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Collaborative Models Of Care In The Appalachian Region Of Tennessee: Examining Relationships Between Level Of Collaboration, Clinic Characteristics, And Barriers To Collaboration, Jeffrey Ellison

Electronic Theses and Dissertations

Decades of research have shown that there are significant advantages to maintaining close communicative and collaborative relationships between primary care and behavioral health providers. Fiscal, structural, and systemic barriers, however, often restrict the degree to which such interprofessional collaboration can occur. In the present study the authors examined relationships between primary care clinics in the Appalachian region’s characteristics (i.e., clinic type, rurality, and clinic size), barriers (i.e., fiscal, structural, and systemic) reported to using increased collaboration, and the level of collaboration used at a particular clinic.

For the present study 136 surveys were completed by providers working in primary care …

Impulsivity, Venturesomeness, And Pride: Potential Moderators Of The Relationship Between Childhood Trauma, Substance Use, And Physical Aggression, Joshua P. Hatfield

Electronic Theses and Dissertations

Impulsivity, venturesomeness, and pride variables were examined as potential moderators of the associations between childhood trauma and physical aggression, alcohol use and physical aggression, and drug use and physical aggression. Participants (n = 457) were college students recruited from a university in the Southeast. It was hypothesized that childhood trauma, alcohol use, and drug use would be associated with increased scores of physical aggression. In addition, it was hypothesized that impulsivity, venturesomeness, authentic pride, and hubristic pride would moderate these relationships. Linear, multivariate hierarchical regression analyses were used to examine these variables as potential moderators. Hypotheses concerning hubristic pride as …

Utilizing Visual Attention And Inclination To Facilitate Brain-Computer Interface Design In An Amyotrophic Lateral Sclerosis Sample, David B. Ryan

Electronic Theses and Dissertations

Individuals who suffer from amyotrophic lateral sclerosis (ALS) have a loss of motor control and possibly the loss of speech. A brain-computer interface (BCI) provides a means for communication through nonmuscular control. Visual BCIs have shown the highest potential when compared to other modalities; nonetheless, visual attention concepts are largely ignored during the development of BCI paradigms. Additionally, individual performance differences and personal preference are not considered in paradigm development. The traditional method to discover the best paradigm for the individual user is trial and error. Visual attention research and personal preference provide the building blocks and guidelines to develop …

Surviving The Death Of A Sibling : A Phenomenological Study Of Childhood Bereavement., Edith Crumb Gunter

Electronic Theses and Dissertations

The loss of a sibling can be devastating to children, especially for children ages 7-12, who are at a critical juncture in their development. The loss can impede their development if their bereavement is not effectively addressed. For this reason, this dissertation evaluated four theoretical frameworks to provide a foundation for bereavement support for children: Assumptive World Theory, Dual Process Model, Meaning Reconstruction Theory, and Tasks of Mourning. Developmental theories and considerations were explored to gain knowledge of children’s levels of understanding, processing, and coping. Method: This study utilized a sample of five children ages 7-12 who had survived the …

Unnatural Pedagogy : A Computational Analysis Of Children's Learning To Learn From Other People., Baxter S. Eaves 1984-

Electronic Theses and Dissertations

Infants rely on others for much of what they learn. People are a ready source of quick information, but people produce data differently than the world. Data from a person are a result of that person's knowledgeability and intentions. People may produce inaccurate or misleading data. On the other hand, if a person is knowledgeable about the world and intends to teach, that person may produce data that are more useful than simply accurate data: data that are pedagogical. This idea that people have special innate methods for efficient information transfer lies at the heart of recent proposals regarding what …

The Phenomenon Of Abstract Cognition Among Scholastic Chess Participants: A Case Study, Brent C. Laws

Electronic Theses and Dissertations

A qualitative investigation was conducted to explore the phenomenon of abstract cognition among a purposive sample of 5 secondary scholastic chess club participants. The case study enabled the researcher to explore the faculties of abstract cognition among students of contrasting skills and abilities in playing chess. The study also allowed for the consideration of potential visual-spatial, logical, academic, social competency and life benefits of chess play. Through analysis of interviews, chess simulations, blindfold chess play, and narration of chess lines and sequences, the investigator was able to extract meaning and code schemata into a holistic understanding of the phenomenon of …

Sleep-Related Arousal And Spontaneous Movement Properties In Methadone-Exposed Neonates: A Videographic Assessment On The First Or Second Postnatal Night, Hira Shrestha

Electronic Theses and Dissertations

Prenatal substance exposure such as alcohol, nicotine, and opiates is known to modulate autonomic regulatory function during sleep, and to decrease arousability and spontaneous movements (SM). SM during sleep may reflect a protective mechanism for immature patterns of arousals. Neurodevelopmental compromise in sleep and arousal systems may underlie sudden infant death syndrome (SIDS) risk in which infants expire during sleep. Previous studies from our laboratory found abnormal patterns of neonatal arousal, sleep fragmentation, and deficits in sleep-related SM in infants with prenatal alcohol exposure. In this study, prenatal exposure to methadone was hypothesized to disrupt the development of sleep and …

Mental Health Referral In Primary Care: Influence Of A Screening Instrument And A Brief Educational Intervention, Michael T. Miesner

Electronic Theses and Dissertations

Although less than half of all patients with mental disorders seek mental health treatment per se, approximately 80% of all people will visit their primary care physician (PCPs) within a year (Strosahl, 1998). However, it is not well understood how to best handle patients presenting with mental health issues in primary care practices. The purpose of this project was to implement an intervention involving a screening measure for anxiety and mood disorders in a primary care setting to increase the volume of anxiety and mood disorder screening, to increase the accuracy of disorder detection, and to also enhance PCPs patterns …

An Examination Of Risk And Protective Factors For Suicidal Behavior In A Low-Income, Underserved Primary Care Sample, Kristin L. Walker

Electronic Theses and Dissertations

Suicidal behavior, including ideation and attempts, is a significant public health problem. Due to the complexity of suicidal behavior, it is necessary to consider an array of factors that could serve as risk and protective factors. Previous research has shown that deficits in social problemsolving ability are associated with increased risk for suicidal ideation and attempts; conversely, problem solving strengths are associated with reduced risk. This dissertation project, consisting of 3 individual manuscripts, was designed to explore the relationship between social problemsolving ability and suicidal behavior in low-income primary care patients. Furthermore, additional constructs including health related quality of life, …

Studying Eye Gaze Of Children With Autism Spectrum Disorders In Interaction With A Social Robot, Huanghao Feng

Electronic Theses and Dissertations

Children with Autism Spectrum Disorders (ASDs) experience deficits in verbal and nonverbal communication skills including motor control, emotional facial expressions, and eye gaze attention. In this thesis, we focus on studying the feasibility and effectiveness of using a social robot, called NAO, at modeling and improving the social responses and behaviors of children with autism. In our investigation, we designed and developed two protocols to fulfill this mission. Since eye contact and gaze responses are important non-verbal cues in human's social communication and as the majority of individuals with ASD have difficulties regulating their gaze responses, in this thesis we …

Obstructive Sleep Apnea Syndrome And Neuropsychological Dysfunction: Understanding The Impact Of Obesity, Chelsea A. Hilsendager

Electronic Theses and Dissertations

Obesity is the largest risk factor for the development of obstructive sleep apnea syndrome (OSAS), which is a common sleep-related breathing disorder that is associated with cognitive dysfunction. A growing body of literature suggests that obesity is related to negative neuropsychological outcomes independent of other health problems known to impact cognitive functioning (e.g., type II diabetes, cardiovascular disease). The purpose of this study was to investigate the impact of obesity on the cognitive functioning of individuals with OSAS. Specifically, this study aimed to examine whether or not differences existed between obese and non-obese persons with OSAS on a battery of …

Longitudinal Perspective Of Participation In A Double Blind Placebo Surgery Trial, Jessica Kuhne

Electronic Theses and Dissertations

Parkinson’s disease (PD) is a chronic and progressive neurological disorder that causes both motor symptoms and non-motor symptoms in individuals. Overall, PD impacts the physical, emotional and social functioning in the lives of those impacted by the disorder. In 2001, Freed et al. investigated the effects of fetal tissue transplantation in participants with PD by conducting a double-blind sham-controlled surgery trial. The quality of life (QoL) study was conducted concurrently by McRae et al. (2004) in order to determine whether QoL improved in participants in the transplant group compared to the sham group after the one-year period of the double-blind. …

Self-Esteem, Spirituality, And Acculturation And The Relationship With Depression In Latinos, Fernando M. Avila

Electronic Theses and Dissertations

The purpose of this dissertation is to examine the relationship between acculturation, self-esteem, spirituality and its association with depression in a community sample of Latinos. Previous research with Latinos has identified these factors as potentially being correlated with depression and with quality of life. The weight that these three variables can have on depression may be profound. Self-esteem and spirituality have been identified as protective factors that may assist individuals with depression by enhancing an individual's sense of worth. Acculturation is a construct that has been shown to influence Latinos in various ways. These variables have been established as predictors …

Dispositional Mindfulness And Working Memory In The Context Of Acute Stress., Lauren M. Vines

Electronic Theses and Dissertations

The neuropsychological domain of working memory and the nearly 3000 year-old Buddhist construct of mindfulness appear to be disparate concepts. However, the measurable decline of working memory capacity (WMC) under stress, in combination with the stress-reducing and attention-focusing effects of mindfulness suggest potential augmentation of working memory through the engagement of mindful practice. A theoretical process through which dispositional mindfulness exerts a moderating effect on WMC reduction following an acute stressor is proposed. To investigate processes within this theoretical framework, a sample of undergraduate college students (N = 67) were assessed across various measures, including level of dispositional mindfulness, affective …

Taking Clinical Judgment Out Of The Equation : A Call For The Standardization Of Mci Diagnostic Criteria And Construction Of A Model To Predict Conversion To Dementia., Adam Tyler Gerstenecker

Electronic Theses and Dissertations

Although the diagnostic criteria for mild cognitive impairment have evolved considerably since their inception, they remain varied and able to be interpreted and implemented in different ways depending on the judgment of the clinician. Because of this issue, a wide range of incidence, prevalence, and conversion rates are found in the research literature. Using data collected from 400 patients with amnestic mild cognitive impairment, limitations inherent in current mild cognitive impairment diagnostic criteria were addressed. First, using Alzheimer’s Disease Neuroimaging Initiative diagnostic criteria, an equation was constructed to predict conversion from mild cognitive impairment to dementia by analyzing the predictive …

Toying With Americanization: The Impact Of Corporate Paternalism On Immigrant Children In Early 20th Century Colorado Coal Mining Communities, Jamie Devine

Electronic Theses and Dissertations

During the early 20^th century coal miners' lives in Southern Colorado were fraught with violence and hardships. Many immigrant men brought their families to remote areas to live in company towns and work in coal mines. The Colorado Fuel and Iron Company (CF&I) attempted to assimilate these ethnically diverse immigrants into American society. One method was to impart American values onto the children living in these company towns. CF&I purchased American toys for the children during Christmas and created kindergartens for the children to attend with the intent of imparting American values. In contrast, the parents of these children …

Breaking Your Own Heart: A Qualitative Study Of Grief After Initiating A Breakup, Laura P. Finkelstein

Electronic Theses and Dissertations

This study explored how young adult initiators of romantic relationship dissolution experience grief and support through the breakup process. Participants were six female and three male undergraduate students at The University of Idaho, all of whom had initiated a breakup within the past six months. Initiators responded to a variety of questions about their experiences in a semi-structured interview. Based on a qualitative analysis of these interviews, a variety of themes emerged highlighting the often minimized experience of initiating a romantic relationship breakup in early adulthood. Additional analysis compared themes based on participant gender and age. Results suggest that initiators …

Measuring Mindful Interoception : Development Of The Mindful Interoception Sampling Task (Mist)., Samuel J. Dreeben

Electronic Theses and Dissertations

Sustained, non-evaluative, present moment interoception or ? "mindful interoception" (MI) is a central feature of many widely practiced clinical interventions, including mindfulness-based therapies, cognitive-behavioral therapies, focusing-oriented psychotherapy, and Gestalt therapy. However, to date, no valid measures of MI have been developed. The lack of such a measure has precluded attempts to discern A) to what extent MI ability changes as a function of MI-based therapies, B) if change in MI mediates symptom reduction, and C) if individual differences in MI ability are associated with anxiety, mindfulness, and other hypothetically related constructs. The purpose of the current study was to develop …

The Effect Of Romantic Jealousy On Self-Control: An Examination Of Trait Constructs And Sex Differences Based On Survey And Experimental Data, Lyndsay A. Nelson

Electronic Theses and Dissertations

A large body of research has demonstrated that the experience of romantic jealousy is often associated with a variety of negative outcomes. However, evolutionary psychologists have provided evidence that jealousy is an adaptive emotion that can aid with mate retention. Together these lines of research suggest that jealousy may at times work to protect and enhance one’s relationship, whereas in other cases it could lead to harmful consequences. Considering the varying outcomes of jealousy, it is critical that research explore more specifically how this complex state operates and how it affects individuals’ functioning. In the present research I conducted 2 …

Attitudes Toward Suicide, Mental Health, And Help-Seeking Behavior Among African Immigrants: An Ecological Perspective, Sheri A. Nsamenang

Electronic Theses and Dissertations

The population of Africans in the United States is growing, yet little is known about the impact of migration on the attitudes of African immigrants toward suicide, mental health, and helpseeking behavior. Migration entails movement from one cultural environment to another, and the process requires adaptation to the host country. According to Ecological Theory, interactions between the societal structures, values, and beliefs of the host country, cultural values from the country of origin, and individual-level characteristics may affect mental health-related attitudes and behaviors. As such, the current study used mixed methods, administered via online survey, to investigate socio-cultural predictors of …

The Effects Of Working Memory On Brain-Computer Interface Performance, Samantha A. Sprague

Electronic Theses and Dissertations

Amyotrophic lateral sclerosis and other neurodegenerative disorders can cause individuals to lose control of their muscles until they are unable to move or communicate. The development of brain-computer interface (BCI) technology has provided these individuals with an alternative method of communication that does not require muscle movement. Recent research has shown the impact psychological factors have on BCI performance and has highlighted the need for further research. Working memory is one psychological factor that could influence BCI performance. The purpose of the present study is to evaluate the relationship between working memory and brain-computer interface performance. The results indicate that …

A Meta-Analytic Review Of The Relationships Between The Therapeutic Alliance, Empathy, And Genuineness In Individual Adult Psychotherapy., Jacob B. Nienhuis

Electronic Theses and Dissertations

This dissertation explored the relationship between the therapeutic alliance and perceptions of therapist empathy and genuineness through a systematic review and meta-analysis. Alliance, empathy, and genuineness are each integral parts of the therapeutic relationship. Prior meta-analyses demonstrated that alliance, empathy, and genuineness each had a moderate relationship to therapy outcome. No previous analysis has explored how therapist empathy and genuineness contribute to the therapeutic alliance. Studies for this analysis were obtained through a multi-part search strategy. Out of 2,141 obtained abstracts, 46 studies contained enough data for inclusion in the meta-analysis. Thirty-six studies reported alliance/empathy relationships, six studies reported alliance/genuineness …

Putting The Person First : An Examination Of Thought Disorder And Personality Heterogeneity In Schizophrenia., Catherine Rose Robertson

Electronic Theses and Dissertations

The Recovery Model of mental illness, emerging as the new zeitgeist in regards to treatment, emphasizes the optimization of functioning for each individual, using personal strengths and preferences to drive the recovery process. Thought disorder has long been considered a core symptom of schizophrenia and has been implicated in multiple domains of functional outcome. In spite of its relationship to functioning and substantial heterogeneity of the phenomenon, little to no research has examined potential factors which may be related to these differences in thought disorder and its related domains of functioning. The current study proposes that “normal” personality traits, such …

The Mediating And Moderating Effects Of Coping Mechanisms Following High School Victimization, Kevin D. Hyatt

Electronic Theses and Dissertations

Victimization from bullying has become a more serious issue as available avenues for bullying have increased and as the media has been alerted to the devastating effects of the phenomenon. Victimization has been linked to increased externalizing and internalizing disorders including depression, anxiety, stress, and at its worst suicide. Research has been focused on the negative outcomes following victimization, with some authors only recently examining the buffering or exacerbating effects of coping mechanisms. Participants (n=642) from a moderately sized southeastern university completed a survey to examine problem-focused and emotion-focused coping as potential moderators and maladaptive coping as a potential mediator …

Explaining Combat Related Posttraumatic Stress Disorder: An Integrated Mental Illness And Military Process Model, Mandi F. Deitz

Electronic Theses and Dissertations

The purpose of the current study was to examine a process model of combat-related and mental-illness related processes that explain increased likelihood of Posttraumatic Stress Disorder (PTSD). This dissertation proposed the development of PTSD may occur due to cultural, social, and self-related pathways associated with veterans’ dual encounters with combat (i.e., severity) and mental illness symptoms. Participants were 195 military veterans recruited from multiple sites and strategies to maximize sample size and representation. Participants were asked to complete several self-administered assessment inventories, including: the Posttraumatic Stress Disorder Checklist-Military, the Trauma Symptom Checklist, the Combat Experiences scale, the Self-Stigma of Mental …

Addressing Self-Reported Depression, Anxiety, And Stress In College Students Via Web-Based Self-Compassionate Journaling, Jessica Rose Williamson

Electronic Theses and Dissertations

Depression, anxiety, and stress in the college undergraduate population have been steadily rising over the past decade. Trait self-compassion has been shown to be significantly and negatively related to perceptions of stress and symptoms of depression and anxiety. Research has indicated that self-compassion inductions are effective in increasing state self-compassion. In general, selfcompassion inductions are designed to be easily self-administered. Current research on Internetbased interventions indicates that self-administered therapeutic techniques are effective in reducing self-reported depression, anxiety, and stress. The goal of the current study was to compare the effects of self-compassionate journaling, narrative journaling, and a true control group …

Health-Related Quality Of Life And Suicidal Behaviors In Primary Care Patients: Conditional Indirect Effects Via Interpersonal Needs And Depressive Symptoms, Catherine Rowe

Electronic Theses and Dissertations

Suicide is a public health problem and complex relationships exist between intrapersonal suicide risk factors and interpersonal risk factors. Health-related quality of life (HRQL) may interact with difficulties with interpersonal relationships and psychopathology. We examined thwarted interpersonal needs and depressive symptoms as potential mediators on the association between HRQL and suicidal behaviors. It was hypothesized that thwarted interpersonal needs would mediate the association between HRQL and suicidal behavior, and that this mediating effect would be dependent on the moderating effect of depressive symptoms. It was hypothesized that thwarted interpersonal needs and then depressive symptoms would sequentially mediate the association between …

Getting To The Heart Of Social And Educational Disadvantage: Exploring The Impact Of Social Interactions Across The Class Divide, Ryan M. Pickering

Electronic Theses and Dissertations

Economic inequality between rich and poor in the United States is now at an all- time high. The increasing economic inequality in the United States may have deleterious effects for social interactions across the so-called “class divide.” Individuals from different socioeconomic status (SES) backgrounds may find cross-class interactions stressful or intimidating, particularly when they are from a lower-status group.

Across two studies, I examine the impact of cross-class social interactions on cognitive performance and physiological reactivity. In the first study, individuals from lower-SES backgrounds participate in a social interaction with an individual from either a higher or lower-SES background, or …

Role Of The Ventral Tegmental Area And Ventral Tegmental Area Nicotinic Acetylcholine Receptors In The Incentive Amplifying Effect Of Nicotine, Ashley B. Sheppard

Electronic Theses and Dissertations

Nicotine has multiple behavioral effects as a result of its action in the central nervous system. Nicotine strengthens the behaviors that lead to nicotine administration (primary reinforcement), and this effect of nicotine depends on mesotelencephalic systems of the brain that are critical to goal directed behavior, reward, and reinforcement. Nicotine also serves as a ‘reinforcement enhancer’ – drug administration enhances behaviors that lead to other drug and nondrug reinforcers. Although the reinforcement enhancing effects of nicotine may promote tobacco use in the face of associated negative health outcomes, the neuroanatomical systems that mediate this effect of nicotine have never been …

Prevalence, Types, Risk Factors, And Course Of Intimate Partner Violence In Appalachian Pregnant Women, Tifani Fletcher

Electronic Theses and Dissertations

Intimate partner violence (IPV) during pregnancy can lead to a myriad of poor physical and psychological outcomes for both mother and child. There is a paucity of research examining IPV risk factors for rural pregnant women and on information regarding the course of the specific types of IPV throughout pregnancy. The current project was an investigation of the prevalence of IPV and IPV risk factors for different types of IPV in an Appalachian pregnant sample that contained women from both rural and nonrural locations (Study 1), and was an examination of the occurrence of any IPV and the different types …