MS, Kent State University, 2018, College of Arts and Sciences / Department of Computer Science

Posting on the internet, including weblogs or social media, is one of the ways individuals seek for an outlet to express themselves or mental health concerns. For many mental health issues such as psychosis, the timing of detection and treatment is critical; short and long-term outcomes are better when individuals begin treatment close to the onset of psychosis. While the internet offers a positive medium for short term therapy, it is not a face to face therapy session, wherein a trained professional is better able to deduce the root of the problem. Many clinicians are adopting electronic communication to strengthen their therapeutic alliance with their patients. The drawback of psychiatry is that it lacks objectified tests for mental illnesses that would otherwise be present in medicine. Current neuroscience has yet not found genetic markers that can characterize individual mental illnesses. A thought disorder (ThD) which is a widely found symptom in people suffering from schizophrenia, is diagnosed from the level of coherence when the flow of ideas is muddled without word associations. A system that can explore the use of speech analysis for aiding in psychiatric diagnosis is highly desirable and would help early detection and effective treatment results. This thesis introduces a framework – Prediction Onset Prediction System (POPS) - to predict the onset of psychosis based on written language habits. A scrape of a multitude of individual comments is analyzed using a trained psychosis prediction module that is able to predict if an individual is psychotic (based on the semantics) using natural language processing, machine learning techniques and a customized corpus with terms consist with psychotic language tendencies created using speech analysis techniques. The effectiveness of the corpus and its implication in psychosis detection is explored.

Committee: Kambiz Ghazinour (Advisor) Subjects: Computer Science; Health; Mental Health; Psychology; Sociology; Teaching; Technology

Master of Arts, Case Western Reserve University, 2024, Psychology

Lack of insight in psychosis has been associated with poor treatment engagement and involuntary hospitalization and is considered a core feature of psychotic disorders. One factor that may improve treatment engagement in psychosis, perhaps for individuals with low insight, is the presence of social support. Social support may improve well-being in psychosis by mitigating adverse effects of life stressors and improving treatment engagement, however, the relationships between insight, social support, and treatment engagement are not clear. We hypothesized that greater insight and social support would result in better treatment engagement. Second, we hypothesized that greater social support would enhance treatment engagement for individuals with low insight. Results did not support a relationship between insight and treatment engagement, thus social support did not moderate a relationship between the two. We discuss explanations for these findings, including limitations of the insight measure for this sample and the impact of barriers to treatment.

Committee: Sarah Hope Lincoln PhD (Committee Chair); Norah Feeny PhD (Committee Member); James Overholser PhD (Committee Member) Subjects: Clinical Psychology; Health Care; Psychology

Master of Arts in Medical Ethics and Humanities, Northeast Ohio Medical University, 2023, College of Graduate Studies

Perinatal psychiatric illness, which encompasses many conditions including postpartum depression and postpartum psychosis, has been stigmatized for thousands of years, following the introduction of the archaic medical diagnosis of “hysteria” and widespread use by early physicians. Throughout the evolution of medical practice through the 19th century, when psychiatry was established as an important medical discipline, women continued to experience poor health outcomes associated with lack of understanding of how pregnancy, parturition, and motherhood can affect mental health and the development of psychiatric illness. Though perinatal psychiatric illness has since been recognized as an important cause of morbidity in this population, with unique considerations in intervention, the stigma remains. Films have been recently produced addressing perinatal psychiatric illness in hopes of diminishing this stigma and helping those who suffer. One such film, A Mouthful of Air, seeks to provide commentary on the social complexities surrounding perinatal psychiatric illness. This thesis analyzes A Mouthful of Air through feminist ethics lenses to demonstrate the intention and effect of artistic choices in representation of perinatal psychiatric illness and how these may inadvertently stigmatize illness rather than address misunderstandings.

Committee: Julie Aultman (Advisor); Brian Harrell (Committee Member); Erica Stovsky (Committee Member) Subjects: Medical Ethics

Master of Arts (M.A.), University of Dayton, 2023, Psychology, Clinical

While stigma is generally attached to all mental illnesses, individuals who experience psychosis are reported to be one of the most stigmatized minority groups in society. The aim of this study was to explore different factors that might play a role in the stigmatization of individuals with this condition. More precisely, the present project examined the effects of auditory content valence (i.e., pleasant vs. neutral vs. unpleasant), participant spirituality (i.e., high vs. low), and diagnostic circumstance (i.e., psychosis in the context of a psychiatric disorder vs. a medical condition) on stigma towards psychosis, as well as the interaction between these three variables. Undergraduate students (N = 123) first completed a demographic questionnaire and a spirituality measure. A week later, participants were presented with six fictional descriptions of patients, three of whom were experiencing psychosis symptoms in the context of bipolar disorder I, and three who were experiencing psychosis in the context of a brain tumor. After reading each patient description, participants listened to five recordings simulating the fictional patient's auditory hallucinations. For each patient condition, participants were presented with auditory recordings of hallucinations that were pleasantly/positively valenced, neutrally valenced, and unpleasantly/negatively valenced. After reading each description and listening to the audio recordings, participants were asked to complete a questionnaire that measured their stigma towards the fictional patient. Results indicated that auditory content valence has a significant effect on stigma. More precisely, participants reported higher social stigma towards fictional patients with negatively valenced hallucinations compared to those with neutrally valenced hallucinations. At the same time, participants reported higher social stigma towards fictional patients with neutrally valenced hallucinations compared to those with positively valenced hal (open full item for complete abstract)

Committee: Julie Walsh-Messinger (Advisor); Erin Kunz (Committee Member); Lee Dixon (Committee Member) Subjects: Clinical Psychology; Mental Health

Master of Arts, Case Western Reserve University, 2023, Psychology

Social relationships are associated with better physical and psychological health outcomes in several populations, including individuals with psychosis. This association may occur through main effects, stress-buffering effects, or, most likely, a combination of the two. Studies are needed to further understand the relationship between social support and positive outcomes, and potential mediating and moderating factors. The present study hypothesized that perceived social support is related to quality of life, and that self-esteem and positive affect mediate this relationship. Additionally, the present study hypothesized that perceived social support moderates the negative effects of psychotic-like experiences on quality of life. Results of atemporal mediation and moderation models to test these hypotheses revealed that hypothesis 1 was supported and hypothesis 2 was not. Results offer increased understanding about how perceived support is related to quality of life. Results are clinically applicable to both the general population and help-seeking individuals including those with psychosis.

Committee: Sarah Hope Lincoln (Committee Chair); Norah Feeny (Committee Member); Brooke MacNamara (Committee Member) Subjects: Clinical Psychology

Master of Arts, University of Toledo, 2022, Psychology - Clinical

Self-report measures of schizotypy are an important tool for identifying individuals who may be considered at higher risk for developing a schizophrenia-spectrum disorder. Previous research into the specificity of such measures has led to mixed results, such that it is unclear whether individuals who are not at higher risk of psychosis are being incorrectly identified as being at risk based on these measures. Using latent profile analysis, the current study aimed to analyze what overlap may exist in the response patterns of individuals with schizophrenia (SCZ) symptoms, non-schizophrenia-spectrum disorder symptoms, and non-symptomatic individuals. It was hypothesized that at least three latent profiles would emerge: (1) one profile characterized by high scores across all dimensions of schizotypy and comprised mostly of individuals with SCZ symptoms, (2) another characterized by low scores across all dimensions and comprised mostly of non-symptomatic individuals, and (3) one or more profiles with low to average scores across the dimensions and comprised mostly of individuals with symptoms of non-schizophrenia-spectrum disorders. A total of 676 respondents (Mage = 42.4 years, SD = 15.7; 82% female; 83% White) recruited online through ResearchMatch completed the current study. The sample was divided into five groups based on their endorsement of symptoms of the following disorders: SCZ (N = 73), autism spectrum disorder (ASD; N = 111), depression (DEP; N = 124), or obsessive-compulsive disorder (OCD; N = 149). The other 219 respondents endorsed no symptoms of clinical severity. Participants completed four symptom screening measures, four self-report measures of schizotypy, and demographic questions via a single Qualtrics survey. A latent profile analysis (LPA) was conducted in Mplus using dimensional scores from the four self-report measures of schizotypy. The optimal LPA model included four latent profiles and had an entropy value of 0.92, indicating high classificat (open full item for complete abstract)

Committee: Dr. Peter Mezo (Committee Chair); Dr. Jon Elhai (Committee Member); Dr. Kamala London Newton (Committee Member) Subjects: Clinical Psychology; Psychology

Doctor of Philosophy (PhD), Ohio University, 2022, Clinical Psychology (Arts and Sciences)

Several studies have found that neurocognition is related to social and functional outcomes in chronic psychotic spectrum disorders and identified negative symptoms and social cognition as potential mediating mechanisms. However, few studies have examined the relationship of specific facets of neurocognition to social outcomes, though this may be of greater clinical utility. No studies to date have examined these more nuanced relationships across the psychotic spectrum, in individuals high and low in schizotypal traits, and those who recently experienced a first episode of psychosis (FEP). The present study investigated the relationship of language and social functioning across the psychotic spectrum to identify whether: 1) social and language performance differ across the spectrum, 2) language is related to social functioning across the spectrum, and 3) language is indirectly related to social functioning through negative traits/symptoms and/or social cognition. The total sample was comprised of 101 participants: 42 low in schizotypal personality traits, 44 high in schizotypal personality traits, and 15 FEP individuals. Participants completed a comprehensive battery of language, social cognition, and social functioning tests. We found that language and social functioning performance differed by group. The FEP group performed worse than the low schizotypy group across both social functioning and language tasks. The FEP group also performed worse on social functioning tasks than the high schizotypy group, but we observed few differences between the FEP and high schizotypy group on language measures. The high schizotypy group performed worse on social functioning than the low schizotypy group, but differences on measures of language were variable. Regression models revealed that language performance, specifically proverb interpretation, was significantly associated with performance-based social functioning. We found partial support for our exploratory mediation (open full item for complete abstract)

Committee: Julie Suhr (Committee Chair); Nicholas Allan (Committee Member); Michelle O'Malley (Committee Member); Aubrey Moe (Committee Member); Timothy Anderson (Committee Member) Subjects: Clinical Psychology

PHD, Kent State University, 2018, College of Arts and Sciences / Department of Psychological Sciences

Among individuals with schizophrenia disorders, the experience of trauma during childhood is common. Childhood trauma has been connected to numerous adverse outcomes, yet its impact on the phenomenology of schizophrenia is still largely unknown. The present study's primary aim was to test the relationships of emotion perception, paranoia, and social functioning with self-reported childhood traumatic experiences in a sample of community mental health outpatients diagnosed with schizophrenia. Potential mechanisms of these relationships were tested in two sets of mediation models: the first set tested if the effect of childhood trauma acted on paranoia through emotion perception, and the second tested if the effect of childhood trauma acted on social functioning through emotion perception and paranoia. We also tested the relationships of these variables with specific symptoms in schizophrenia. Results indicated significant relationships between emotion perception and paranoia, as well as between paranoia and social functioning. Analyses found no evidence of significant relationships between childhood trauma and any of the other tested variables. Consequently, both sets of mediation models did not show evidence of significant mediational effects. Exploratory results indicated that paranoia displays different relationships depending upon whether contextual information is present (i.e., accidental situations) or not (i.e., ambiguous situations). Findings and limitations are discussed in detail, as well as possible explanations for the hypothesized relationships that were not supported by our results. To conclude, implications of this study are examined and potential future research is suggested to continue improving early detection of those at risk for worse deficits in schizophrenia.

Committee: Nancy Docherty Ph.D. (Committee Chair); Jeffrey Ciesla Ph.D. (Committee Member); John Updegraff Ph.D. (Committee Member); Deborah Barnbaum Ph.D. (Committee Member); Richard Adams Ph.D. (Committee Member) Subjects: Psychology

Psy. D., Antioch University, 2017, Antioch New England: Clinical Psychology

Despite very high rates of trauma-related disorders among individuals with early psychosis, no clinical practice guidelines for the treatment of comorbid early psychosis and trauma-related disorders exist to date. Indeed, the routine exclusion of individuals with past and current psychosis from participation in trauma research and practice has limited the accumulation of research evidence that could inform such clinical practice guidelines. While preliminary research evidence suggests that traditional, empirically supported treatments for trauma-related disorders can be safely and effectively employed to reduce symptoms of posttraumatic stress and chronic psychosis, it remains unclear whether such treatments are appropriate for individuals in the early stages of psychotic illness. Clinical experts (N = 118) representing 121 early psychosis programs across 28 states were surveyed using the expert consensus method. Forty-nine clinical experts responded, and reached consensus on 46 of 49 expert consensus items related to the treatment of comorbid early psychosis and trauma-related disorders. Conjoint or family therapy and individual therapy were rated as treatment approaches of choice. Anxiety or stress management and psychoeducation were rated as interventions of choice for addressing both trauma symptoms and psychotic symptoms. In addition, case management was rated as an intervention of choice for addressing psychotic symptoms. No consensus was reached on expert consensus items regarding the appropriateness of a parallel treatment approach for the treatment of comorbid early psychosis and trauma-related disorders, sensorimotor or movement interventions for addressing trauma symptoms, or exposure interventions for addressing psychotic symptoms. In areas where expert consensus exists, clinical practice guidelines for the treatment of comorbid early psychosis and trauma-related disorders are offered in accordance with the expert consensus method. In areas where expert (open full item for complete abstract)

Committee: Martha Straus PhD (Committee Chair); William Slammon PhD (Committee Member); Tara Niendam PhD (Committee Member) Subjects: Clinical Psychology

Doctor of Philosophy, University of Toledo, 2015, Psychology - Clinical

Exner's (2003) Comprehensive System and Meyer et al.'s (2011) Rorschach Performance Assessment System use Form Quality scores as a method for assessing the accuracy of perceptions on the Rorschach. However, Form Quality is a rather coarse classification method as it is based on just three options along a continuum of perceptual accuracy. There is currently not a fully dimensional Rorschach score that can thoroughly and efficiently tap into both the frequency with which particular objects are reported while taking the test and the perceptual fit of those objects to the cards. This study is focused on exploring the structure of a fit variable, Form Accuracy, in combination with a frequency variable, Percept Frequency, to make progress on a new dimensional method of scoring perceptual accuracy that will improve the ability to identify distorted perceptual processes and impaired reality testing and thus improve validity coefficients in the Rorschach-based identification of psychosis. Percept Frequency tables were developed from six internationally collected samples from Argentina, Brazil, Italy, Japan, Spain, and the U.S. that quantified how often objects were reported while completing the Rorschach task. Form Accuracy ratings were obtained from a database of 13,031 objects that had been rated an average of 9.9 times by different judges from eleven countries who were asked to rate the extent to which the object fit the contours of the inkblot at the location where it was seen. A criterion database containing 159 protocols and 3,897 scorable responses was then scored for Form Accuracy and Percept Frequency. Hierarchical Linear Modeling was used to complete structural analyses of Form Accuracy and Percept Frequency scores at the response level, and correlations of these variables were computed at the protocol level with a criterion measure assessing severity of disturbance based on psychiatric diagnoses. Across different levels of aggregation, there was resounding evidenc (open full item for complete abstract)

Committee: Gregory Meyer PhD (Committee Chair); Jeanne Brockmyer PhD (Committee Member); Joni Mihura PhD (Committee Member); Jason Rose PhD (Committee Member); Donald Viglione PhD (Committee Member) Subjects: Clinical Psychology

Doctor of Philosophy, University of Toledo, 2015, Psychology

This research represents the second step in a planned series of studies that is expected to culminate in a behavioral measure that assesses solely for problems in thinking and perception based on the Rorschach Performance Assessment System (R-PAS; Meyer, Viglione, Mihura, Erard, & Erdberg, 2011). The Thought and Perception Assessment System (TPAS) is designed for use in clinical practice and research using all ten of the traditional Rorschach cards. Because coding only focuses on two sets of variables, test administration procedures are substantially simplified relative to the standard R-PAS procedures. TPAS will yield time savings and dimensional behavioral assessment data for the identification of problems in thinking and perception. TPAS can be further abbreviated and simplified by using it with a smaller subset of cards. These short-form card sets yield further time savings and also provide the ability to conduct alternate forms-retest evaluations with independent stimuli. Using archival data, Eblin and colleagues (Eblin, 2012; Eblin, Meyer, Mihura, & Viglione, 2014) derived the short-form card sets using only the R-PAS Thinking and Perception variables. In addition to the standard 10-card option, one short-form series consisted of two 5-card options, another consisted of two 4-card options, and the final series consisted of three 3-card options. Eblin and colleagues' analyses demonstrated that each of the short-form card series had merit, with the 4-card series being less optimal than the 5- and 3-card series because it offers no benefit over five cards and not as many options as the 3-card series. As such, the 4-card series is not used here. In general, part-whole correlations, reliability coefficients, and validity coefficients were acceptable for each short-form card set and slightly decreased as a function of decreasing the number of cards in each series. The primary limitation of Eblin and colleagues' (Eblin, 2012; Eblin et al., 2014) previous research is (open full item for complete abstract)

Committee: Gregory Meyer Ph.D. (Committee Chair); Joni Mihura Ph.D. (Committee Member); Wesley Bullock Ph.D. (Committee Member); Stephen Christman Ph.D. (Committee Member); Donald Viglione Ph.D. (Committee Member); Nicole Kletzka Ph.D. (Committee Member) Subjects: Behavioral Sciences; Clinical Psychology; Psychological Tests; Psychology

Doctor of Philosophy (PhD), Wright State University, 2011, Biomedical Sciences PhD

There is a high comorbidity of type-2 diabetes and neuropsychiatric disorders. However, there is paucity of preclinical research to study this phenomenon. The validity of the db/db mouse as an animal model to study type-2 diabetes and related macrovascular and microvascular complications is well established. The first part of this dissertation was designed to investigate comprehensively the db/db mouse behavior as preclinical evidence of type-2 diabetes related major neurobehavioral complications. Juvenile (5-6 weeks) and adult (10-11 weeks) db/db mice were screened for behavioral depression in forced swim test (FST), psychosis-like symptoms using pre-pulse inhibition (PPI) test, anxiety behavior employing elevated plus maze (EPM) test, locomotor behavior and thigmotaxis using open field test, emotional learning using fear potentiation of startle (FPS) test and working memory deficits in Y-maze test. Both juvenile and adult group db/db mice displayed behavioral despair with increased immobility time in FST. There was an age-dependent progression of psychosis-like symptoms with disrupted PPI in adult db/db mice. In the EPM test, db/db mice were less anxious as observed by increased percent open arms time and entries. They were also hypolocomotive as evident by a decrease in their basic and fine movements. There was no impairment of working memory in the Y-maze test in db/db mice. In the FPS test, db/db mice showed impaired learning response indicative of abnormalities in DA neuronal activity in the amygdala. The second specific aim of this dissertation was to examine possible neurochemical basis for the observed behavioral deficits. Monoamine neurotransmitters dopamine (DA), norepinephrine (NE) and serotonin (5-HT) are elemental to normal functioning of the brain. Current theories of the basis for major neurobehavioral disorders involve abnormalities in use of NE, 5-HT and DA in specific brain regions. Recent studies report that the DA agonist reverses diabetes-relat (open full item for complete abstract)

Committee: James Lucot PhD (Advisor); Khalid Elased RPh, PhD (Committee Member); David Cool PhD (Committee Member); Michael Hennessy PhD (Committee Member); Heather Hostetler PhD (Committee Member) Subjects: Biomedical Research

Master of Arts, University of Toledo, 2012, Psychology

The present research represents the first step in a planned series of studies that will ultimately culminate in a Rorschach-based system that assesses solely for problems in thinking and perception. The system is provisionally dubbed the Thinking and Perception Behavioral Assessment System (TP-BAS) and is designed for use in clinical practice and research. The TP-BAS will yield time savings, the ability to conduct test-retest evaluations, and dimensional behavioral assessment data for the identification of problems in thinking and perception. The most recently developed system for conducting broadband Rorschach assessments is the Rorschach Performance Assessment System (R-PAS; Meyer, Viglione, Mihura, Erard, & Erdberg, 2011). The aim of the present research was to develop series of ¿¿¿¿¿¿¿short-forms¿¿¿¿¿¿¿ of R-PAS Thinking and Perception variables. Each short-form makes use of only the Thinking and Perception variables. One short-form consisted of one 10-card option, another short-form consisted of two 5-card options, another short-form consisted of two 4-card options, and the final short-form consisted of three 3-card options. Thus, short-forms of the R-PAS were created in two ways. First, the number of variables was reduced to just the Thinking and Perception variables. Second, alternatives to using the full Rorschach card set were developed by reducing the number of cards to be administered in all but one of the TP-BAS card sets. It was first determined which R-PAS Perception and Thinking variables meaningfully differ in the frequency with which they occur across cards. Second, on a card-by-card basis, the mean and standard deviation were computed for the variables that were found in to meaningfully differ in frequency across cards in step 1. Third, TP-BAS card sets were assembled by balancing their relative difficulty, as determined in steps 1 and 2. Fourth, card sets and series were compared to one another regarding part-whole correlations with the full-form, (open full item for complete abstract)

Committee: Gregory Meyer PhD (Committee Chair); Joni Mihura PhD (Committee Member); Donald Viglione PhD (Committee Member); Jeanne Brockmyer PhD (Committee Member) Subjects: Behaviorial Sciences; Mental Health; Psychological Tests; Psychology

PHD, Kent State University, 2011, College of Arts and Sciences / Department of Psychological Sciences

The purpose of this study was to examine the predictive relationship between psychological stress and symptom change among individuals with a history of psychotic symptoms. The study had a number of specific aims. First and foremost, the study retrospectively examined the impact of stressful experience, operationalized based on conservation of resources (COR) theory, on mood and psychotic symptoms. COR theory is a general model of stress, and in past research has been applied primarily to normal populations; this was the first study of its kind to apply COR theory to a sample of seriously mentally ill participants. Second, the study attempted to replicate earlier findings regarding the role of negative affect as a mediator of the impact of stressful events on psychotic symptoms. Third, following COR theory, the study investigated the putative buffering effect of resource gains (i.e., positive life events) on the impact of resource losses. The participants in this study were 77 stable outpatients at a community mental health clinic who were diagnosed with either a schizophrenia-spectrum disorder or a bipolar disorder with psychotic features. Participants were assessed at two time points, separated in time by approximately 9 to 12 weeks. During the initial interview, diagnoses were established and baseline symptoms were assessed. During the terminal interview, symptoms were reassessed, and gains and losses in resources were retrospectively examined for the preceding six weeks. Results supported the hypothesis that cumulative resource losses are causally related to psychosis symptom exacerbations and increased levels of depression and anxiety. There was also evidence that the interaction of baseline social functioning with resource losses predicted symptom exacerbations, and that resource gains were associated with symptom improvements. Mixed support was found for other hypotheses. There was no evidence that changes in depression and anxiety mediated the associations b (open full item for complete abstract)

Committee: Nancy Docherty PhD (Committee Chair); Stanford Gregory PhD (Committee Member); John Gunstad PhD (Committee Member); William Merriman PhD (Committee Member) Subjects: Psychology