The legalization of cannabis is increasing across the United States, for both recreational and medical use. This has resulted in a change in public opinion regarding the risks of cannabis use. This is particularly true for the current generation of older adults, which experiences a greater prevalence of cannabis use than previous members of this cohort. Due to decreased perception of risk and medical or emotional issues associated with old age, older adults increasingly use cannabis to cope with their psychiatric and medical symptoms. Current studies provide evidence of an association between using cannabis for medical symptoms and the development of a Cannabis Use Disorder (CUD). However, there is a lack of literature addressing the association between types of symptoms treated with medical marijuana and developing symptoms of CUD. This study developed a survey using the Cannabis Use Disorder Identification Test (CUDIT) and measures for motives and symptoms of cannabis use. This was done to evaluate the presence of CUD symptoms in older adults (ages 55+) who used cannabis in the past six months while owning a Medical Marijuana License (MML). Data preparation included an examination of outliers, multicollinearity, and data distributions. The primary analysis regressed cannabis use pathology onto psychiatric motives and physical motives. The results of this study suggest that those utilizing cannabis for anxiety symptoms experience more symptoms of a cannabis use disorder. At the same time, there was a negative association between using cannabis order for medical symptoms and developing cannabis use disorder symptoms. Additionally, there was no correlation between the amount of cannabis used and its use for physical symptoms.

Eating and feeding disturbances are prevalent yet understudied health conditions in youth. They are characterized by aberrant eating behaviors, cognitive and emotional dysfunctions, and dysregulated body weight. The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition defines several feeding and eating disorders with a common onset in youth; however, data on their clinical validity at young ages are lacking. Further non-normative eating behaviors exist, but their clinical relevance needs elucidation. This Special Issue compiles state-of-the-art reviews and empirical research on the presentation, development, course, and maintenance of diverse eating and feeding disturbances as a prerequisite for delineating evidence-based interventions for treatment and prevention.

The population of students with emotional and behavioral needs represent a significant proportion of the population of students in today's public schools. To help meet their needs, consultants from outside mental health agencies are often contracted to support school personnel who work with these students. There is little research, however, on this practice, its implementation, or its effectiveness. The purpose of this study was to describe the experience of consultation among teachers, counselors, and administrators. Data were collect through open-ended interviews. An analysis of these interviews reveal that members of a school community generally view the practice as a positive experience and a worthwhile investment. Differences between administrators and direct service providers (i.e., teachers, counselors) were identified. Administrators focused on operational or logistical elements of consultation and teachers and counselors spoke more to relational elements, such as personal characteristics of the consultant and the ability to develop a working relationship with the consultant. Further, school personnel with clinical training seemed to welcome the consultation as an opportunity for constructive feedback, but perhaps more importantly, the clinical supervision they would not otherwise receive.

We spend a large portion of our life at work, however that workplace is generally more suited for some than for others. There is a bias towards extraverted people in the design of the workplace which can have outright negative effects on the introverted population and as an extension, people with schizoid personality disorder. The purpose of the thesis was to identify areas which could be subject to change in the workplace in order to facilitate a larger population and increase the well-being of introverted people, particularly those with schizoid personality disorder (SPD). Data was collected through a questionnaire (N = 52) and the analysis presented evidence of a difference in how important the participants deem it that a workplace is designed for socialisation and how possible it is to work without interruptions from other colleagues. The results indicated a large difference between the more and less extraverted groups in how important and how possible it was to work without interruptions from their colleagues. The results also indicate a significant difference between how important they deem it that a workplace should be designed for socialisation. In conclusion the author suggests areas which can be improved in the workplace design to facilitate a larger group of the population and not just be beneficial to the extraverted population.

Generalized Anxiety Disorder (GAD) is a chronic, disabling, and prevalent disorder that is characterized by excessive worry, high anxiety symptoms, and tension. While the understanding of GAD has developed greatly in the past decade, much of the underlying mechanisms and pathology are still unknown. Due to a poor understanding of GAD and a high rate of comorbidity with other disorders, GAD is often misdiagnosed and mistreated. GAD is treated with psychotherapy, typically cognitive behavioral therapy (CBT), and pharmacotherapy, typically benzodiazepines and antidepressants. However, the treatment response is often inefficient, greatly varied and not well understood in many patients. As patients suffering from GAD are frequent hospital and primary care users, GAD causes a substantial economic burden on both the patient and society. In order to alleviate the burden caused by GAD, much research is being performed to more efficiently diagnose and treat the disorder. Potentially the amendment of the Diagnostic and Statistical Manual of Mental Disorders, with the fifth addition (DSM-V), might improve the diagnostic criteria and outcome of GAD. As mechanisms behind the pathology of GAD are discovered such as the contrast avoidance model, a better method for treating GAD may be applied. The goal of this review is to discuss the large burden caused by GAD and how it may be resolved in the future.

Perinatal mood disorders such as postpartum depression and postpartum posttraumatic stress disorder are an area of growing concern. There have been few studies regarding ways to identify women at risk of developing these disorders in the antepartum period. During the antepartum period, women attend prenatal appointments with their provider to assess the health of their pregnancy. This period is ideal to administer emotional health questionnaires to identify if patients may be at risk of developing postpartum mood disorders. The aim of this study was to identify if there are differences on antepartum emotional health questionnaire scores between women who have postpartum mood disorders, and those who do not. The data come from 19 women undergoing scheduled cesarean deliveries at Boston Medical Center. The questionnaires collected information about stress, depression, anxiety, and symptoms of postpartum depression and posttraumatic stress disorder. We compared the scores of the women who had postpartum depression and postpartum posttraumatic stress disorder to the women who did not, to examine if the scores in the antepartum period correlated with postpartum mood disorders. We did not find any differences between the postpartum depression group, but did find a difference on one questionnaire between the postpartum posttraumatic stress disorder group. Within our cohort, we found similar incidences of postpartum depression, postpartum posttraumatic stress disorder, and self-harm/suicidal ideations compared to national incidences. Future studies should include more participants and a more heterogenous cohort as it pertains to cesarean delivery type, indication for cesarean delivery, intrapartum events, and histories of depression, anxiety, posttraumatic stress disorder, and other mood disorders. Although we only found a difference on one questionnaire for one of the postpartum mood disorders, future studies should prioritize the antepartum period as a time to identify and address concerns of postpartum mood disorders.

Objective: Alcohol use disorder (AUD) remains a leading cause of worldwide mortality and morbidity. The development of neuroanatomical biomarkers offers the potential of novel clinical indicators to guide prevention, early diagnosis, and treatment. Methods: In 76 participants with DSM-5 diagnosed AUD (Mage = 35.75; 51.3% female) and 79 controls (Mage = 34.71; 59.5% female), we utilized magnetic resonance imaging (MRI) to investigate four novel measures: hippocampal and amygdalar subregion volumes, sulcal morphology (SM), and fractal dimensionality (FD). MRI processing, segmentation, and SM and FD quantification were completed using FreeSurfer v6.0 and v7.0, and MATLAB toolboxes, respectively. A significance value of p < .05 was employed for analysis and sex, age, and intracranial volume were included as covariates. Results: Volumes of the right presubiculum, subiculum, and molecular layer head; left lateral and accessory basal nuclei; and corticoamygdaloid transition area were significantly lower in AUD participants relative to healthy controls. Widths of the left occipito-temporal, right middle occipital and lunate, and right marginal part of the cingulate sulci and depth of the post-central sulci were significantly increased in AUD participants relative to controls. Finally, decreased left caudate, left thalamus, right putamen and right pallidum FD and greater inferior lateral and third ventricle FD were observed in AUD participants relative to controls. Each novel measure’s reliability was assessed using test-retest data from the Human Connectome Project and indicated high reliability with median intraclass correlations of .93, .91, .88, and .93 for the hippocampal subfields, amygdalar nuclei, SM, and FD, respectively. Conclusion: These results indicate selectively decreased hippocampal and amygdala subregion volume, increased sulcal depth and width, and differences in FD as promising neuroanatomical biomarkers for AUD. / Thesis / Master of Health Sciences (MSc)

The upcoming Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) will change how Alcohol Use Disorder (AUD) is characterized by going from a twoactor hierarchical model to a unidimensional disorder. In addition, the number of criteria needed are being reduced—which may increase AUD prevalence rates. The present study examines how these changes will impact college students as compared to their non-college attending peers. Participants were asked to complete questionnaires about their alcohol use and what criteria they meet, a daily functioning questionnaire, and a measure to determine their willingness to engage in risky behaviors. Results indicate that college students will show a disproportionate increase in diagnoses, even though college students who meet criteria show no significant differences in functional impairment compared to students who do not meet criteria. These results suggest that the new criteria may not be a good indicator of AUD presence for college students.

Schizoaffective disorder has routinely exhibited poor outcomes related to diagnostic accuracy and reliability. These pitfalls have been linked to the conceptual nature of Schizoaffective Disorder’s combined psychotic and affective symptoms. Clinicians likely perceive the psychotic components of Schizoaffective Disorder as more severe than the affective symptoms, and have demonstrated a bias toward misdiagnosing Schizoaffective Disorder as Schizophrenia. Thus, the present study sought to examine the clinical conceptualizations of Schizoaffective Disorder compared to Schizophrenia, Bipolar Disorder with psychotic features, and Major Depressive Disorder with psychotic features. The participants were clinicians recruited via email and randomly assigned to either select symptoms from a predetermined criteria list (Recognition group) or to freely list features of the disorders based on their own mental representations (Unprompted group). Participants’ conceptualizations of Schizoaffective Disorder were not entirely congruent with DSM-5 criteria; they conceptualized it as less psychotic than Schizophrenia and less affective than the two mood disorder tasks. Schizoaffective Disorder exhibited the lowest proportion of accurate endorsements, and Schizophrenia had the highest proportion. We hypothesized that Schizoaffective Disorder would have the most overextension endorsements because of its fuzzy boundaries, but Schizophrenia had the highest instead. The Recognition Group outperformed the Unprompted Group overall, which can be explained by the availability heuristic. This study’s findings support the notion that Schizoaffective Disorder’s poor diagnostic outcomes are possibly related to clinicians’ conceptualization of the construct, or that its current diagnostic formulation is not congruent with what clinicians observe in clinical settings.

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