Psychiatry and Psychology Commons^™

Mindfulness Matters: Reducing Anxiety In Prelicensure Undergraduate Nursing Students Using Virtual Reality Meditation Prior To High Fidelity Simulation., Lindsey K. Hildreth

Honors Theses and Capstones

Abstract:

The aim of this study was to evaluate the effectiveness of a 5-minute virtual reality (VR) meditation intervention in reducing self-reported anxiety among prelicensure nursing students immediately prior to their participation in a high-fidelity clinical simulation. Anxiety levels were measured using a Visual Analog Scale (VAS) and compared between students who participated in the VR meditation intervention and those in a control group receiving standard prebrief, and no VR meditation. It was hypothesized that students who engage in VR meditation would demonstrate a reduction in anxiety compared to students in the control group.

Tele-Psychiatry Adoption And Its Effect On Rural Mental Health Service Availability, Anna Heineman, Kaylee Canterbury, Taylor Carpenter

Theses, Dissertations and Capstones

Purpose of study: This study examined the association between tele-psychiatry implementation and mental health service availability in rural healthcare settings. The analysis compared tele-psychiatry to traditional in-person psychiatric care among rural populations, focusing on access and utilization outcomes, including time to first psychiatric appointment, number of completed visits, and appointment no-show rates.

Methods: A qualitative literature review following a systematic approach was conducted using peer-reviewed articles published between 2016-2026. Databases included PubMed, ProQuest Health, CINAHL, Journal of Medical Internet Research, and the National Library of Medicine, with Google Scholar used as a supplemental source. The review followed PRISMA …

Clinical And Demographic Characteristics Of Participants In A Hepatitis C Treatment Trial In Rural Kentucky: How Policies Around Treatment Access May Impact Elimination Efforts In The United States, Jennifer R. Havens, Brittney D. Williams, Takako Schaninger, Virginia A. Shepherd-Tackett, Michelle R. Lofwall, Michele Staton, Sharon L. Walsh, Hannah K. Knudsen

Behavioral Science Faculty Publications

Introduction: The advent of curative direct acting antiviral (DAA) drugs to treat those actively infected with the hepatitis C virus (HCV) has allowed for discussion around HCV elimination. Restrictive state-by-state policies for the coverage of DAAs for Medicaid recipients may hamper elimination efforts in the United States by limiting access to these curative treatments. Methods: The purpose of the current analysis was to examine the sociodemographic, drug use and clinical characteristics of participants in the Kentucky Viral Hepatitis C Treatment (KeY Treat) study in the context of Medicaid policies in the United States. The goal of KeY Treat was to …

The Interaction Of Tobacco Retailer Density And Rurality With Tobacco Use Prevalence In Kentucky, Shyanika W. Rose, W. Jay Christian, Judy Van De Venne, Delvon T. Mattingly, Bethany Shorey Fennell, Saber Feizy, Mary Kay Rayens

Behavioral Science Faculty Publications

Purpose: Tobacco retailer density is a key correlate of tobacco use prevalence in the United States, but this relationship has typically been examined in urban areas. We examined the relationship between retailer density and tobacco use across Kentucky counties, a state with high smoking rates and a substantial rural population.

Methods: We obtained a list of tobacco retailers from the 2021 Kentucky Synar program, used for minor’s access inspections. We merged these data with county-level prevalence estimates for cigarette and smokeless tobacco use for each county in Kentucky, calculated using pooled 3-year estimates (2017-2019) of Kentucky Behavioral Risk Factor Surveillance …

Acceptability And Appropriateness Of Harm Reduction Vending Machines Compared To Syringe Service Programs In Appalachian Kentucky, Hannah K. Knudsen, Jennifer R. Havens, April M. Young

Behavioral Science Faculty Publications

Objective:

Many rural people who inject drugs do not use syringe service programs (SSPs). In addition, people who use drugs but do not inject may perceive that SSPs are not intended for their use. Harm reduction vending machines (HRVMs) may be preferred by some individuals. This study examines attitudes and preferences regarding HRVMs to consider possibilities for enhancing the reach of harm reduction services. Method:

Structured surveys were conducted with 712 people who use drugs in two rural Appalachian counties in Kentucky. Participants rated the acceptability/appropriateness of SSPs and HRVMs; HRVM preference was the difference between the two scales. Linear …

Perceived Neighborhood Disadvantage And Current Nicotine Pouch Use Among U.S. Youth, Delvon T. Mattingly, Meman Diaby, Jing Zhang, Juhan Lee, Melinda J. Ickes

Behavioral Science Faculty Publications

Introduction: Nicotine pouches (NPs) are emerging nicotine products that appeal to youth due to their discreet use, tobacco-free formulation, and flavor availability. However, given their recent introduction to the market, little is known about how neighborhood environments may influence US youth NP use.

Methods: We imputed cross-sectional data from the 2023 National Youth Tobacco Survey (n = 22,069, ages 9 + years) and developed a neighborhood risk score (range: 1–4) by averaging 10 items related to neighborhood disorder, safety, and disadvantage. To estimate associations between the risk score and current (past 30-day) NP use, we fit logistic regression models adjusted …

Beyond Weak Ties In Prison: An Investigation Of Core Support Networks Of Incarcerated Persons, Siyun Peng, Martha Tillson, Maria Rockett, Marisa Booty, Carrie B. Oser

Behavioral Science Faculty Publications

Tie formation has been a core interest of network researchers. However, most existing research on tie formation in prisons has focused on weak ties, assuming that a core network approach is less applicable within total institutions such as prisons. Drawing on egocentric network data from 389 incarcerated individuals and 1352 named network members, this study demonstrates that relationships between incarcerated persons can be examined using a core support network framework. We find that about 20 % of participants include at least one incarcerated peer in their core support networks, with these ties providing both practical and emotional support comparable to …

Decreasing Prevalence In Youth Depressive Episodes: Evidence From The 2021-2024 National Survey On Drug Use And Health, R. Andrew Yockey, Aminul Apu, Timothy Grigsby, Jacob Bleasdale, Delvon T. Mattingly, Rachel Hoopsick

Behavioral Science Faculty Publications

Background: Major depressive disorder (MDD) is a leading contributor to the global burden of disease and commonly develops during adolescence. The COVID-19 pandemic was linked to significant increases in depressive symptoms among youth, but less is known about whether these increases have continued in recent years.

Objective: Using the first four consecutive years of methodologically comparable national data since the pandemic, we examined changes in past-year major depressive episode (MDE) among U.S. adolescents aged 12–17 years from 2021 to 2024 and evaluated demographic and substance use factors.

Methods: We analyzed pooled, cross-sectional data from the 2021–2024 National Survey on Drug …

Differences In The Use Of Smokeless Tobacco, Alcohol, And Co-Use Among U.S. High-School Students: Analysis Of National Youth Risk Behavior Survey Data, Ganna Kostygina, Yoonsang Kim, Alex Kresovich, Simon Page, Shyanika W. Rose, Sherry L. Emery

Behavioral Science Faculty Publications

Introduction: This study was aimed to examine the bidirectional relationships and patterns of concurrent smokeless tobacco and alcohol use among U.S. high-school students, investigating whether demographic characteristics and behavioral factors differentially predict concurrent versus single substance use of smokeless tobacco or alcohol (referred to as either-alone use in the remaining parts of this paper).

Methods: Analysis of nationally representative Youth Risk Behavior Survey data was perfomed, combining 3 cross-sectional surveys (2019, 2021, 2023) from 39,164 students in Grades 9–12. Logistic regression examined the bidirectional smokeless tobacco–alcohol associations, whereas multinomial models compared the characteristics of concurrent users, users of smokeless tobacco …

An Exploratory Study To Determine The Feasibility And Processes Needed To Implement The Immunization Neighborhood To Increase Hpv Vaccination Among African American Adolescents And Adolescents In The General Population: A Multi-Partner Perspective, Jennifer Cunningham-Erves, Freneka Minter, Pamela C. Hull, Amanda F. Dempsey, Alexandria Demons, Mariya Chalise, Consuelo H. Wilkins

Behavioral Science Faculty Publications

Limited education and healthcare access are major contributors to Human Papillomavirus (HPV) vaccination disparities among African American adolescents. The Immunization Neighborhood (IN) involves enhanced communication and collaboration among providers to address people’s needs by expanding access points and education to increase vaccination. Because needs of immunization providers and parents to effectively collaborate are unknown, this study explored the feasibility of and processes needed for IN utilization across key partners: pediatricians, pharmacists, school nurses, health department staff, and African American parent–child dyads. We conducted a semi-structured interviews in a qualitative, descriptive study with a purposive sample of 30 African American parent–child …

Extended-Release Vs Sublingual Buprenorphine In Pregnancy Through 12 Months Post Partum: A Randomized Clinical Trial, T. John Winhusen, Michelle R. Lofwall, Frankie Kropp, Daniel Lewis, Marcela C. Smid, Jessica L. Young, Candace Hodgkins, Elizabeth E. Krans, Zachary Hansen, Elisha M. Wachman, Davida M. Schiff, Constance Guille, Vania Rudolf, Tara Chowdhury, Lawrence Leeman, Mitra Lewis, Abigail G. Matthews, Gerald Cochran, Jacquie King, Christine Wilder, Carmen Rosa

Behavioral Science Faculty Publications

Importance: Treating opioid use disorder (OUD) in pregnancy with sublingual buprenorphine is an evidence-based practice, but it has disadvantages that could be addressed with an extended-release formulation.

Objective: To evaluate the effectiveness and safety of extended-release buprenorphine vs sublingual buprenorphine for OUD in pregnancy through 12 months post partum.

Design, Setting, and Participants: This 2-group, open-label, noninferiority, randomized clinical trial was conducted between July 2, 2020, and October 30, 2024, among adults with OUD and a singleton pregnancy of 6 to 30 weeks’ gestational age at 13 outpatient cross-disciplinary peripartum OUD treatment sites.

Interventions: Randomization to sublingual or extended-release buprenorphine …

Feeding The Family—A Food Is Medicine Intervention: Preliminary Baseline Results Of Clinical Data From Caregivers And Children, Gabriela Drucker, Christa Mayfield, Elizabeth T. Anderson Steeves, Sara Maksi, Tabitha Underwood, Julie Brown, Marissa Frick, Alison Gustafson

Behavioral Science Faculty Publications

Background/Objectives: Food is Medicine (FIM) programs have been shown to be effective at addressing food and nutrition insecurity among individuals. However, more evidence is needed to determine effective interventions at the household level and their impact on child health outcomes. Feeding the Family is a randomized controlled trial which aims to determine whether the amount of food provided and the ability to select foods in FIM interventions have an incremental effect on child and caregiver clinical outcomes relative to nutrition counseling alone. The objective of this paper is to describe the population at baseline among those enrolled in Feeding the …

Frequent Police Contact And Nonfatal Overdose Among People Who Use Drugs In Rural Appalachia, Javier A. Cepeda, Talia Loeb, Zach R. Salazar, Brittney D. Williams, Brooke Hiltz, Brandon Del Pozo, Eileen V. Pitpitan, Leo Beletsky, April M. Young, Jennifer R. Havens

Behavioral Science Faculty Publications

Introduction: Police contact shapes subsequent health practices and outcomes among people who use drugs (PWUD). However, the relationship between police encounters with overdose remains under-researched. We evaluated how police stop-and-search was associated with nonfatal overdose and identified correlates of frequent police contact among PWUD in rural Kentucky.

Methods: From May 2023– April 2024, 774 PWUD were enrolled in the Social Networks of Appalachian People and KyOSK studies. The exposure of interest was self-reported police stop-and-search in the past 6 months (0, 1–3, ≥4 times). The primary outcome was self-reported nonfatal overdose in the past 6 months. We evaluated the association …

Social Engagement Moderates The Relationship Between Cognitive Functioning, Depressive Symptoms, And Restless Sleep In Older Black Adults, Sunkanmi Folorunsho, Olufunmilola Abraham, Darlingtina K. Esiaka

Pharmacy Practice and Science Faculty Publications

INTRODUCTION: Older Black adults face higher dementia risk, but it is unclear whether social engagement offsets the effects of depression and restless sleep.

METHODS: We analyzed 1,905 Black adults aged 50+ from the 2016-2020 Health and Retirement Study (HRS). Linear mixed-effects models tested how depressive symptoms, restless sleep, and social engagement predicted baseline cognition and cognitive decline.

RESULTS: Higher depressive symptoms and restless sleep were associated with lower baseline cognition (about 0.2 and 0.5 points lower) and faster decline (β×time ≈ −0.07 and −0.05). Greater social engagement predicted higher baseline cognition (about 0.6 points higher) and slower decline (β×time ≈ …

The Effects Of Childhood Maltreatment On Executive Functioning: The Difference Between Cumulative Trauma, Abuse Severity, And Neglect, Kelly Krehbiel

Master's Theses or Doctor of Nursing Practice

Childhood maltreatment is prevalent in the United States with around 558,899 children being victims of abuse in 2022 (U.S Department of Health & Human Services, 2024). Neglect is the most common form of abuse with around 74 percent of abused children being neglected; however, neglect tends to be the least researched form of abuse. Childhood maltreatment has long-term effects on a person’s mental, physical, and cognitive health. Previous research suggests that childhood maltreatment leads to severe deficits in executive functioning skills such as working memory and cognitive flexibility. Executive functioning skills are important for almost every aspect of life including …

Effect Of Antipsychotic Medication Use And Type On Mortality And Cardiovascular Risks In Nursing Home Patients With Dementia, Hamid R. Okhravi, Fang Fang, Melissa P. Hunter, Brynn E. Sheehan

Glennan Center for Geriatrics and Gerontology Faculty Publications

Introduction

Antipsychotic medication (APM) use in nursing home (NH) patients with dementia is common but carries risks. This study assessed the association between APM use and mortality, stroke, and myocardial infarction (MI) compared to non-use, as well as differences between first- and second-generation APMs.

Methods

A serial cross-sectional study using Medicare data examined outcomes from 2012 to 2015 in a national sample of 328,138 US NH residents aged 50 and older with dementia. Multivariate logistic regressions were used to analyze risk.

Results

APM use was associated with increased mortality in all years (odds ratio [OR] range: 2.39 to 1.23, all …

Emotion Regulation Difficulties And Substance Use: The Role Of Conscientiousness, Caitlyn M. Donnelly

Theses and Dissertations

Difficulties in emotion regulation have been consistently linked to substance use among college students. However, individual differences may influence this relationship. Conscientiousness, a personality trait characterized by self-control, planning, and goal-directed behavior, has been proposed as a potential protective factor. The present study examined associations among difficulties in emotion regulation, conscientiousness, and substance use behaviors, as well as whether conscientiousness moderates the relationship between emotion regulation difficulties and substance use. Using a quantitative, cross-sectional, correlational design, data was collected from college students recruited through a university participant pool. Participants completed self-report measures of emotion regulation difficulties, conscientiousness, and substance use …

The Use Of Virtual Reality In Ptsd Research And Practice, Kenneth B. Abrams, Lindsay Okindo, Marta E. Bacon, Yiking Skylar Yu, Sofia Santamaria Germani, Malvika Malhotra, Nancy A. Cullen

Psychology Faculty Work

In the aftermath of traumatic events such as combat, sexual violence, or a natural disaster, individuals may develop posttraumatic stress disorder (PTSD). Technological advancements in virtual reality (VR) over the past few decades have opened new avenues for improving the assessment, treatment, and understanding of PTSD. VR allows users to be immersed in interactive, computer-generated environments that simulate real-world scenarios, such as a warzone or assault location, that would be difficult or unsafe to reproduce using traditional methods. The present paper offers an overview of how VR technology has been employed in both clinical and research settings related to PTSD. …

The Restorative Effects Of Virtual Reality Nature Simulations: An Empirical Investigation, Isabel T. Folger, Yichen Zhang, Kenneth B. Abrams

Psychology Faculty Work

Although extensive research demonstrates that nature films can facilitate recovery from stress and cognitive overload, it remains unclear whether more immersive media, such as virtual reality (VR), are more effective than similar two-dimensional films. The present study examined the effects of immersiveness on affective, cognitive, and physiological restoration. Three levels of immersiveness for film viewing were employed: 2D (computer monitor), standard VR (visual and auditory input), and enhanced VR (standard VR plus olfactory and haptic input). All participants were exposed to parallel versions of a six-minute nature film. We hypothesized that greater immersiveness would produce stronger restorative effects. All versions …

Contemporary Approaches To Group Psychotherapy Supervision, Michelle A. Collins-Greene (Ed.), Molyn Leszcz, Nina W. Brown, Ellen Wright, Scott Giacomucci, Les R. Greene, Susan P. Gantt, Leah M. Niehaus, Francis Kaklauskas, Tony L. Sheppard

Counseling & Human Services Faculty Publications

This chapter captures the work of contemporary supervisors of group psychotherapy, all of whom have practiced many years and have trained and supervised innumerable group leaders. They demonstrate the diversity of settings and theoretical orientations that are prominent in the current era. Their essays speak for themselves and provide wonderful illustrations and models for supervisors-in-training and consultation to emulate. They also talk about who influenced, mentored, and supervised them.