While research has indicated that impaired mental health partially mediates the relationship between adverse childhood experiences (ACEs) and alcohol and illicit drug use, little research has examined potential mediators in the relationship between ACEs and smoking, the number one cause of preventable mortality in the United States. Accordingly, this study examined the potential mediating effect of psychological distress on the relationship between ACES and smoking using data from Wave II of the ACE Study, a cross-sectional study completed between June and October of 1997 on a sample of adult health maintenance organization members (N = 7,211). The theoretical underpinnings for this study were grounded in the developmental psychopathological perspective which examines both environmental and biological influences as they interact to promote or impede social, emotional, and behavioral development. Mediation modeling employing both linear and logistic regression techniques indicated that, after adjusting by select covariates, psychological distress (as assessed using the SF-36 Mental Component Summary score) partially mediated the relationship between several of the ACEs examined and smoking in women. These same relationships were not found in men. This research contains several key findings with social change implications. First, additional research should be conducted to examine the causes, developmental paths, and critical points that link ACEs and psychological distress to smoking among women. Second, given the gender differences in the association between ACEs and smoking, gender-specific intervention programs that build resiliency, increase positive social support, and provide tools for developing alternative coping strategies may be important adjuncts to smoking cessation programs, particularly for women with a history of ACEs.

This study is exploratory in nature. The material was highly individualistic and subjective, so I have deviated from the traditional empirical research approach. My purpose is to grasp what kind of person was attracted to attending a dance workshop. How does Halprin’s use of dance assist people in learning about themselves? What kinds of information do people learn about themselves through her dance process? What techniques does Halprin combine with the medium of dance to get results? Are people enhanced, or better integrated by the Halprin process? Finally, my intention was to be stimulated by the Halprin process to explore possible uses of dance in combination with my traditional psychodynamic, verbal approach to social casework.

Indiana University-Purdue University Indianapolis (IUPUI) / “Gendered and Racialized Experiences at Central State Hospital, Indianapolis, 1877 – 1910” analyzes the treatment of African American patients at the now-defunct Central State Hospital in Indianapolis, Indiana, throughout the Gilded Age and Progressive Era, from the late 1870s through the 1900s. This thesis examines the impact of scientific racism and institutionalized sexism on female African American patients’ diagnoses, medical treatment, and the outcome of institutionalization through a close reading of hospital publications and a series of statistical studies of patient data. This thesis also analyzes the intersection of race and gender through the case study of one African American woman, Elizabeth Williams Furniss, who was institutionalized during the 1890s until her death in 1909. I argue that scientific racism and a deeply entrenched sexism significantly shaped the treatment of African American patients and women of all races throughout the Gilded Age and Progressive Era. Preconceived notions of race, gender, and class determined diagnoses, treatments, and treatments outcomes, without regard to individual patients’ needs. I also suggest ways for historians to identify and measure the impact of scientific racism and institutionalized sexism on African American patients in northern psychiatric institutions through statistical studies of patient data.

Background: Persons treated during compulsive care are in a vulnerable situation. Caring for someone against their will involves great responsibility and places high demands on the staff's psychiatric skills, empathy and ability to interpersonal relationships. Many people who have been treated under compulsive psychiatric care are critical to the health care content and its execution. Aim: The aim of the studie was to describe people's experiences of compulsive care in Swedish psychiatric hospital care. Method: A qualitative study of 15 blogs with inductive approach and descriptive design was chosen. The material from the blogs has been analyzed with inspiration from content analysis. Results: The result was subdivided into three categories; A care process characterized by powerlessness, fear and ambivalence, Interaction and participation on the terms of care and Meaningful environmental factors. Conclusion: The result described both positive and negative experiences from compulsive care. The care process was often described as difficult to handle and included a great powerlessness. There was a great dissatisfaction regarding communication, information and personal treatment. The conclusion is that if persons are informed of what the compulsive care will entail and what is expected of them, the chances are higher that they will feel respected and that their wellbeing generally improves during the care period. If the person's autonomy is considered, the experience of an unequal power relationship in healthcare and in the meeting with healthcare professionals changes.

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Background: This study explores the use of storytelling and patient narrative in mental health care. The focus is how the use of storytelling can reduce suffering and support the recovery process for individuals with psychiatric illnesses. The objective is to review research on the role of storytelling in promoting health, mitigating suffering, and fostering recovery in healthcare from a caring perspective. The study aims to answer the question of whether storytelling can reduce suffering in patient care. Design and Method: This study is a systematic literature review of qualitative studies that utilized the method meta-synthesis and thematic analysis. The authors searched for relevant articles, screened them based on inclusion and exclusion criteria, and extracted data using an inductive approach. A total of 15 articles were chosen, and the extracted data were analyzed to identify common themes and subthemes. Results: The main themes that emerged in the analysis of the fifteen articles were suffering, lifestory and the caring relationship and the subthemes were shame and stigma, loss of self and isolation, hope, meaning, growth, and recovery. Conclusion: A significant finding from the study is that the caring relationship between the nurse and the patient is important in order to provide a supportive context for the rewriting of the patient's life story, which in turn can contribute to the relief of suffering.

<p>Individuals with mood disorders are particularly vulnerable to weight gain, due in part to an illness symptom profile that impacts appetite and energy and the iatrogenic weight-gain effects associated with psychotropic medications. The exact physiological mechanisms through which medication causes weight gain have yet to be clearly elucidated. The studies comprising this thesis examine changes in caloric consumption, physical activity and basal metabolic rate (BMR) in depressive disorder (MDD) patients starting on selective serotonin reuptake inhibitors (SSRIs). Since both depression and obesity have been linked to inflammation, we also monitored changes in cytokines and adipokines throughout treatment. In our sample, we observed a mean weight gain from baseline, prior to medication, to 6 months after the initiation of pharmacotherapy. We note that this weight gain is not likely due to increased caloric consumption, but could be related to the proportions of macronutrients being consumed and expended, as well as physical activity level. We also observed changes in adipokines and cytokines that are reflective of pharmacotherapy and not weight gain, even in the absence of clinical improvement. Collectively these studies have begun to shed light on the mechanisms involved in the weight gain experienced by MDD patients being treated with SSRI antidepressants. A better understanding of these mechanisms will lead to better management of the adverse metabolic side effects associated with psychotropic medication, and will improve patient compliance.</p> / Master of Science (MSc)

Public health concerns were prominent during the COVID-19 pandemic, particularly regarding rising cases of anxiety and depression among adults. U.S. healthcare providers were especially affected by the unrelenting demands on their time and service. Psychiatric Mental Health Nurse Practitioners (PMHNPs) provided patient care during the pandemic to meet the increasing need for mental health services as people began experiencing mood disturbances such as anxiety, depression, and grief. The purpose of this qualitative study was to explore the perceived effect of the COVID-19 pandemic on the mental health of PMHNPs. A qualitative design using the interpretive description method allows researchers to use pre-existing knowledge to inform their research and actively participate in knowledge synthesis, focusing on variations in data. Individual interviews with 18 PMHNPs were conducted via video teleconferencing, and their data were evaluated and interpreted for meaning. After a thorough analysis of the interview transcripts, nine themes were identified: adaptive coping, improved access, support, self-care, work strain, complications, maladaptive coping, pandemic strain, and polarization. This study illuminated the challenges PMHNPs faced during the pandemic and the strategies they employed to cope with difficulties and will inform future research and practice in mental health care.

The study attempted to identify R425 diplomates' perceptions of their psychiatric competencies. An exploratory descriptive survey investigated specific strengths and weaknesses of the R425 diplomates in the psychiatric clinical units in the KwaZulu-Natal Province, as perceived by the diplomates themselves. The diplomates were reportedly competent in performing numerous, but not all cognitive, psychomotor and affective skills addressed by this survey. The R425 diplomates perceived themselves to be incompetent in designing and implementating rehabilitation programmes/workshops, managing community projects, conducting research and managing crises in psychiatric nursing units. / Health Sciences / M.A. (Health Studies)