Graduation Year

2026

Document Type

Dissertation

Degree Type

Dissertation/Thesis

Degree Name

Doctor in Psychology (Psy. D.)

Abstract

Depression, a pervasive and historically stigmatized disorder, has been treated through various paradigms over centuries, from spiritual to medical frameworks. Despite advances, Treatment-Resistant Depression (TRD) remains a significant clinical challenge, affecting a substantial proportion of patients. Transcranial Magnetic Stimulation (TMS) offers a promising approach for those unresponsive to conventional treatments. This study aims to assess the efficacy of TMS in treating TRD and its broader psychological effects using the Minnesota Multiphasic Personality Inventory-3 (MMPI-3). Participants undergoing TMS at Lexington Forensic Psychiatry were invited to partake in the study. The treatment regimen consisted of 36 TMS sessions over nine weeks. Psychological symptoms and personality traits were evaluated pre- and post-treatment using the MMPI-3. Data were anonymized and will be analyzed through within-subjects t-tests and correlation analyses to observe changes in psychological symptoms.

Initial data from four participants revealed diverse outcomes. Participant one displayed significant improvements across various scales, including emotional/internalizing dysfunction, thought dysfunction, and depressive symptoms. Participant two exhibited improvement in emotional distress and thought dysfunction but showed increased scores in scales related to persecution and impulsivity. Participant three showed minor changes, with an improvement in behavior-restricting fears but increased somatic complaints. Participant four experienced an increase in both maladaptive traits, such as aggression and impulsivity, and emotional disturbance, as indicated by MMPI-3 scores.

The findings underscore the complexity and heterogeneity in TMS treatment outcomes for TRD. While some individuals showed notable improvements, others exhibited increased symptoms, suggesting the need for personalized approaches in TMS treatment planning. Recruitment challenges due to the extensive nature of the MMPI-3 suggest the need for efficient study designs to improve participant retention. The study's ongoing objectives are to evaluate predictive MMPI-3 scales for treatment response, assess symptom reductions, and identify cases of personality psychopathology in non-respective profiles.

This study highlights the potential of TMS as a viable treatment for TRD while also demonstrating the importance of comprehensive psychological assessments, like the MMPI-3, in understanding and predicting treatment outcomes. Further research with a larger sample size is essential to refine TMS protocols and enhance its efficacy and applicability in clinical setting

Faculty Mentor

Dustin Wygant, Ph.D.

Department Affiliation

Psychology

Committee Member

Melinda Moore, Ph.D.

Department Affiliation

Psychology

Committee Member

Michael McClellan, Ph.D.

Department Affiliation

Psychology

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