1 (TAAR1). This study evaluated a common variant (CV) in the human TAAR1 gene, synonymous single nucleotide polymorphism (SNP) V288V, to determine the involvement of TAAR1 in MA dependence.

Methods: Participants (n = 106) with active MA dependence (MA-ACT), in remission from MA dependence (MA-REM), with active polysubstance dependence, in remission from polysubstance dependence, and with no history of substance dependence completed neuropsychiatric symptom questionnaires and provided blood samples. In vitro expression and function of CV and wild type TAAR1 receptors were also measured.

Results: The V288V polymorphism …

Polysubstance Opioid Use In A Justice-Involved Population: An Analysis Of Patterns And Reentry Outcomes, Amanda Marie Bunting

Theses and Dissertations--Sociology

The public health crisis surrounding opioid use is pronounced among justice-involved populations, who face high rates of overdose mortality as well as HIV, and hepatitis C due to injection drug use. The majority of opioid-related overdoses are due to polysubstance use (PSU), and a better understanding of the prevalence and patterns of PSU are necessary in order to inform interventions. This dissertation project has three aims: (1) understand the patterns of opioid PSU among a justice-involved population, (2) identify PSU patterns most at-risk for post-release relapse, and (3) examine engagement in post-release health service utilization. Post-release aims are guided by …

Associations Between Ethnic-Racial Identity, Family Factors And Alcohol Problems Among Diverse Emerging Adults, Chloe Walker

Theses and Dissertations

The current study examined how multiple dimensions of ethnic-racial identity (ERI) were associated with alcohol use and alcohol use disorder (AUD) symptoms and how these relations varied by individuals’ ethnic-racial group among 1850 diverse emerging adults (M = 18.46, SD = .38). Further, measurement invariance of the Ethnic Identity Scale-Brief (EIS-B) was tested across Latinx, White, Black, Asian, and Multiracial students. Additionally, alternative models were examined that tested whether family factors (i.e., parent education and family history of alcohol problems) moderated the relations between ERI and alcohol problems to further examine nuances in these relations. Results indicated that the …

Modified Eye Movement Desensitization Therapy Protocol Treating Substance Abuse Disorders, Elise Von Tersch

Walden Dissertations and Doctoral Studies

Quality substance abuse treatment is needed to help fight the battle against drug addiction. This qualitative study was designed to explore some of the approaches to eye movement desensitization (EMDR) therapy that therapists trained in Parnell's adapted EMDR model use in conjunction with treatment for addictions. The purpose of this narrative inquiry was to investigate the experience of therapists who incorporate substance abuse treatment with Parnell's adapted EMDR model when treating trauma and substance use disorders. The population studied comprised licensed mental health therapists who had completed Parnell's EMDR training and implemented Parnell's modified EMDR protocol in their professional practice. …

Prescreening Recommendations For Patients On Medical Cannabis, Wen Chieh Hu

Walden Dissertations and Doctoral Studies

Marijuana is the most frequently used illegal substance in the United States and is most widely used among young people aged 12 to 21 years. Accurate screening and monitored issuance of medical cannabis recommendations have been shown to decrease abuse rates of the substance, create fewer deaths from opiates, reduce crime rates, reduce marijuana use in youths, decrease car crash deaths, and lessen prevalence of suicide in young men. The purpose of this project was to explore whether multiple screening methods for depression and anxiety in patients who seek medical cannabis referrals for anxiety and depression would improve screening and …

Military Sexual Trauma Survivors' Experiences And Perceptions Of Cognitive Processing Therapy, Sally A. Mead

Walden Dissertations and Doctoral Studies

Military sexual trauma (MST) has been associated with poor emotional and psychological well-being, less overall life satisfaction, and poorer health in general as well as higher rates of posttraumatic stress disorder (PTSD). The Department of Veterans Affairs provides treatment for veterans who experienced MST and recommends cognitive processing therapy (CPT) as a preferred treatment modality. Quantitative studies have shown that CPT can decrease symptoms of PTSD; however, a neglected area of study concerns the experiences of veterans who receive CPT for MST-related PTSD. In this generic qualitative study, the perceptions and experiences of female veterans who were survivors of MST …