Schizophrenia is a severe neuropsychiatric disorder of largely unknown etiology that is often accompanied by high rates of cigarette smoking, reduced quit success, and high relapse rates. Dysregulated dopamine signaling and aberrant synaptic plasticity in the mesocorticolimbic pathway are implicated in the pathophysiology of schizophrenia and conferred substance abuse disorder and relapse vulnerability. Genetic factors are presumed to play a significant role in the development of schizophrenia, with a 40-50% concordance rate for monozygotic twins, although genetic markers are inconsistent. As such, epigenetic factors have instead been implicated. Specifically, there is strong evidence to suggest DNA methylation at several candidate genes contributes significantly to the pathophysiology of schizophrenia. To investigate this heritable component, our laboratory has developed a novel heritable model of drug abuse vulnerability in psychosis. This model is the first to show heritable increases in dopamine D2 receptor sensitivity via several behavioral and neurobiological markers, including enhanced behavioral responding to nicotine and changes in D2 signaling cascades in brain regions associated with psychosis and comorbid drug abuse. Increased D2 receptor sensitivity is the most consistent biomarker of psychosis found in preclinical animal models and postmortem brain tissue of individuals diagnosed with schizophrenia, lending considerable strength to the validity of the model. This study aimed to further validate the model as a useful and valuable tool for better understanding the pathophysiology of comorbid nicotine use and relapse in psychosis, and to explore more effective therapeutic targets than current antipsychotic medications. Results reveal DNA methylation as an epigenetic mechanism conferring heritability of the psychosis-like phenotype in the model. We additionally demonstrate altered relapse-like behavior, clinically consistent with reduced quit success and elevated relapse vulnerability. Interestingly, changes in relapse-like behavior were correlated to elevated protein levels of brain derived neurotrophic factor (BDNF), a marker of activity-dependent plasticity, in brain areas associated with drug reward. Further, modulation of the metabotropic glutamate type 5 (mGlu5) receptor alleviates the enhanced nicotine conditioned place preference observed in the model. Mechanistically, mGlu5 modulation restores normal dopamine D2 signaling and mitigates aberrant plasticity responses that are thought to drive the behavior in a region-specific manner.

Introduction The prevalence of prediabetes in adults aged 18 or older was as high as 38% between 2017-2020. Youth-onset T2DM is a more aggressive phenotype than T2DM that occurs later in life. Young adults with T2DM have poorer health outcomes, lose an average of 15 years of life, all resulting in significant economic burden impacting the person. Current self-management interventions do not improve health outcomes in young adults with T2DM. Purpose The purpose of this research was to explore the self-care experiences of young adults living with T2DM. Methods Existential hermeneutic phenomenology informed the research. Inclusion criteria as follows: adults aged 18 to 30 with a self-reported diagnosis of T2DM, physical presence in the United States, English proficiency. Purposive and snowball sampling were used. Nineteen participants were interviewed: 16 self-identified as Black, 2 as White, and 1 as Latino. Interviews were transcribed verbatim. Transcripts were analyzed using an iterative approach for meaning units and themes. Thematic meanings were identified from the data. Results The grand theme my journey and two themes: finding out and navigating, three subthemes include distress, around me, and my duties. The second subtheme, around me, included two micro themes: support and juggling. The third subtheme, my duties, included three micro themes: exercise, education, and trigger surveillance. Several factors were unique to young adults' perception of self-care. Perceptions of time, support networks, novel coping strategies, and search for disease literacy impacted self-care perceptions and understanding. Results suggest the need for future person-centered, self-care intervention research with young adults that could result in improved health outcomes.

Background: Posttraumatic stress disorder (PTSD) presents a significant mental health challenge for many veterans, prompting interest in innovative interventions such as the use of service dogs. Despite this, there remains a gap in understanding the specific impact of service dogs on the mental well-being of veterans who served in combat zones. Aim: This integrative review aims to explore the associations between service dog exposure and the mental health of veterans following deployment to combat zones, focused on those with PTSD. Through a systematic literature search, review, and synthesis, the study seeks to identify gaps in knowledge to inform future research efforts and interventions. Design: Adopting an integrative review design, the review explores existing literature to uncover insights into the associations between service dog exposure and veterans' mental well-being. The study ensures a comprehensive examination of relevant research articles by employing a systematic literature search methodology and rigorous inclusion and exclusion criteria. Methods: Inclusion criteria involve selecting research articles published in peer-reviewed journals focusing on veterans' participation with service dogs or canine exposure and their subsequent mental health outcomes. Exclusion criteria are non-U.S. research, abstracts without full-text articles, grey literature, and non-research articles. This rigorous approach aims to assemble reliable evidence to enhance understanding and inform future research and interventions supporting veterans' mental well-being. Results: This study examines the demographics, characteristics, challenges, and benefits associated with veterans with PTSD and their service dogs. Veterans in the studies ranged from 36.8 to 50.9 years old, were predominantly male, and mostly white, with significant portions being honorably discharged and married. The service dogs were mostly male, mixed-breed, or Labrador Retrievers sourced from shelters. Veterans faced challenges obtaining and training their dogs, such as demanding training processes and adjusting to public attention. Despite these challenges, service dogs provided substantial benefits, including reduced PTSD symptoms, improved sleep, increased physical activity, and emotional reconnection. Studies showed a reduction in PTSD severity, improved quality of life, and enhanced social participation for veterans with service dogs. However, veterans also experienced drawbacks like increased public attention and misconceptions about service dogs. The bond between veterans and their dogs was associated with lower anxiety and higher positive affect, highlighting the overall positive impact of service dogs on veterans' mental health and daily life. Conclusion: This study demonstrates the substantial benefits of service dogs for veterans with PTSD, including reductions in stress, anxiety, and PTSD symptoms and improvements in depression management, safety, and quality of life. Unexpected challenges with nonobedience issues arose, but they did not diminish the overall positive impact. Future research should explore the cost-effectiveness of service dog programs, their effects on different veteran demographics, and standardized training protocols. The findings emphasize the need for continued support and refinement of service dog programs to optimize their benefits and improve the well-being of veterans with PTSD.

Dairy producers play a central role in evaluating and seeking treatment or care for animal pain. The primary aim of this study is to examine dairy producers’ emotional states and professional quality of life and analyze the relationship between these variables and their perception of pain in dairy cattle. Dairy farm owners and managers of 65 southeastern U.S. herds participated in a survey that included demographic information, the Depression, Anxiety, and Stress Scale, a modified Professional Quality of Life Scale, and 23 items requiring participants to evaluate various painful conditions in cattle.

Mental health is an ever-growing crisis among adolescents and young adults, with suicide as second leading cause of death and the number of those negatively affected continually on the rise. Transitions are one of the major stressors prevalent among these age groups, placing individuals at risk for mental health deficits. This quantitative voluntary response comparative study assesses the transitional mental health of pre-nursing students and students in the nursing program at East Tennessee State University. Emailed to all with a declared major of pre-nursing or nursing, this study measured mental health using evidenced based assessment tools. The PHQ-9 for depression and the GAD-7 for anxiety, along with additional demographic information and mental health service usage questions, was sent to and completed by participants. A total of n = 173 responses were received. Of these responses n = 99 or 57.2 percent were nursing students, a participation rate of 9.6 percent, and n = 74 or 42.8 percent were pre-nursing students. The research revealed that depression and anxiety scores were above the cutoff for moderate depression and anxiety in both groups, as well as identified a deficit in availability of mental health resources, with over 10 percent of students unable to access counseling or psychiatric services. Contraindicatory to literature, which predicted improving mental health in the progression through university studies, this study reveals a variable and even worsening trajectory of mental health as students transition into the nursing program and progressed through college.

The purpose of the present study was to investigate the influence of pain causal attributions on patient pain-related functioning, treatment engagement, and clinical outcomes. Additionally, the impact of discordant pain causal attributions between patients and their providers as well as between interdisciplinary providers was examined. Patients rated their pain functioning and causal pain attributions during a regular clinic visit. Following the patient’s visit both the behavioral medicine provider and internal medicine resident provided ratings of similar pain-related functioning domains and causal attributions. Follow-up data were collected from the electronic medical record three months following that clinic visit. Overall, results revealed that patients’ chronic pain attributions did influence pain-related functioning, however the impact was relatively small. There was insufficient evidence to conclude that chronic pain attributions influence a patient’s readiness to adopt self-management coping strategies and their subsequent treatment engagement. Additionally, results confirmed that different health care disciplines attribute the cause of patients’ chronic pain in distinct ways and these unique perspectives can lead to discrepant pain-related functioning assessments between providers. Discordant ratings between providers were shown to influence referring patterns for interdisciplinary services and the patient’s overall opioid dose. Similarly, discrepancies between patients and their providers influenced subsequent referral for behavioral health services, the patient’s attendance at those visits, and their overall morphine equivalent doses. Together the results indicate the important role pain attributions can play in chronic pain management and highlight the central role of the patient-provider and provider-provider relationship.

The purpose of this study was to identify to what degree specific factors influence the level of satisfaction experienced by foster parents whose foster children are recieving mental health services from agencies that they have been referred to by a Coming of Age Foster Family Agency.

Social workers are trained during the course of their education to work with the elderly and to understand the various dynamics of aging. These professionals also receive education on substance abuse and how to assess clients as well as link them to appropriate supportive services. How can social workers be more inclined to effectively treat the elderly substance abuser? What are, if any, special considerations a social worker should be aware of when working with the geriatric population? What treatment modalities seem to be more effective with the elderly client? This study utilized a qualitative analysis consisting of interviews with eight clinicians who specialize in the area of addiction treatment amongst the aging population. The purpose of this study was to gain insight and knowledge that can be used to promote social worker awareness of elderly substance abuse as well as the identification of effective addiction treatment methods in the field of gerontological social work. The findings of this study will impact future social work practice, policy and research in the areas of education, treatment, and advocacy for the aging and substance abuse populations. Keywords: gerontology, substance abuse, aging, polypharmacy, interventions

The Brisbane Longitudinal Twin Study (BLTS) was being conducted in Australia and was funded by the US National Institute on Drug Abuse (NIDA). Adolescent twins were sampled as a part of this study and surveyed about their substance use as part of the Pathways to Cannabis Use, Abuse and Dependence project. The methods developed in this dissertation were designed for the purpose of analyzing a subset of the Pathways data that includes demographics, cannabis use metrics, personality measures, and imputed genotypes (SNPs) for 493 complete twin pairs (986 subjects.) The primary goal was to determine what combination of SNPs and additional covariates may predict cannabis use, measured on an ordinal scale as: “never tried,” “used moderately,” or “used frequently”. To conduct this analysis, we extended the ordinal Generalized Monotone Incremental Forward Stagewise (GMIFS) method for mixed models. This extension includes allowance for a unpenalized set of covariates to be coerced into the model as well as flexibility for user-specified correlation patterns between twins in a family. The proposed methods are applicable to high-dimensional (genomic or otherwise) data with ordinal response and specific, known covariance structure within clusters.

Mental illness is not only the leading cause of disability among adults, but there is also an emerging public health crisis in childhood mental illness. A majority of parents do not recognize symptoms of psychological disorder in their children, and current policies and programs for mental health service delivery are not sufficiently responsive to the early help-seeking dynamics of families. Using a concurrent mixed methods design, this study explored how parents in the Pikes Peak region of Colorado learned to recognize their child's mental illness. Phenomenological interviews, augmented by poetic inquiry and quantitative measurements, were used to discover factors that inhibited or enhanced five mothers' recognitions. These factors were then evaluated using a frequency distribution analysis and a rank-order correlation. The phenomenon of recognition was, for these mothers, a process of waiting to hear that 'normal' had stopped, wherein they miscategorized symptoms as normal behaviors in a passing developmental phase. Prior experience with mental illness appeared to significantly decrease both the length of time and the level of distress necessary for recognition. Ultimately, recognition did not occur until someone in their social network validated their concerns and provided explicit confirmation, which galvanized them to seek treatment. Governance network collaborations can facilitate positive social change by standardizing guidance on how to differentiate symptoms of a disorder from normal childhood development. Public policies and programs such as universal mental health screening, mental health literacy, and more supportive and responsive school policies can foster dialogue for parental recognition in Colorado and throughout the country.