Antidepressants lessen major depressive disorder symptoms for two-thirds of patients with the psychiatric disorder, and the other third typically acquire treatment resistance. Roughly half of those treated will discontinue medications if symptoms are alleviated. Reports of major depression symptoms denote that deficient gamma-aminobutyric acid (GABA) concentrations linked with dysregulation among dysfunctional networks and emotional processes. Moreover, pharmacology proposes neurotransmitter system alterations, particularly GABA, that modulate emotional processes, notably the Resting-State Networks, will reduce major depression symptoms. However, pharmacological approaches are unproductive given that major depression prescriptions cause extraneous side effects or exacerbate symptoms. Consequently, this research recognizes how antidepressant efficacy emphasizes that pharmacology offers no robust models of treatable root causes. Impending studies reveal alternative mindfulness-based major depression treatments advances, except meditation mechanisms are less established. Transcranial focused ultrasound offers an alternative multi-pronged therapy after recent experiments with the non-invasive stimulation techniques improved mood and likely enhanced meditation practices. Cognitive Psychology network models and neuroscience pharmacology mechanisms will guide this research so that modern multi-pronged treatments are evaluated similarly to antidepressants. This analysis employed functional magnetic resonance imaging that measured functional network changes observed in patients that received ultrasound neuromodulation to components of the subject’s Resting-State Network. Additionally, magnetic resonance spectroscopy defined the predicted changes needed to assess relevant neuromodulatory systems, specifically GABA. In this manner, the study will reprocess transcranial focused ultrasound data through additional analysis to extrapolate top-down mechanisms of the non-invasive therapy and mindfulness practices.

In the early seventies, the field of psychiatry was taken aback by Stanford professor Dr. David Rosenhan’s 1973 book, On Being Sane in Insane Places. Although his findings were later deemed a scientific misconduct resulting from data falsification, his work raised awareness of problematic social and environmental factors in psychiatric facilities. Much has been done to improve psychiatric facilities, but there remains area for growth if the psychiatry field aims to engage and provide patients with a therapeutic setting in psychiatric hospitals. This research explores the relationship between a patient’s social and physical experience in a psychiatric hospital and their engagement with mental health treatment after discharge. Using qualitative methodology including ethnographic observations and photographs of psychiatric units in Seattle and interviews with mental health professionals there. Participants are recruited through convenience and snowball sampling. Additionally, an analysis will be provided discussing the environmental factors of psychiatric rooms through the evaluation of room design and its effectiveness in creating a therapeutic environment. Predicted results include a negative relationship between a patient’s socio-physical experience in an inpatient psychiatric facility and their engagement in future treatment after discharge. Indicating that a negative socio-physical experience may reduce a patient’s continual engagement with treatment posthopitalization. This study will provide a foundation for a second research phase examining patients directly on their experiences. Findings will enable future mental health providers to improve upon these experiences and hence, a patient’s receptivity to post-hospitalization treatment.

A disorder of consciousness (DOC) is when an individual experiences a severe injury to the brain, typically after a traumatic brain injury (TBI), and consciousness becomes impaired. The main disorders of consciousness are coma, vegetative state (VS), and minimally conscious state (MCS). The American Academy of Neurology Practice Guidelines report that 40% of patients receive an inaccurate diagnosis of a DOC by clinicians. Diagnostic error can influence medical professionals to recommend decisions that may lead to premature or ill-suited treatment withdrawal and unsuitable rehabilitative treatments that can induce poorer health outcomes or death. The Coma Recovery Scale-revised (CRS-r) behavioral assessment has been identified as having the strongest content validity and recognizing misdiagnoses compared to repeated behavioral assessments, but no single DOC assessment alone is recommended to diagnose patients who experience DOC symptoms. Revising the assessment criteria would increase the validity and reliability of diagnostic protocol. Neuroimaging techniques are used to measure anatomical and functional connectivity in the brain, and an integration of a neuroimaging technique with a behavioral assessment may be used to accurately identify states of consciousness. The aim of this literature review is to analyze the validity and reliability of common testing measures for patients with a DOC, hypothesizing that an implementation of a multimodal testing measure that integrates sensory stimulation and functional connectivity measures will increase the validity of a diagnosis. The results of this literature review show that a multimodal testing measure can increase the accuracy of diagnosing patients with the appropriate DOC.

Emotional processing theory is the underlying model for traditional exposure therapy. This approach to exposure presumes that the amount to which fear reduces from peak fear levels within an exposure session predicts successful treatment of specific phobias such as arachnophobia. Inhibitory learning theory (ILT) offers a different approach to exposure centered around forming new non-threat associations (i.e., memories) by way of fear acceptance rather than attempts to focus on reducing fear levels (i.e., fear reduction). ILT may be more effective for helping phobic populations because the model promotes the learning of non-fear associations in the presence of the feared stimuli.