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- Creators: School of Social and Behavioral Sciences
The relevance of depression in the clinical realm is well known, as it is one of the most common mental disorders in the United States. Clinical depression is the leading cause of disease for women worldwide. The sex difference in depression and anxiety has guided the research of not just recent studies but older studies as well, supporting the theory that gonadal hormones are associated with the mechanisms of emotional cognition. The scientific literature points towards a clear correlative relationship between gonadal hormones, especially estrogens, and emotion regulation. This thesis investigates the neural pathways that have been indicated to regulate mood and anxiety. Currently, the research points to the hypothalamic-pituitary-adrenal axis, which regulates the stress response through its ultimate secretion of cortisol through the adrenal cortex, and its modulated response when exposed to higher levels of estrogen. Another mechanism that has been investigated is the interaction of estrogen and the serotonergic system, which is noteworthy because the serotonergic system is known for its importance in mood regulation. However, it is important to note that the research seeking to determine the neurobiological underpinnings of estrogen and the serotonergic system is not expansive. Future research should focus on determining the direct relationship between cortisol hypersecretion and estrogens, the specific neurobiological effects of serotonergic receptor subtypes on the antidepressant actions of estrogens, and the simultaneous effects of the stress and serotonergic systems on depressive symptoms.
A recent analysis has predicted that close to a million Americans will have died from contracting COVID-19 (Sullivan, 2021, para. 1). Unsurprisingly, the most vulnerable people, like those who have been incarcerated, have been hit the hardest (Brennan Center for Justice, 2020, para. 1). The ongoing COVID-19 pandemic has created additional stress affecting inmates both physically and mentally. Therefore, the maintenance of good mental health among inmates should be a concern. However, the nature of the correctional environment limits the therapeutic options available to health care professionals. Among the challenges mental health professionals face in ensuring quality care are a poor rapport between the care provider and client, having a client living in an environment where distressing factors are omnipresent, and a lack of resources (Gussak, 2015, p. 2). All of these issues are exacerbated when the client requiring mental health care is in the correctional system. Depression and anxiety are some of the most common disorders affecting the prison population. However, in the correctional system, therapies that have been found effective among a general population have been shown to not benefit 30% to 60% of clients (Abbing, Baars, Van Haastrecht, & Ponstein, 2019, p. 1). Effectively treating depression is of great concern because, as Gussak (2007) found, depression can lead to self-harming behaviors and suicide when left untreated (p. 2). Additionally, addressing and treating anxiety is of particular importance today as COVID-19 has been a significant source of distress; explicitly, one incarcerated journalist reported witnessing entire units of inmates experiencing high levels of anxiety and panic attacks (Popperl et al., 2020, para. 5). Thus, a critical review of the available literature can reveal the particular effectiveness of art therapy in treating depression and anxiety in prison populations. The impacts of implementing more effective therapies in the correctional system are a reduction in recidivism and successful reintegration into society. Consequently, this literature review will suggest a potential application of art therapy for improving the mental health of those incarcerated in the correctional system with the intent of engendering positive social impact.
Homeless individuals encounter barriers such as lack of health insurance, increased cost of care and unavailability of resources. They have increased risk of comorbid physical disease and poor mental health. Depression is a prevalent mental health disorder in the US linked to increased risk of mortality. Literature suggests depression screening can identify high-risk individuals with using the patient health questionnaire (PHQ-9).
The objective of this project is to determine if screening identifies depression in the homeless and how it impacts healthcare access. Setting is a local organization in Phoenix offering shelter to homeless individuals. An evidence-based project was implemented over two months in 2019 using convenience sampling. Intervention included depression screening using the PHQ-9, referring to primary care and tracking appointment times. IRB approval obtained from Arizona State University, privacy discussed, and consent obtained prior to data collection. Participants were assigned a random number to protect privacy.
A chart audit tool was used to obtain sociodemographics and insurance status. Descriptive statistics used and analyzed using Intellectus. Sample size was (n = 18), age (M = 35) most were White-non-Hispanic, 44% had a high school diploma and 78% were insured. Mean score was 7.72, three were previously diagnosed and not referred. Three were referred with a turnaround appointment time of one, two and seven days respectively. No significant correlation found between age and depression severity. A significant correlation found between previous diagnosis and depression severity. Attention to PHQ-9 varied among providers and not always addressed. Future projects should focus on improving collaboration between this facility and providers, increasing screening and ensuring adequate follow up and treatment.
In the last 10 years there has been an increase in the number of mental health disorders in the United States. As these individuals with abnormal behavior start to become the norm, psychological research will need to adapt. The present work seeks to explore how to solve this problem by introducing abnormal behavior into social psychology. This can be done by measuring how depression and anxiety are related to aggression. The results from this study show that depression, anxiety, and aggression are all significantly correlated with each other and that only depression was a significant predictor for aggression. Although there are some limitations to this study, the results still suggest that the field of social psychology may need to start looking at how abnormal behavior can affect peoples’ behaviors.
Methods: This quasi-experimental pre/post design project was guided by the ACE Star Model and Leininger’s Theory of Cultural Care. The affiliated University’s IRB approved this project. The Diabetes Empowerment Education Program (DEEP) was implemented in a free, community clinic in a medically underserved area. Spanish speaking patients (n = 15) with A1C levels
> 8mg/dl were recruited to participate in a 6-week group educational program facilitated by community health workers. Outcomes included A1C levels, weight, and two surveys from the Michigan Diabetes Research Center - DM knowledge test and the DM empowerment scale.
Results: Paired sample t-tests were used to analyze the outcomes. The participants had an average pre-A1C of 8.82 mg/dl with post-A1C of 8.01 mg/dl (p = .028). Pre-knowledge test scores averaged 9.40 with post-test average of 12.07 (p < .001). Empowerment scores increased from 4.09 to 4.63 (p = .001). The reduction between the average pre-and post-weight measures were not statistically significant (p = .681).
Discussion: The implementation of a culturally-tailored DM educational program in a medically underserved community had a significant impact on reducing A1C levels, improving DM knowledge, and enhancing empowerment levels. Although the sample size was small and limited to one clinic, applying these programs can have a measurable clinical impact in the treatment of Hispanic DM patients. Future research can further exam how to duplicate this project on a larger scale and over a sustained period.