Digital Commons Network^™

On The Rebound: Resilience And Subjective Cognitive Symptoms In Cancer, Giuliana V. Zarrella

Theses and Dissertations

Recent studies have shown a strong connection between resilience and subjective cognitive symptoms in clinical populations. However, there is limited understanding of this relationship in cancer survivors, and no studies examine whether resilience training could alleviate subjective cognitive symptoms in these patients. This study examined the relationship between subjective cognitive function and resilience in non-CNS cancer survivors who participated in a resiliency training intervention, at baseline and from pre- to post-intervention, as well as investigated potential influences of change in subjective cognition. Adult cancer survivors (N=275) participated in the Stress Management and Resilience Training-Relaxation Response Resilience Program (SMART-3RP) …

Using Natural Language Processing To Understand The Lived Experiences Of People Identifying With Adhd: What Themes Emerge In Social Media Posts?, Gabby C. Scalzo

Theses and Dissertations

Compared to the amount of research conducted on how to identify and understand children with Attention-Deficit Hyperactivity Disorder (ADHD), there has been relatively little work done to understand the lived experiences of adults with ADHD. Increased understanding of how adults with ADHD conceptualize themselves in the context of their diagnosis would help clinical experts tailor research and treatments to better serve these communities. However, there are several barriers towards conducting high-quality qualitative research, including time- and labor-intensity. This study, informed by qualitative research traditions, used innovative data sources (i.e., social media) and analytic techniques (i.e., machine learning) to reduce these …

Identifying Mechanistic Pathways To Rigidity Associated With Obsessive-Compulsive Personality Disorder Traits Using A Novel Decision-Making Paradigm, Hannah L. Heintz

Theses and Dissertations

Cognitive and behavioral rigidity is observed across several mental disorders and is a defining characteristic of Obsessive-Compulsive Personality Disorder (OCPD), a highly prevalent and debilitating, yet understudied, disorder. In particular, treatments for OCPD are underdeveloped due to our poor understanding of the mechanisms leading to the disorder’s key feature of rigidity. Two related disorders, anorexia nervosa (AN) and obsessive-compulsive disorder (OCD), have shown distinct mechanistic pathways leading to symptoms of rigidity, indicating that this trait can arise as a result of a number of differentially impaired cognitive processes, each requiring unique interventions. To examine the relationship between symptoms of OCPD …

Development Of A Validity Scale For The Icd-11 Personality Disorder Measure (Psi-11), Rae Lutz

Theses and Dissertations

Invalid responding is a significant issue in the utilization of self-report information. Invalid responding can be assessed by stand-alone validity measures or embedded validity scales. The International Classification of Diseases (ICD) is one of two major diagnostic systems which provide guidance on diagnosing personality disorder, with the most recent version (ICD-11) providing a fully dimensional model for personality disorders. No existing measures aimed at assessing dimensional personality pathology have addressed the combination of PD severity and trait qualifiers that were based upon ICD-11 guidelines. To address this gap, Clark et al. (2021) developed the ICD-11 Personality Disorder Measure (PSI-11). However, …

Community Informant And Mental Health Provider Perspectives On Access To Mental Healthcare For Lgbtqia+ Communities In Virginia, Chariz Seijo

Theses and Dissertations

The existing literature on mental health disparities for lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA+) populations suggests members of LGBTQIA+ populations are at greater risk of mental health disorders than cisgender and heterosexual individuals. The COVID-19 pandemic has also exacerbated mental health disparities for many, including LGBTQIA+ populations. Combined with mental health provider shortages and anti- LGBTQIA+ bills across the country, inequities in mental healthcare are a significant concern. This qualitative study was designed to gather unique perspectives of key community informants and mental health providers on their experiences with mental healthcare provision to LGBTQIA+ communities in Virginia. …

Psychiatric Diagnostic Decision-Making: Investigating The Theory Of The Dual-Process Model, Christopher S. Kleva

Theses and Dissertations

Diagnostic decision-making is an important component of clinical practice; however, there is substantial diagnostic unreliability within mental health diagnoses. The lack of reliability emphasizes the importance of investigating diagnostic decision-making; however, the research to date is limited, primarily relying on a vague definition of decision-making based on the dual-process model. The present study is an exploratory attempt to apply the dual-process model to explain how mental health clinicians (n = 30, 73.3% cisgender female, 96.7% psychologists) arrive at making diagnostic decisions through the use of an interactive interview mechanism. For each participant, we are able to create a figure …

Examining Genetically-Informed Etiologic Models Of Co-Occurring Posttraumatic Stress Disorder And Recreational Cannabis Use Among College Students, Terrell A. Hicks

Theses and Dissertations

The college years encompass a period of increased risk recreational cannabis use (RCU), as well as a time of increased risk for trauma exposure and developing posttraumatic stress disorder (PTSD). Given the high co-occurrence between RCU and PTSD, and the potentially negative consequences of the two (e.g., worse academic outcomes), there is a need to understand the etiologic mechanisms of these commonly co-occurring conditions. Two primary phenotypic models exist: self-medication model (i.e., PTSD to RCU) and the high-risk model (i.e., RCU to PTSD). To date, there are two existing studies longitudinally examining the etiologic models proposed to explain co-occurring RCU …

Profiles Of Family Functioning In Pediatric Hematology-Oncology Patients: Longitudinal Associations With Child Well-Being, Sydney Sumrall

Theses and Dissertations

This study aims to assess 1) patterns of family functioning and 2) longitudinal associations between family functioning patterns and well-being in a vulnerable cohort of children with chronic illness. Caregivers of hematology (16.4%) and oncology (83.6%) patients ages 7-20 (N=55; M_age = 13.3 [SD = 2.7]; 52.7% female; 45.5% non-Latinx White, 38.2% Black or African American, 12.7% Latinx, 1.8% Asian, and 1.8% multi-racial,) reported on family functioning via the Family Assessment Device. Cluster analyses identified three mutually exclusive clusters: one high adaptive group, one moderate adaptive group, and one maladaptive group. Group membership was not significantly …

Physical Activity In Adolescents With And Without Adhd: Longitudinal Associations With Sleep, Adhd, And Internalizing Symptoms, Caroline N. Cusick Lowman

Theses and Dissertations

Adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD) are at risk for developing clinically significant sleep problems and comorbid internalizing symptoms. Physical activity (PA) has significant positive associations with a variety of health outcomes, including sleep and aspects of mental health. As such, the US Department of Health and Human Services recommends adolescents receive at least 60 minutes of moderate-to-vigorous PA (MVPA) per day. However, it is unknown whether adolescents with ADHD have different patterns of physical activity compared to their peers. Importantly, it may be that PA can serve as a buffer between ADHD symptoms and development of comorbid difficulties with sleep …

Sustaining Breaths For Restorative Rest: A Preliminary Evaluation Of Sleep, Mental Health, And Cognitive Function Following Hypoglossal Nerve Stimulation For Obstructive Sleep Apnea, Elliottnell Perez

Theses and Dissertations

Introduction: Obstructive sleep apnea (OSA) is a sleep-related breathing disorder that produces repetitive obstruction or collapse of the upper airway. Positive airway pressure (PAP) therapy is the gold standard treatment for OSA. Hypoglossal nerve stimulation (HNS) is considered an alternative treatment for patients who are unable to tolerate PAP therapy. The purpose of the study was to examine sleep, mental health, and cognitive health outcomes before and after HNS to determine its viability as an alternative treatment.

Methods: The study utilized a single-group, pretest-posttest design. Objective and subjective sleep was measured using actigraphy, sleep diary, and questionnaires. Objective and subjective …

Alcohol And Other Addictive Behaviors Among Bariatric Surgery Patients, Rachel M. Arnold

Theses and Dissertations

Research has repeatedly highlighted a high rate of comorbidity of addictive behaviors in both clinical and non-clinical samples. While polydrug use has received significant attention in recent years, less is known about rates of comorbidity with behavioral addictions such as eating, work, exercise, or sex. Individuals with a history of bariatric surgery may provide a unique opportunity to examine the potential co-occurrence of addictive behaviors. High rates of food addiction symptoms and changes in alcohol use patterns post-surgically have highlighted a potential gap in our understanding of bariatric patients and their needs post-surgically. Using a composite measure of addictive behaviors, …

Using Individual Determinants To Predict Behavioral Health Service Use In Integrated Pediatric Primary Care, Alfonso L. Floyd Jr.

Theses and Dissertations

Mental health problems (e.g., attention, externalizing, internalizing) are commonly observed in youth and are often associated with significant impairment and an increased need for mental health services. Conceptual frameworks, such as Andersen’s Behavioral Model of Health Service Utilization, have proposed that several individual determinants (e.g., predisposing, enabling, and need factors) may influence service use for mental health problems among youth. Despite the glaring need for mental health treatment among youth with mental health problems, studies indicate that many affected youths do not receive mental health care. Integrated pediatric primary care (IPPC) settings provide an ideal setting for youth and families …

Sleep Self-Efficacy, Loneliness, And Physical Activity: Assessing The Pathways Between Sleep Quality And Mental Health Using Structural Equation Modeling, Amber M. Fox

Theses and Dissertations

Although there is robust empirical support that poor sleep contributes to declines in mental health, explanations of this relationship remain unclear. The purpose of the present study was to examine the pattern of associations between sleep quality, sleep self-efficacy, loneliness, physical activity, and mental health among U.S. adults across the lifespan, and whether they differed by gender or age group. A structural equation model with invariance analysis was developed and examined data from 2,300 adults (M_age = 44.1, SD = 16.78) participating in the online study Investigating Sleep Longitudinally Across Normal Development (ISLAND). Sleep quality was measured by …

Breaking The Cycle: A Longitudinal Study Of Factors That Disrupt Peer Selection And Influence Processes Among Urban Youth, Kelly E. Oconnor

Theses and Dissertations

Having friends who engage in problem behavior (i.e., aggression, substance use, delinquency) has consistently been linked to adolescents’ own engagement in problem behavior. There are, however, several key gaps in the literature on peer influence. Few studies have considered the influence of friends’ prosocial behavior and there has been limited research to identify promotive factors that influence urban youths’ affiliation with peers who engage in problem and prosocial behavior across early adolescence, a time of heightened susceptibility to peer influence. The purpose of this study was to identify modifiable promotive factors that reduce adolescents’ problem behavior by decreasing exposure to …

Genetics And Alcohol Interventions In Youth, Zoe E. Neale

Theses and Dissertations

Alcohol is the most commonly used substance among youth, and risky alcohol use is associated with harmful consequences such as accidents, academic consequences, and physical and emotional health problems. Alcohol use disorders are approximately 50% heritable, yet most efforts to prevent and intervene upon youth alcohol use focus only on environmental factors. Furthermore, current prevention and intervention programs tend to have modest effects and are not uniformly effective for all individuals. Gene-by-intervention (GxI) studies offer an opportunity to expand current understanding of interventions by examining whether underlying genetic risk may contribute to differential program effects. Much of the current GxI …

Expand Your Horizon: Investigating An Online Intervention For Weight Bias Internalization, Alexandria Davies

Theses and Dissertations

Weight bias internalization (WBI; i.e., self-directed weight stigma or the degree to which individuals apply negative weight-based stereotypes to themselves), is problematic because it is associated with increased stress, emotional eating, healthcare avoidance, and exercise avoidance. Thus, WBI exacerbates health disparities and there is an urgent need to create treatments that address this concern. The current study examined the preliminary effectiveness of a previously developed online body gratitude journaling intervention (i.e., Expand Your Horizon) compared to an active control writing condition in emerging adult women with WBI. Racially/ethnically diverse women (N=100; n=49) or Expand Your Horizon ( …

Western Clinicians’ Diagnostic Accuracy Of Culture-Bound Syndromes, Lisa Y. Chung

Theses and Dissertations

Culture-bound syndromes are of increasing importance in today’s more diverse world. The current study measured the ability of clinicians trained in a western setting to accurately diagnose culture-bound syndromes from cultures outside of their background. Eight-four clinicians were recruited through the American Psychological Association (APA) membership directory. All recruited clinicians were asked to read three vignettes. In two vignettes a patient was suffering from either Hwabyung or Ataque de Nervios and the third vignette represented a control GAD vignette. The clinicians were asked to diagnose the patient in the vignette, to explain what information informed their diagnosis, to complete two …

A Psychometric Evaluation Of The Best In Class Adherence And Competence Scale, Katrina A. Markowicz

Theses and Dissertations

It is critical to utilize treatment integrity instruments to support the evaluation of evidence-based programs in early classroom contexts. However, in the early childhood field, guidelines for collecting treatment integrity data are underdeveloped. Consequently, most treatment integrity instruments employed in the field solely assess adherence, vary in design features and have little psychometric evidence supporting their use. As such, this represents a gap in the field that might slow efforts to implement evidence-based programs. The current study examines the score reliability and validity of an observational treatment integrity instrument (The BEST in CLASS Adherence and Competence Scale [BiCACS]; Sutherland et …

E-Cigarette Use And Perceptions Among Adolescents With Attention-Deficit/Hyperactivity Disorder: The Role Of Parental Messages About Tobacco, Mayra S. Ramos

Theses and Dissertations

Adolescents with attention-deficit/hyperactivity disorder (ADHD) are at increased risk of using e-cigarettes compared to their neurotypical peers. Parent-adolescent communication about tobacco use and number of ADHD symptoms can influence adolescents’ perceptions of e-cigarettes and their e-cigarette use. Adolescents with ADHD (n = 80) completed questionnaires assessing parental messages about tobacco use; e-cigarette harm perceptions; susceptibility to use e-cigarettes; and e-cigarette use. Parents reported on messages about tobacco use, adolescent’s ADHD symptomatology, and completed demographic questionnaires. Twenty-percent of adolescents reported e-cigarette ever use. Adolescent girls were significantly more likely to report higher e-cigarette harm perceptions than boys. Parents reported providing messages …

Mobile-Based Contingency Management To Promote Daily Self-Monitoring Of Pain Severity And Related Measures In An Online Sample Of Individuals With Chronic Pain, Kathryn Polak`

Theses and Dissertations

Between 11% and 40% of the US population experience chronic pain. One promising pain management solution is remote self-monitoring. Unfortunately, low rates of adherence have impeded the use of remote self-monitoring among chronic pain patients. One robust strategy for improving adherence is contingency management (CM). This project pilot tested a fully-automated CM app (DynamiCare Rewards) programmed with an escalating variable-ratio reinforcement schedule for promoting daily self-monitoring of pain symptom severity, related variables (e.g., sleep), and prescription opioid use over a 28-day period in a sample of individuals with chronic pain. A pilot RCT compared participants randomized to CM (n …

The Buffering Effects Of Resilience On Alcohol Use: A Phenotypic And Genotypic Investigation, Shannon Cusack

Theses and Dissertations

The college years encompass a time of vulnerability for problematic alcohol use/alcohol use disorder (AUD) and exposure to traumatic events (TE), which is a transdiagnostic risk factor for AUD, posttraumatic stress disorder (PTSD), and comorbid AUD-PTSD. However, not all who experience a TE develop these disorders, highlighting the need to identify factors that impact post-trauma outcomes. Resilience has been shown to be associated with lower alcohol consumption and related problems following TE, though the buffering effects of resilience on alcohol use have not yet been examined. Further, twin studies demonstrate that resilience is moderately heritable, but further research is needed …

For I Know The Plans I Have For You: God Locus Of Control, Spiritual Change, And Death Anxiety In Primary Brain Tumor Patients, Kelci D. Willis, Julia Brechbiel, Rachel Boutte, Laurel Kovalchick, Kyra Parker, Audrey Ann Louis Villanueva, Ashlee R. Loughan

Graduate Research Posters

Background/Purpose. Primary brain tumor (PBT) patients risk experiencing death anxiety given the high mortality rate of their diagnosis. In line with Terror Management Theory (TMT), many diagnosed with cancer utilize religion as a method of coping with the disease. However, previous literature on the relation between death anxiety and religion in cancer patients indicates mixed findings of either a negative relationship or no association. To the authors’ knowledge, no study has analyzed these two constructs together in PBT patients. The current study sought to address this gap by investigating the relationship between religiosity and death anxiety in an understudied population. …

Empirical Relationships Among Trauma Exposure, Anxiety Sensitivity, And Post Traumatic Stress Disorder, Sandra Yankah, Michael Southam-Gerow, Samantha Dehart, Payton Beam

Graduate Research Posters

This review synthesized and critically reviewed empirical studies that assessed relationships among trauma exposure, anxiety sensitivity (AS), and Post Traumatic Stress Disorder (PTSD). Across the literature, the prominent theory conceptualized anxiety sensitivity as a causal risk factor within two competing models. One model posited that individuals with dispositionally high AS prior to experiencing a potentially traumatizing event (PTE) have a greater likelihood of developing PTSD after trauma exposure. The second model theorized that the introduction of a PTE raises an individual’s baseline level of AS, leading to the development and maintenance of PTSD symptoms. Emerging research highlighted the possibility of …

Gene-By-Intervention Effects On Alcohol Dependence Symptoms In Emerging Adulthood, Zoe E. Neale, Sally I. Kuo, Fazil Aliev, Peter B. Barr, Jinni Su, Kit K. Elam, Thao Ha, Kathryn Lemery-Chalfant, Danielle M. Dick

Graduate Research Posters

The Importance of Peer Influence for LGBTQ+ Youth in Rural Communities

Aaron Kemmerer

supported by findings from Safe as Yourself (SAY) Project

Traci Wike (PI), Leah Bouchard, Maurico Yabar, and Aaron Kemmerer

Objectives: To explore the experiences and narratives of LGBTQ+ youth in rural North Carolina. To elaborate on the influence of peer support and impact of peer victimization for LGBTQ+ youth in rural North Carolina.

Methods: Data was collected from eleven young people who were interviewed from 2019-2020 at an LGBTQ+ youth center in rural North Carolina. The interviews were coded and analyzed using narrative analysis on a team …

Multidimensional Recovery Among An Opioid Use Disorder Outpatient Treatment Population, Anna Beth Parlier-Ahmad, Lori Beck, Caitlin E. Martin

Graduate Research Posters

Background: Given the current opioid crisis, recovery from opioid use disorder (OUD) warrants attention. SAMHSA’s working definition of recovery highlights dimensions that support recovery including health, home, community, and purpose. Recovery capital captures factors that support recovery within these dimensions and has been associated with recovery outcomes. Prior research highlights possible gender differences in recovery outcomes. Objective: 1) Describe and compare recovery capital among an OUD outpatient treatment population by gender; 2) Identify the relationship between recovery capital and length of time in treatment within this population.

Methods: Patients (n=126) taking medication for OUD at a single outpatient substance use …

Life Satisfaction: Measurement Invariance And Correlations With Adolescent Adjustment, Sarah K. Pittman, Robert F. Valois, Albert D. Farrell

Graduate Research Posters

Background

Low life satisfaction during adolescence has been associated with adjustment problems. There are few well-validated measures available to assess adolescents’ life-satisfaction. The purpose of this study was to investigate the structure of the Life Satisfaction Scale, evaluate its measurement invariance across sex and race/ethnicity, and investigate its associations with related constructs.

Methods

Participants were 3,340 adolescents from rural middle schools in Florida. Half the participants were female, 51% were White, 15% were Black, and 22% were Latinx. Adolescents completed the Life Satisfaction Scale, the Children’s Report of Exposure to Violence scale, and the Problem Behavior Frequency Scale.

Results

Confirmatory …

Suicidal Ideation And Self-Injury Prevalence And Impairment In An Urban Integrated Primary Care Clinic, Kathryn L. Behrhorst, Bruce Rybarczyk, Ph.D., Heather A. Jones, Ph.D.

Graduate Research Posters

Introduction: Suicide is the second leading cause of death for adolescents (Rosenbaum & Ougrin, 2019). Pediatric primary care staff are often the first line of intervention for youth presenting with suicidal thoughts and NSSI (Taliaferro et al., 2013). The primary aim of the current study was to describe reported suicidal ideation, attempts, and NSSI in youth presenting to an urban integrated primary care setting.

Methods: Within an outpatient pediatric primary care clinic, patients were referred by medical staff and introduced to behavioral health services. Patients were asked about their history of suicidal thoughts/attempts and NSSI (Mage = 12.63; SD = …

Profiles Of Adjustment Among Children In Institutional Care In Ghana: Predictors Of Positive Functioning, Anna W. Wright

Theses and Dissertations

Worldwide, approximately 2-8 million children reside in institutional care, which can lead to developmental setbacks. Given the need for institutional care persists, it is important to continue investigating which improvements can be made to provide optimal care. The current mixed-methods study included participants from Accra, Ghana. Study 1 involved cluster analyses to determine patterns of adjustment for 100 children in institutional care (CIC) (M age = 13.31 years, SD = 3.14; 40% female) and 100 children in families (CIF) (M age = 13.37 years, SD = 3.08; 40% female) across several domains. ANOVA was used to evaluate whether …

Adverse Childhood Experiences In Children Presenting To Integrated Pediatric Primary Care, Irene A. Jacobs

Theses and Dissertations

The prevalence of adverse childhood experiences (ACEs) has created a significant public health concern in the United States. A vast body of literature examining adult populations has displayed a dose-response association between cumulative ACEs and chronic illnesses (Chapman et al., 2004; Felitti et al., 1998). ACEs research conducted with children and adolescents has indicated higher ACE scores associated with learning and behavioral problems (Burke et al., 2011), health risk behaviors (Garrido et al., 2018), and mental health challenges (Mackner et al., 1997). However, ACEs research and subsequent interventions have largely relied upon retrospective data retrieved from adults (Felitti et al., …

A Randomized Trial Of Cbt4cbt For Women In Residential Treatment For Substance Use Disorders, Sydney S. Kelpin

Theses and Dissertations

Women with substance use disorders (SUD) face unique barriers to substance use treatment, and as a result, are less likely than their male counterparts to seek treatment for the disorder. Cognitive behavioral therapy (CBT) is an evidence-based treatment known to reduce relapse rates by teaching clients to recognize and respond to their cues for substance use. Recent research suggests CBT may be particularly of benefit to women. Despite the effectiveness of CBT, its dissemination in clinical practice is limited due to a range of barriers (e.g., time, cost). Computer-based training for cognitive behavioral therapy (CBT4CBT) offers an opportunity to improve …