Psychiatry and Psychology Commons^™

Bridging Diagnostic Safety And Mental Health: A Systematic Review Highlighting Inequities In Autism Spectrum Disorder Diagnosis, Abirami Srivarathan, Andrea Bradford, Sara Shearkhani, Layla Heimlich, Sheryl Jefferson, Kristen E Miller, Kelly Smith, Helen Haskell, Traber D Giardina

Faculty, Staff and Students Publications

Introduction: There is increased recognition that diagnostic errors disproportionately affect marginalised and underserved patient populations in the USA. However, evidence on diagnostic inequities in mental disorders is sparse and not well integrated into the overall diagnostic safety literature.

Objective: We systematically reviewed and narratively synthesised evidence on inequities in diagnosis of mental disorders, guided by the Diagnostic Process Framework developed by The National Academies of Sciences, Engineering, and Medicine.

Methods: We conducted a systematic review and a narrative synthesis. Medline, Embase, PsycInfo and CINAHL were searched for studies published between 2015 and 2024. Studies were eligible if they reported on …

A Clinical Pathway For Differential Diagnosis Of Adhd Vs Trauma: Early Childhood Recognition And Intervention, Maria Neiers

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Distinguishing Attention-Deficit/Hyperactivity Disorder (ADHD) from Complex Posttraumatic Stress Disorder (C-PTSD) presents significant diagnostic challenges due to overlapping symptom presentations, shared neurobiological impacts, and frequent comorbidities. This paper explores the nuanced clinical differentiation between ADHD and C-PTSD, and other trauma disorders, in pediatric populations, emphasizing the importance of trauma-informed assessment, early identification, and integrative clinical reasoning. The discussion highlights how structured diagnostic reasoning can reduce uncertainty, enhance diagnostic clarity, and support effective treatment planning. As a central contribution, this paper introduces an original clinical reasoning flowchart and a case conceptualization to illustrate its practical application in real-world diagnostic dilemmas. The need …

Enhancing Research Training Curricula Through The Ethical Integration Of Ai-Powered Tools: Opportunities And Challenges For Counselor Educators, Joshua C. Watson, Chris Leeth, Kevin Wong, Justen Schroeder

Journal of Counselor Preparation and Supervision

This article reviews existing training models used to teach research courses and facilitate researcher identity development in counselor education curricula and suggests how generative artificial intelligence (GenAI) can be incorporated into these courses as an instructional aid that improves researcher efficiency. Various GenAI tools used across stages of the research process are introduced with a discussion of their ethical implications and how they can be integrated into exiting lesson plans.

Counselor-In-Training Perceptions Of Artificial Intelligence: Implications For Counselor Education, Leo Gonzalez Jr., Deija Mccalla

Journal of Counselor Preparation and Supervision

This study examined the perceptions of counselors-in-training (CIT) on artificial intelligence (AI) in counseling practice and training. 31 CIT responded to three open-ended questions about the benefits, drawbacks, and overall attitudes of integrating AI into counseling practice and education. Thematic analysis was used to analyze the responses. The findings showed that CIT perceive AI as a clinical support tool, especially for tasks such as diagnosis and treatment planning. Additionally, CIT voiced concerns of potential overreliance on AI, ethical risks, confidentiality concerns, and the possible loss of human connection. Furthermore, although several CIT expressed cautious optimism regarding AI's use in counselor …

Artificial Intelligence In Counselor Education: Innovative Strategies For Teaching, Supervision, And Clinical Training, Shannon Shoemaker, Nikki Freeburg, Kevin Duquette

Journal of Counselor Preparation and Supervision

As artificial intelligence (AI) transforms mental health and education, counselor educators must prepare future practitioners to engage with these technologies ethically and effectively. This article presents a systematic framework for incorporating AI into counselor education through three key approaches: AI-generated content, AI analysis, and AI interactions. The framework addresses critical considerations including ethical implementation, prompt engineering, and cultural competence while maintaining alignment with professional standards. Drawing from current literature and ethical guidelines, we provide structured guidance for implementing AI across various content delivery styles, with emphasis on preserving clinical judgment and therapeutic relationships. Comprehensive appendices include implementation guides, assessment rubrics, …

A Pilot-Study Evaluating The Fidelity Of Chatgpt In Client Simulations, Eric Tod Beeson, Yusen Zhai, Russell Fulmer, Andrew M. Burck, Rakesh Maurya

Journal of Counselor Preparation and Supervision

Generative AI (genAI) is expanding in counselor education. This pilot study evaluated ChatGPT 4o's voice mode for simulating client scenarios during 53-minute mock-intake sessions with master’s-level counseling students. Analyzing eight domains (authenticity, consistency, emotional expression, empathy, cultural dynamics, self-awareness, goal setting, and role play confusion), ChatGPT’s responses showed good to excellent fidelity when compared to a typical client. Limitations such as formulaic and idealized responses raised authenticity concerns. ChatGPT offers a scalable, cost-effective tool for pre-practicum training, with potential to enhance skill development across the curriculum. Educators are encouraged to integrate genAI thoughtfully, prioritizing ethical considerations and iterative prompt refinement.

Utilizing Artificial Intelligence Therapeutic Adjuncts To Support Autistic Adults Between Counseling Sessions, Carlos J. Castaneda Jr, Nicole Noble, Afroze N. Shaikh

Journal of Counselor Preparation and Supervision

The integration of artificial intelligence (AI) into mental health care presents innovative opportunities for therapeutic interventions. This pilot study examined the use of a customized Artificial Intelligence Therapeutic Adjunct (AITA) as a supplementary counseling tool for adults with level one autism spectrum disorder who attended weekly counseling sessions. Using a Single Subject Design to review trends in mental health symptoms and perceptions of the AITA, participants engaged with the AITA over four weeks, completed weekly anxiety and depression assessments, and post-intervention and satisfaction surveys. Thematic Analysis identified common counseling concerns and the AITA’s use of counseling techniques. Although findings suggest …

Reimagining The Counseling Profession: Preparing Counselors For Ai And Digital Health Integration, Carl J. Sheperis, Dusti L. Annan-Coultas, Caronne C. C. Rush

Journal of Counselor Preparation and Supervision

Digital health technologies including artificial intelligence (AI) are transforming mental healthcare delivery, creating new opportunities and challenges for counseling practice. This article examines digital health applications in counseling, including telehealth, mobile apps, digital therapeutics, virtual reality, and AI-powered tools. We explore key implications for practice, including enhanced accessibility, impacts on therapeutic relationships, and ethical considerations. The article presents a six-domain competency framework covering privacy and security, technical proficiency, ethical literacy, clinical integration, therapeutic adaptability, and administrative management. A case study illustrates the practical application of hybrid digital care, while a discussion of counselor education highlights the need for curriculum updates. …

Letter From The Editors: Special Issue: Artificial Intelligence In Professional Counseling And Counselor Preparation, Rachel Jacoby, Sandra Logan-Mckibben

Journal of Counselor Preparation and Supervision

No abstract provided.

Understanding And Predicting Flossing Behavior In A Rural Appalachian Community Using The Multi-Theory Model, Rahib K. Islam, Manoj Sharma, Amanda H. Wilkerson, Bradford Layman, Clyde Dunn, Shamima A. Somi, Ratnesh Sharma, Karen Gruszynski, Syed S. Quadri, Vinayak K. Nahar, Robert E. Davis

School of Medicine Faculty Publications

Effective flossing is essential for preventing periodontal disease. However, in a rural Appalachian community, adherence to flossing routines remains low, contributing to significant oral health disparities. The purpose of this study was to conceptualize intention of initiation and sustenance of flossing behaviors using the multi-theory model (MTM) of health behavior change. A cross-sectional survey was administered to individuals recruited from a shopping mall in rural Appalachia. The MTM constructs were measured and data were analyzed using multiple linear regression models. Of the 228 participants, 55% did not floss daily. Behavioral confidence (β = 0.571, p < 0.001) was a significant predictor for the intention of initiation of flossing among non-daily flossers, while emotional transformation (β = 0.377, p = 0.836) significantly explained sustenance among non-daily flossers. For daily flossers, changes in the physical environment (β = 0.432, p = 0.003) significantly predicted the intention of initiation of flossing, whereas emotional transformation (β = 0.344, p = 0.008) and practice for change (β = 0.594, p < 0.001) significantly predicted sustenance of flossing behavior. The MTM appears to be a robust framework for understanding and predicting flossing behaviors in rural Appalachian populations. Interventions designed to enhance behavioral confidence, physical environment changes, emotional transformation, and practice for change could improve flossing adherence. Further research should explore these constructs to develop targeted public health strategies.

Enhancing Interprofessional Competence Among Speech Pathology, Nursing, Social Work, And Psychology Students Using Simulated Case Presentations, Elizabeth Oommen, Emily Helder, Kayla Johnson, Stacia L. Hoeksema, Laura Schipper

University Faculty Publications and Creative Works

Background: This study assesses the impact of an Interprofessional Education (IPE) program (which included simulated case presentations), on the perceived competence and quality of interprofessional (IP) work products of undergraduate social work, nursing, psychology students, and graduate students in speech-language pathology.

Methods: Participants included 123 students who participated in IP colloquiums through reviewing clinical cases, developing IP assessment and treatment goals, and presenting these to fellow students and faculty. Pre- and post-testing using IPEC Competency Self-Assessment Tool was used for assessment. For each colloquium, the students from all disciplines also submitted a single worksheet for their assigned case, …

A Religious Etiology Of Genito-Pelvic Pain And Pain With Penetration, Emily L. Carlson

Theses and Graduate Projects

Pelvic pain during penetration (PPDP) has been described using various diagnostic terms, including vaginismus, dyspareunia, and vulvodynia. The most recent and comprehensive classification is Genito-pelvic pain/penetration disorder (GPPPD) which is characterized by psychological distress associated with pain during or in anticipation of vaginal penetration (DSM-5-TR; American Psychiatric Association [APA], 2022). The etiology of PPDP is multifactorial, involving a complex interplay of biological, psychological, and relational factors. Religious and cultural influences may play a significant role in shaping individuals’ experiences of sexual pain. This study investigated the etiology of PPDP in relation to the religious influences among women raised in Judeo-Christian …

Modeling The Importance Of Life Exposure Factors On Memory Performance In Diverse Older Adults: A Machine Learning Approach, Evan Fletcher, Marianne Chanti-Ketterl, Emily Hokett, Yi Lor, Umesh Venkatesan, Ruijia Chen, Omonigho M. Bubu, Rachel Whitmer, Paola Gilsanz, Zvinka Z. Zlatar

Moss-Magee Rehabilitation Papers

INTRODUCTION: Many health life exposure factors (LEFs) influence cognitive decline and dementia incidence, but their relative importance to episodic memory (an early indicator of cognitive decline) among diverse older adults is unclear. We used machine learning to rank LEFs for memory performance in a large and diverse US cohort.

METHODS: Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) and Study of Healthy Aging in African Americans (STAR), participants underwent neuropsychological testing and answered questionnaires about multiple LEFs. XGBoost and Shapley Additive exPlanation values ranked the importance of factors influencing cross-sectional episodic memory in the full sample and by sex and …

Dissatisfaction And Residual Symptoms In Younger And Older Adult Patients After Total Knee Arthroplasty, Nicholas Pohl, Parker Brush, Adrian Santana, Sebastian Fras, Eleanor Jenkins, Arjun Saxena

Department of Orthopaedic Surgery Faculty Papers

INTRODUCTION: Total knee arthroplasty (TKA) is an increasingly used treatment option for younger patients with osteoarthritis. Previous research has found only 66% patients < 60 years who underwent TKA postoperatively reported that their knees felt normal. However, the prior studies did not compare underlying causes for dissatisfaction based on age. This study compared the satisfaction and residual symptom rates between patients ages < 60 and ≥60 years and identified specific reasons for their dissatisfaction between the age groups.

METHODS: Patients who underwent unilateral TKA for osteoarthritis from 2014 to 2016 were electronically sent a 15-question survey pertaining to surgery satisfaction. Following patient identification and survey completion, patient demographics, medical history, surgical time, and length of stay were collected through manual review of medical records. Patients who completed surveys were grouped by age (< 60 years or ≥60 years) for analysis.

RESULTS: In total, 1189 ≥ 60-year-old patients and 388 < 60-year-old patients were included. Most patients in both cohorts reported satisfaction with overall knee function (< 60: 68.6%; ≥60: 71.8%; P = 0.175). Fewer < 60-year patients reported normal knee function (66.5% vs. 75.2%; P < 0.001). The most common residual symptom in both cohorts was continued pain.

CONCLUSION: Patients younger than 60 years reported less satisfaction with performing normal activities …

Ethical Considerations Of Deep Brain Stimulation For Treatment Refractory Schizophrenia: Surveying Stakeholders, Judith M Gault, Nicola Cascella, Nidal Moukaddam, Stephanie Lehto, Patrick Hosokawa, Paul S Appelbaum, Akira Sawa, Jocelyn Lippman-Bell, William S Anderson, Wayne Goodman, Sameer A Sheth, Daniel Kramer, John A Thompson, Elyn R Saks, Rachel A Davis

Faculty, Staff and Students Publications

Introduction: Ethical concerns have been raised by both current and historically controversial neurosurgical interventions for treatment-refractory schizophrenia and schizoaffective disorder (TR-SZ). Considering advances in next-generation deep brain stimulation (DBS), initial success in treating a few cases of TR-SZ, and how challenging trial enrollment is, transparency and disseminating knowledge about DBS is important, as is input from involved groups. Here information was presented about DBS as an experimental treatment option for TR-SZ to stakeholders to gauge enthusiasm after consideration of potential risks and benefits.

Methods: Stakeholders were presented with information about DBS (total n = 629). Opinions about whether DBS should …

Anti-Inflammatory Diet And Probiotic Supplementation As Strategies To Modulate Immune Dysregulation In Autism Spectrum Disorder, Carlos Andrés Naranjo-Galvis, Diana María Trejos-Gallego, Cristina Correa-Salazar, Jessica Triviño-Valencia, Marysol Valencia-Buitrago, Andrés Felipe Ruiz-Pulecio, Luisa Fernanda Méndez-Ramírez, Jovanny Zabaleta, Miguel Andres Meñaca-Puentes, Carlos Alberto Ruiz-Villa, Marcela Orjuela-Rodriguez, Juan Carlos Carmona-Hernández, Luisa Matilde Salamanca-Duque

School of Medicine Faculty Publications

Background/Objectives: Autism spectrum disorder (ASD) is a neurodevelopmental condition associated with behavioral and cognitive impairments. Increasing evidence also links ASD with systemic immune dysregulation, including abnormal cytokine profiles and chronic low-grade inflammation. Emerging evidence suggests that targeted dietary strategies and probiotic supplementation may modulate immune responses and gut–brain interactions in patients with ASD. This study aimed to evaluate the immunomodulatory effects of a structured anti-inflammatory diet (NeuroGutPlus) compared to multi-strain probiotics in children with ASD. NeuroGutPlus is a nutritionally complete anti-inflammatory dietary protocol that targets gut integrity, inflammation, and mitochondrial function. It includes a diet low in gluten, FODMAPs, casein, …

Considering Climate Contexts: Examining Promotive And Punitive School Characteristics Among Diverse High School Students, Ashley Bazin, Maryse Richards, Akila Raoul, Allison Lloyd, Elizabeth Rovegno, Yael Granot

Psychology: Faculty Publications

Schools are a critical developmental context for adolescents that can, depending on certain characteristics, do a better or worse job at promoting student resilience and well- being. In working to meet student needs and respond to student behaviors, schools can exhibit more punitive characteristics, like exclusionary discipline practices, or more promotive characteristics, including restorative practices and marshaling of mental health resources. While punitive factors have been associated with more negative outcomes, especially for marginalized students, and promotive factors have been associated with more positive outcomes for students, these factors have rarely been considered together. We conducted an online survey of …

Prior Adolescent Oxycodone Exposure Enhances Pain Sensitivity Following Chronic Intermittent Ethanol In Adult Female Mice, Lisa L. Wilson, Lucas Albrechet-Souza, Linh Ha, Nicholas W. Gilpin, Tiffany A. Wills

School of Graduate Studies Faculty Publications

The opioid crisis remains a critical public health concern, with rising rates of overdose and opioid use disorder. While opioids are effective for managing pain, both chronic use and withdrawal are associated with increased pain sensitivity. Although most prior research has focused on adults, opioid use during adolescence is common and linked to a heightened risk for developing alcohol use disorder and other forms of substance misuse. Like opioids, acute alcohol use can be analgesic, but chronic alcohol exposure and withdrawal lead to increased pain sensitivity. However, the interactive effects of adolescent opioid and adult alcohol exposure on pain remain …

Exploring Young Adults' Experiences And Beliefs In Asthma Medication Management: Pilot Qualitative Study Comparing Human And Multiple Ai Thematic Analysis, Ruth Ndarake Jeminiwa, Caroline Popielaski, Amber King

College of Pharmacy Faculty Papers

BACKGROUND: Young adults take their asthma maintenance medication 67% of the time or less. Understanding the specific needs and behaviors of young adults with asthma is essential for developing targeted interventions to improve disease self-management. Artificial intelligence (AI) has demonstrated its utility in summarizing and identifying patterns in qualitative research and may support or augment human coding efforts. However, there is pause literature to support this assertion.

OBJECTIVE: The objective of this study is to begin to explore the medication management-related needs of young adults with asthma via a pilot feasibility study. We aim to understand how to best assist …

Lipidomic And Proteomic Insights From Extracellular Vesicles In The Postmortem Dorsolateral Prefrontal Cortex Reveal Substance Use Disorder-Induced Brain Changes, Chioma M Okeoma, Wasifa Naushad, Bryson C Okeoma, Carlos Gartner, Yulica Santos-Ortega, Calvin Vary, Savio Lima-Bastos, Victor Corasolla Carregari, Martin R Larsen, Alessio Noghero, Consuelo Walss-Bass, Rodrigo Grassi-Oliveira

Faculty, Staff and Student Publications

Substance use disorder (SUD) significantly increases the risk of neurotoxicity, inflammation, oxidative stress, and impaired neuroplasticity. The activation of inflammatory pathways by substances may lead to reactive astrogliosis and chronic neuroinflammation, potentially mediated by the release of extracellular particles (EPs), such as extracellular condensates (ECs) and extracellular vesicles (EVs). These particles, which reflect the physiological, pathophysiological, and metabolic states of their cells of origin, might carry molecular signatures indicative of SUD. In particular, our study investigated neuroinflammatory signatures in SUD patients by isolating EVs from the dorsolateral prefrontal cortex (dlPFC) Brodmann's area 9 (BA9) from postmortem subjects. We isolated BA9-derived …