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Parent Facilitation Of Child Emotion Regulation In Autism Spectrum Disorder, Aimee K. Rovane Jul 2023

Parent Facilitation Of Child Emotion Regulation In Autism Spectrum Disorder, Aimee K. Rovane

Theses and Dissertations

Parents play a substantial role in their children's emotional regulation (ER) abilities, promoting both adaptive and maladaptive development. Children with autism spectrum disorder (ASD) often have difficulties regulating their emotions, manifesting in externalizing behavioral issues (Mazefsky & White 2014). Though there are many similarities to parents of typically developing (TD) children, parents of children with ASD facilitate their children's ER development (i.e., emotion socialization) in response to unique challenges, often developing resiliency but other times contributing to their children’s dysregulation and behavioral challenges. Using Morris et al.'s (2007) Tripartite Model of Family Impact of Children's Emotion Regulation and Adjustment as …


An Examination Of Sustained Attention During Complex Multitasking Scenarios, Jonathan Cheshire Rann Jul 2023

An Examination Of Sustained Attention During Complex Multitasking Scenarios, Jonathan Cheshire Rann

Theses and Dissertations

This dissertation project examined the time-course of vigilance decrements that occur when operators perform demanding multitasking activities. For this aim, we conducted three experiments which implemented a novel paradigm we developed that measured performance during two sessions: a Single-Task session in which participants performed a go-no-go target detection task in the absence of any other task for approximately 12 minutes; and a Multi-Task session in which participants performed the detection task simultaneously with a driving-based tracking task for the same duration. A total of 183 participants from the University of South Carolina Department of Psychology took part in this study. …


Feasibility Of A Parent-Focused, Stress Management Intervention To Decrease Adolescent Bmi, Reduce Stress, And Increase Well-Being Among African American Families, Colby J. Kipp Jul 2023

Feasibility Of A Parent-Focused, Stress Management Intervention To Decrease Adolescent Bmi, Reduce Stress, And Increase Well-Being Among African American Families, Colby J. Kipp

Theses and Dissertations

African American adolescents in the United States experience a higher prevalence of obesity as compared to their White counterparts. This health inequity presents a public health concern as consequences of weight-related chronic diseases often persist into adulthood and are increasingly problematic. As chronic stress has been found to be higher among African American youth compared to White adolescents, it presents as a potential barrier to participation for African American families in health promotion interventions. Additionally, it may be beneficial to target stress in health promotion programs as a modifiable factor in conjunction with health behaviors that may improve outcomes related …


Comorbid Adhd And Pediatric Sickle Cell Disease: Prevalence And Risk Factors, Sarah Bills Jul 2023

Comorbid Adhd And Pediatric Sickle Cell Disease: Prevalence And Risk Factors, Sarah Bills

Theses and Dissertations

Objective: Sickle cell disease (SCD) is a genetic blood condition that places youth at increased risk for deficits in attention and executive functioning suggestive of increased rates of Attention Deficit/Hyperactivity Disorder (ADHD). There is pronounced inconsistency in reported prevalence rates for attention deficits and ADHD diagnoses among youth with SCD, which is due in part to variability in methodology of previous studies. The primary aim of the present study is to use systematic screening to identify the prevalence of inattentive ADHD symptoms and ADHD diagnoses in a pediatric SCD population seen at a large hematology clinic. A secondary aim is …


An Exploration Of Racial Trauma And Protective Factors In Black Youth, Daria Chantal Thompson Jul 2023

An Exploration Of Racial Trauma And Protective Factors In Black Youth, Daria Chantal Thompson

Theses and Dissertations

Black students’ experiences in school can vary due to racism and discrimination within and outside of the classroom, which can impact their academic progress and overall well-being. In this three-part study, the impact of discrimination is observed to determine if there is a long-term effect of these situations and, if so, determine if there is utility to implement school-based resources to decrease these negative effects. The first study examined whether ethnic-racial socialization in childhood could moderate against symptoms of trauma in young adulthood that were potentially caused by discrimination from peers and teachers in childhood through hierarchical regressions. The second …


Neural Mechanisms Of Lexical Semantics: Investigating The Roles Of Hubs And Distributed Action-Perception Systems, Nicholas Andrew Riccardi Jul 2023

Neural Mechanisms Of Lexical Semantics: Investigating The Roles Of Hubs And Distributed Action-Perception Systems, Nicholas Andrew Riccardi

Theses and Dissertations

Understanding the meaning of words and concepts is vital for communication, forming relationships, and navigating everyday life. Loss of this knowledge through brain damage can have drastic consequences for one’s health and well-being. It is therefore important to learn how this information is organized anatomically in the brain. In this dissertation, I report a series of structural and functional neuroimaging studies in healthy adults and survivors of stroke seeking to understand how lexical semantics are represented. Specifically, I used a variety of tasks to examine the contributions of putative ‘hubs’ and distributed action-perception systems. Results indicated that damage or disruption …


The Effects Of Poly-Strengths On Psychological Wellbeing Amongst Young Adults With Childhood Poly-Victimization, Nakisa Asefnia Jul 2023

The Effects Of Poly-Strengths On Psychological Wellbeing Amongst Young Adults With Childhood Poly-Victimization, Nakisa Asefnia

Theses and Dissertations

The field of trauma and victimization has undergone many evolutions in its efforts to conceptualize the impacts of victimization and more recently poly-victimization. Poly-victimization refers to the experiencing of multiple types of victimization over the lifespan. This has led to an ever-growing base of literature highlighting the many deleterious effects of these experiences on individuals’ wellbeing, and the factors which may make a person more vulnerable to victimization. However, a growing movement in the field aims to take a more strengths-based perspective that highlights the resilience of individuals, rather than risk factors, in the hopes of better understanding the factors …


Effects Of Parenting And Self-Efficacy On Diet, Family Mealtime And Weight-Related Outcomes In African American Adolescents, Haylee Michele Loncar Jul 2023

Effects Of Parenting And Self-Efficacy On Diet, Family Mealtime And Weight-Related Outcomes In African American Adolescents, Haylee Michele Loncar

Theses and Dissertations

Despite substantial research and concern, adolescent overweight and obesity continues to be a significant public health problem. Theory based on developmental literature emphasizes the role of adolescent self-regulatory factors, like self-efficacy, in health behavior engagement and weight-related outcomes. There is also extensive literature that highlights parents’ role in promoting self-regulatory development through warm and responsive behaviors and practices. However, few studies have considered longitudinal associations and changes in weight-related outcomes over time, as well as moderated effects by parenting. This study assessed longitudinal associations between adolescent self-efficacy parenting factors and adolescent BMI, diet, and family mealtime to fill gaps in …


Using Factor Mixture Modeling To Counter Faking, Raul Corrêa Ferraz Apr 2023

Using Factor Mixture Modeling To Counter Faking, Raul Corrêa Ferraz

Theses and Dissertations

Self-reports (SRs) of typical behavior are often the only existing feasible method to gather data on important drivers of human performance. In applications such as personnel selection, SRs are vulnerable to intentional distortions, often referred to as faking. A review of the literature suggests that so far, the methods proposed to address faking are unsatisfactory. In a recent breakthrough, Pavlov et al. (2019) showed that high-stakes scale scores are best modeled as a function of a) propensity to fake, b) honest scores, and c) the interaction of these two terms. Pavlov et al. did not, however, propose any method to …


Understanding Intergenerational Transmission And Frequency Of Ethnic-Racial Socialization Practices Among Racial Ethnic Minority Groups, Ryan Chantz Houston-Dial Apr 2023

Understanding Intergenerational Transmission And Frequency Of Ethnic-Racial Socialization Practices Among Racial Ethnic Minority Groups, Ryan Chantz Houston-Dial

Theses and Dissertations

Ethnic-racial socialization (ERS) is a multidimensional concept that can be defined as the transmission of attitudes, beliefs and messages about ethnic-racial group membership (Hughes et al., 2006). To counteract the negative effects of discriminatory experiences, ethnic minority parents proactively impart race-salient messages to their youth. Sociodemographic variables such as regional location has been shown to affect the frequency of ERS messages as well (Thornton et al., 1990). The current study examines ERS practices in 436 African American, Hispanic/Latinx and Asian American parents. This study also explores the concept of intergenerational transmission, in which parents pass on to their own children …


An Examination Of The Prevalence And Predictors Of Drugging Victimization And Drugging Perpetration In A National Sample, Amber Nicole Wallace Apr 2023

An Examination Of The Prevalence And Predictors Of Drugging Victimization And Drugging Perpetration In A National Sample, Amber Nicole Wallace

Theses and Dissertations

Objective: The current study sought to expand the understanding of the nascent phenomenon of drugging, the administering of a drug or alcohol substance to an individual without their knowledge or consent (Swan et al., 2017). Specifically, in this paper, the lifestyle-routine activities theory (L-RAT) is used as a framework to examine what factors may contribute to the occurrence of drugging. Prevalence rates of drugging victimization and drugging perpetration are examined by participant characteristics including gender, sexual orientation, and race/ethnicity, and by risk behaviors including illicit drug use, marijuana use, and binge drinking. Trait sensation seeking, which has been shown to …


The Relation Between Adhd Symptoms And Life Satisfaction/Self-Esteem Among Youth: Family Structure And Parenting Practices As Moderators, Yvette Rother Apr 2023

The Relation Between Adhd Symptoms And Life Satisfaction/Self-Esteem Among Youth: Family Structure And Parenting Practices As Moderators, Yvette Rother

Theses and Dissertations

Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) may be particularly vulnerable to lower life satisfaction and self-esteem, given negative perceptions about their abilities and self, as well as related impairments in academic, social, and interpersonal functioning. Family factors, such as family structure and parenting behaviors, can impact youth development and behaviors. However, it is unclear what role family factors play in the relation between ADHD symptoms and life satisfaction and self-esteem among youth. This study therefore examined whether ADHD symptoms have an impact on the life satisfaction and self-esteem of children and adolescents in grades 4-12. Moreover, it explored whether …


Sleep Challenges And Temperament Among Infants At Elevated Likelihood Of Autism Spectrum Disorder, Miranda Hope Foster Oct 2022

Sleep Challenges And Temperament Among Infants At Elevated Likelihood Of Autism Spectrum Disorder, Miranda Hope Foster

Theses and Dissertations

The current study used parent report in a prospective longitudinal design to examine the relationship between early sleep difficulties and temperament among infants with an older sibling diagnosed with ASD (EL-ASIB, n = 32), those born pre-term (EL-PT, n = 24) and those with no familial history of ASD (LL, n = 28) across the first year of life. At 3, 4, 6 and 12 months, caregivers completed the Short Form of the Infant Behavior Questionnaire-Revised (IBQ-R) (Putnam et al., 2014). To understand how sleep difficulties are related to temperament, a new scale of Sleep Challenges was created with items …


Gratitude Buffers The Effects Of Stressful Life Events On Early Adolescents’ Life Satisfaction And Externalizing Behaviors But Not Internalizing Behaviors, Mimi Scott Webb Oct 2022

Gratitude Buffers The Effects Of Stressful Life Events On Early Adolescents’ Life Satisfaction And Externalizing Behaviors But Not Internalizing Behaviors, Mimi Scott Webb

Theses and Dissertations

Identifying psychological strengths that foster healthy development in youth has become a topic of exploration in the field of positive psychology (e.g., Suldo & Huebner, 2004; Valle et al., 2006). Gratitude is a promising trait-like characteristic with qualities indicative of a potential psychological strength that may serve as a protective factor for early adolescents in the face of stressful life events. This study utilized data from a sample of 1,880 middle school students from the Southeastern United States. Hierarchical regression analyses investigated gratitude’s role as a moderator in the relationship between stressful life events and adolescent well-being. Specifically, gratitude’s ability …


An Intersectional Lens To Covid-19: Promoting Youth Well-Being In The Midst Of Social-Political Stressors, Magdalena S. Moskal Oct 2022

An Intersectional Lens To Covid-19: Promoting Youth Well-Being In The Midst Of Social-Political Stressors, Magdalena S. Moskal

Theses and Dissertations

Guided by interpretative phenomenological methodology and intersectionality theory, this thesis aims to uncover the mental health experiences of youth surrounding the COVID-19 pandemic. This study also seeks to situate these experiences with the subsequent stressors that young people face in the current social-political context (e.g., witnessing trauma in the media, uprisings to address racism and the resulting backlash, rhetoric of the 2020 presidential election). Furthermore, this thesis aims to give insight and voice how intersectionality shapes the COVID-19-related experiences of youth in South Carolina. Data was collected through semi-structured interviews with 23 participants aged 16-21 years old in South Carolina. …


Experiences Of Stigma, Social Support, And Anxiety In People Living With Hiv In South Carolina, Sarah J. Miller Oct 2022

Experiences Of Stigma, Social Support, And Anxiety In People Living With Hiv In South Carolina, Sarah J. Miller

Theses and Dissertations

People living with HIV (PLHIV) experience numerous psychosocial stressors, including HIV-related stigma and heightened prevalence of mental health disorders such as depression, substance use disorders, and anxiety. However, limited research has investigated predictors of anxiety within this population. This study aimed to explore the relationship between HIV-related stigma and anxiety symptoms among PLHIV in South Carolina (SC) and to examine the role of social support as a mediator for this relationship. A total of 402 PLHIV receiving HIV care at large immunology center in SC completed a paper and pencil survey, reporting sociodemographic variables, as well as experiences of HIV-related …


Predicting Therapists’ Intentions To Use An Innovation: The Role Of Innovation-Specific, Individual, And Organizational Factors, Jonathan KuʻUhoaepilipono Ahuna Oct 2022

Predicting Therapists’ Intentions To Use An Innovation: The Role Of Innovation-Specific, Individual, And Organizational Factors, Jonathan KuʻUhoaepilipono Ahuna

Theses and Dissertations

Understanding factors that contribute to an individual’s decision to use an innovation can increase the public health impact of innovations in children’s mental health services. Objective. This study examined whether and to what extent therapists’ innovation-specific judgements (e.g., innovation is easy to use, socially desirable) were associated with intentions to use an innovation using constructs from one of the most robust theories of innovation use–the Unified Theory of Acceptance and Use of Technology (UTAUT). Method. Two aims were addressed using data collected from 95 therapists and 28 supervisors who participated in a multi-site cluster randomized trial. Therapists used either a …


Belonging In Context: An Exploration Of Sense Of Belonging Among College Students, Ladonna L. Gleason Oct 2022

Belonging In Context: An Exploration Of Sense Of Belonging Among College Students, Ladonna L. Gleason

Theses and Dissertations

Feeling a sense of belonging is essential to human health and functioning and has been well documented in the literature. However, questions of context remain. Research in belonging has focused on social aspects of belonging, leaving broader contextual frames unexplored. There has been little work in identifying and differentiating the contexts in which belonging is experienced or in developing an understanding of how the experience of belonging differs across contexts. Current belonging theory lacks this important contextual perspective that could inform the ways in which belonging is constructed and reconstructed through disruption. With the advent of the COVID-19 pandemic, new …


Integrated Behavioral Health And Primary Care: Refining A Determinant Framework, Ariel Michelle Domlyn Jul 2022

Integrated Behavioral Health And Primary Care: Refining A Determinant Framework, Ariel Michelle Domlyn

Theses and Dissertations

The integration of behavioral health and primary care is a best practice to improve patient outcomes and achieve health equity. However, the process of integrating is opaque, requiring organizational change and sometimes a complete system overhaul. Implementation science offers useful ideas for helping healthcare organizations to implement care. This field has identified potential environmental conditions and determinants of successful implementation; however, much is still unknown about how these factors may be relevant for organizations seeking to integrate care. To address the limited existing knowledge in this area, this dissertation gathers practice-based evidence using exploratory methods. Results are translated into an …


An Evaluation Of A School Mental Health Program For Underserved Youth In Rural South Carolina, Tristan Collier Jul 2022

An Evaluation Of A School Mental Health Program For Underserved Youth In Rural South Carolina, Tristan Collier

Theses and Dissertations

School, community, and youth-serving system partnerships can support implementing comprehensive school mental health (SMH) systems including services beyond direct therapy for students (i.e., multiple tiers of support). Utilizing a comprehensive approach to SMH allows clinicians to form stronger relationships with administrators, school staff, and most importantly, students who may need services. This comprehensive approach to SMH includes incorporating the SMH clinician into the culture and daily activities of the schools (e.g., helping direct students in the bus line), to increase the visibility of the clinician and services available as well as provide opportunities for direct outreach to students. One such …


Cognitive Consequences Of Covid-19 Infection And Quarantine-Induced Social Isolation: Hope For The Young And Mildly Infected, Kristin Nickole Kirchner Jul 2022

Cognitive Consequences Of Covid-19 Infection And Quarantine-Induced Social Isolation: Hope For The Young And Mildly Infected, Kristin Nickole Kirchner

Theses and Dissertations

Coronavirus disease 2019 (COVID-19) has infected over 539 million individuals worldwide, and initial research supports the possibility that COVID-19 may damage the central nervous system either directly or indirectly. Neurological signs and noted cognitive deficits observed in even mildly infected patients are a cause for concern for those infected by COVID-19; the effect of social isolation on the central nervous system is also of interest. The present study sought to determine the extent of these potential cognitive deficits in a young and mildly infected sample of college students. Participants completed an extensive survey assessing their experience with COVID-19 and any …


The Moderating Impact Of Gender And Friendship Quality On The Effects Of Interparental Conflict On Adolescent Internalizing Problems, Jessica Dandan Jul 2022

The Moderating Impact Of Gender And Friendship Quality On The Effects Of Interparental Conflict On Adolescent Internalizing Problems, Jessica Dandan

Theses and Dissertations

In response to escalating concerns about the increasing incidence of adolescent internalizing disorders, several mechanisms have been investigated to understand their etiology. Though genetic predisposition contributes to the risk for psychopathology, its interaction with environmental stressors such as interparental conflict appears to further increase this risk. Girls are more susceptible to stressors and twice as likely as boys to develop internalizing problems. However, friendship quality may buffer some of the adverse effects incurred from exposure to interparental conflict. A recent review of proposed mechanisms through which conflict is associated with youth psychopathology pinpointed the need for further adolescent-focused research including …


Race, Racial Matching, And Cultural Understanding As Predictors Of Treatment Engagement In Youth Mental Health Services, Wendy Chu Apr 2022

Race, Racial Matching, And Cultural Understanding As Predictors Of Treatment Engagement In Youth Mental Health Services, Wendy Chu

Theses and Dissertations

Racially marginalized youth experience barriers that impact their ability to maximally benefit from mental health services; thus, efforts to identify strategies that support youth treatment engagement may address mental health and treatment disparities. This study examined the role of youth race, youth-therapist racial matching, and youthreported therapist cultural understanding on youth’s early treatment engagement in mental health services. The youth sample (n = 1159; Mage = 13.8 years, SD = 2.9; 52.1% female) comprised of 778 (67.1%) Latinx, 221 (19.1%) African American, 139 (12.0%) White, and 21 (1.8%) Asian American clients. The therapist sample (n = 126; Mage …


Investigating The Role Of Stressful Life Events And Emotion Regulation As Potential Antecedents Of Gratitude In Early Adolescents, Olivia Schmitke Apr 2022

Investigating The Role Of Stressful Life Events And Emotion Regulation As Potential Antecedents Of Gratitude In Early Adolescents, Olivia Schmitke

Theses and Dissertations

ABSTRACTThe construct of gratitude has gained interest over the last decade along with the rise of positive psychology. Gratitude’s significant relations with psychological and psychosocial factors have been shown in prior research, although support for such relations in children and adolescents exists, to date the literature is more robust around adults. Additionally, presumed antecedents of individual differences in gratitude have been acknowledged. The present study included a sample of 1872 middle school students and aimed to build on previous work to explore the influence of emotion regulation (i.e., cognitive reappraisal and expressive suppression) in the development of gratitude among youth …


The Relation Between Adhd Symptoms And Alcohol And Marijuana Use Outcomes Among College Students: The Mediating Role Of Experiential Avoidance, William Joshua Bradley Apr 2022

The Relation Between Adhd Symptoms And Alcohol And Marijuana Use Outcomes Among College Students: The Mediating Role Of Experiential Avoidance, William Joshua Bradley

Theses and Dissertations

Individuals with attention-deficit/hyperactivity disorder (ADHD) are at significantly greater risk for alcohol and marijuana misuse and abuse compared to their peers. College students with ADHD may be particularly vulnerable to problematic alcohol and marijuana use, given the widespread use and abuse of these substances by college students generally and liability associated with ADHD specifically. Experiential avoidance, or avoidance of unwanted thoughts, feelings, and other internal experiences, is positively associated with ADHD symptoms and substance use problems. However, it is unclear what role experiential avoidance plays in the relation between ADHD and alcohol and marijuana use. This study examined whether experiential …


S-Equol: A Novel Therapeutic For Hiv-1 Induced Gut Dysbiosis, Mason T. Rodriguez Apr 2022

S-Equol: A Novel Therapeutic For Hiv-1 Induced Gut Dysbiosis, Mason T. Rodriguez

Theses and Dissertations

HIV-1 infection affects approximately 38 million people around the world. The advent of cART has greatly improved the quality of life of infected individuals; however, roughly 50% of these individuals will still experience HIV-1 associated neurocognitive disorders (HAND). Additionally, the gut microbiome has been reported to be dysbiotic in HIV-1 infected individuals, regardless of adherence to cART. Current research has pointed to the gut-brain-microbiota axis as a potential target to treat both cognitive deficits and microbial changes. The present study investigated S-equol (SE) as a potential therapeutic for HAND by modulating the gut microbiome. The study included 21 HIV-1 Tg …


Trajectories And Psychiatric Consequences Of Inhibitory Control In Young Males With Fragile X Syndrome, Erin Hunt Apr 2022

Trajectories And Psychiatric Consequences Of Inhibitory Control In Young Males With Fragile X Syndrome, Erin Hunt

Theses and Dissertations

Inhibitory control (IC), the ability to suppress inappropriate responses, emerges late in the first year of life and improves across typical development, concurrent with brain maturation. The development of IC is critical to various social-emotional and behavioral functions, with IC deficits being linked to numerous psychiatric conditions, including attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Fragile X syndrome (FXS) is a single-gene disorder characterized by IC deficits, and elevated rates of ADHD and ASD, making it a useful model for understanding the early development and consequences of IC. In this longitudinal study, we characterized IC trajectories across multiple time …


Moderating Effects Of Parental Feeding Practices And Emotional Eating On Dietary Intake Among Overweight African American Adolescents, Mary Quattlebaum Apr 2022

Moderating Effects Of Parental Feeding Practices And Emotional Eating On Dietary Intake Among Overweight African American Adolescents, Mary Quattlebaum

Theses and Dissertations

This study examined the effects of parental feeding practices and adolescent emotional eating (EE) on dietary outcomes among overweight African American adolescents. Based on Family Systems Theory, it was hypothesized that parental feeding practices, such as parental monitoring and responsibility, would buffer the effects of EE on poor dietary quality, whereas practices such as concern about a child’s weight, restriction, and pressure-to-eat would exacerbate this relationship. Adolescents (N = 127; Mage = 12.83 ۫.74; MBMI % = 96.61 ± 4.14) provided baseline data from the Families Improving Together (FIT) for a Weight Loss trial and an ancillary study. Dietary outcomes …


Impact Of Number Of Alternatives And Spatial Arrangement On Decoy Effects, Jacob M. Stanley Apr 2022

Impact Of Number Of Alternatives And Spatial Arrangement On Decoy Effects, Jacob M. Stanley

Theses and Dissertations

The way in which people make decisions is largely guided by the context of the choice set. Choice sets that contain decoy alternatives can result in context effects that violate rational principles of decision making. Most studies on contextual choice manipulate preference among two alternatives in the context of a decoy using three option choice sets. However, many real-world decisions are made among choice sets with many more than three alternatives, such as in online shopping. We tested for attraction and compromise decoy effects in choice sets with varying numbers of alternatives by using a within-subjects preferential grocery shopping task. …


Associations Between Child Characteristics And Maternal Mental Health In Families Of Children With Autism, Fragile X Syndrome, And Autism Associated With Fragile X Syndrome, Tiffany Nicole Worley Apr 2022

Associations Between Child Characteristics And Maternal Mental Health In Families Of Children With Autism, Fragile X Syndrome, And Autism Associated With Fragile X Syndrome, Tiffany Nicole Worley

Theses and Dissertations

The present study examined the association between various child characteristics and maternal mental health concerns in three high-risk groups of mothers ± those of children with non-syndromic autism spectrum disorder (NSASD), mothers of children with fragile X syndrome (FXS), and mothers of children with fragile X syndrome and autism (FXS+ASD). Research has shown that mothers of children with NSASD and FXS are thought to share a degree of genetic vulnerability to mental health concerns it is key to examine the various other factors that may contribute to difficulties within the family system and maternal stress, depression, and anxiety.

Participants for …