Digital Commons Network^™

The Harm In Seeking Care: Assessing The Relationship Between Healthcare Discrimination And Healthcare Avoidance Behaviors In The Past Year And Since The Start Of The Coronavirus Pandemic In A Transgender And Gender Independent Sample, Kyle L. Mason

Theses and Dissertations

Background: Gender minorities encounter a myriad of barriers to accessing general and gender affirming healthcare. Financial disparities impacting affordability of healthcare costs and insurance-based denials for gender-affirming care are among prominent barriers discussed. Considerations of the prevalence of stigma, discrimination, and erasure of gender minority identities must not be neglected when seeking to understand healthcare accessibility and utilization in this population. Previous researchers have examined gender minority patients’ experiences of discrimination in healthcare settings and delaying care due to fear of discrimination. There is a dearth of knowledge about the relationship between lifetime exposure to varied forms of healthcare discrimination …

Comorbidity In Context: Identifying Patterns Of Depressive And Anxiety Symptoms In African American Early Adolescents, Kathryn Behrhorst

Theses and Dissertations

Depression and anxiety during adolescence includes symptoms of irritability, sleeplessness, feelings of guilt or worthlessness, worry, avoidance, and/or restlessness. Anxiety and depressive symptoms are often comorbid and are associated with impairments across academic, social, and emotional areas of functioning. No studies to date have examined patterns of depressive and anxiety symptoms together for African American adolescents using person-centered analyses. The current study examined patterns of symptoms and domains of anxiety and depression during early adolescence using latent profile analyses (LPA). A sample of 196 African American early adolescents in grades six through eight (M_age = 12.6; 50% female) were …

The Correlation Between Maternal Postpartum Depression And Child Psychopathology, T'Keyah I. Vaughan

Theses and Dissertations

Background: Postpartum depression (PPD) is a phenomenon that affects nearly 10-15% of pregnancies in the US. It is characterized by depressed mood or anhedonia and lasting for more than 2 weeks. PPD changes how moms interact with family members and child-rearing behavior. Depression is a phenomenon that is also known to affect the psychopathology of children. However, the specifics of how postpartum depression impacts children remains controversial. Many studies do not control for major depressive disorder which makes it difficult to disentangle the impact depression has within the first year of life. Furthermore, other PPD risk factors may be confounding …

Social Jetlag, Depressive Symptoms, And Longitudinal Outcomes In College Students, Morgan P. Reid

Theses and Dissertations

Social jetlag refers to the chronic shift in sleep timing between work and free days and has been associated with a variety of negative physical and psychological outcomes. Existing research on social jetlag has relied heavily on cross-sectional studies, preventing researchers and practitioners from assessing the effects of social jetlag over time. The current study used longitudinal data to explore the directionality of the association between social jetlag and depressive symptoms as well as the longitudinal associations between social jetlag, academic performance, and wellbeing in college students. Gender and race were also assessed as potential moderators of these associations. Cross-lagged …

Competing Strength-Based Models Of Trauma And Suicidality In A High-Risk Primary Care Sample, Samantha Mladen

Theses and Dissertations

There is limited research on the relationship between trauma exposure, depression, and suicidality, particularly in high-risk primary care samples. The present study aims to: 1) characterize the prevalence of suicidality, depression, and trauma exposure in this sample; 2)develop and test models of the relationships between suicidality, depression, and trauma exposure in this sample; 3) augment the selected model with key protective factors, including social support and religiosity; and 4) further elaborate the nature of religiosity as a potential protective factor using the subscales of the Attitudes toward God scale, Anger toward God and Comfort with God.

Patients (n …

The Role Of Strength: Navigating Perinatal Loss Among Black Women, Ashley N. Hill

Theses and Dissertations

In the U.S., Black mothers experience fetal and infant mortality at alarming rates when compared to White and Latina mothers (Gregory, Drake, & Martin, 2018). The intent of this study was to examine perinatal loss among Black American women and to expand understanding of how the Strong Black Woman (SBW) ideology influences bereavement. Data were gathered from (N=109) Black American bereaved mothers. It was predicted that endorsement of differing aspects of the SBW would moderate the relationship between perinatal grief and psychosocial outcomes (i.e., depression and post-traumatic growth). Regression analyses, alongside a bootstrapping procedure via PROCESS (Hayes, 2017), …

Longitudinal Patterns Of Depression Symptoms Among Emerging Adults, Sarah W. Clark

Theses and Dissertations

Research has suggested that depression symptoms generally decrease after late adolescence; however, there is increasing attention paid to depression symptoms among college students given the stressors unique to this time period and negative outcomes associated with depression. This study examined latent trajectories of depression symptom severity among college students. Participants were 9,889 college students who participated in the Spit for Science project (Dick et al., 2011). Growth Mixture Modeling was used to identify the presence of four subgroups of individuals with similar patterns of initial level and change in depression severity over four years of college, including Low/Minimal (55.9%), Decreasing …

Does Emotion Regulation Moderate The Association Between Impairment And Depression In Adolescents With Adhd?, Laura D. Eddy

Theses and Dissertations

In comparison with their peers, adolescents with ADHD are at increased risk for developing depression, with prevalence estimates for comorbid depression ranging from 14% to 20%. Youth with comorbid ADHD and depression are at greater risk for multiple negative outcomes compared to youth with ADHD alone, including suspension from school, failing a grade, or difficulties in peer relationships. Identifying risk factors for depression among adolescents with ADHD is important for facilitating early identification and treatment efforts. Research completed to date indicates that interpersonal impairment and emotion regulation may mediate the relationship between ADHD and depression. However, a comprehensive longitudinal model …

Antidepressant-Like Effects Of Amisulpride, Ketamine, And Their Enantiomers On Differential-Reinforcement-Of-Low-Rate (Drl) Operant Responding In Male C57/Bl/6 Mice, Doug Smith

Theses and Dissertations

Major depressive disorder (MDD) is a widespread psychiatric disorder that affects millions of people worldwide and is hypothesized to occur due to impairments in several neurotransmitter systems, including the monoaminergic and glutamatergic neurotransmitter systems. Antidepressant medications targeting multiple monoamine neurotransmitters have been shown to be effective for the treatment of depression. Racemic amisulpride is an atypical antipsychotic that has been used at low doses to treat dysthymia, a mild form of depression, and functions as an antagonist at DA_2/3, 5-HT_2B, and 5-HT₇ receptors. Recent preclinical studies have suggested that the S(+) isomer may be more …

Behavioral Phenotyping Of Vmat1 Knockout Mice: Relevance To Neuropsychiatric Disorders, Kevin A. Webster Ph.D.

Theses and Dissertations

Schizophrenia is a debilitating mental disorder that causes a large economic burden and is prevalent across all cultures and countries around the world. Although both environmental factors and genetics are known to play an important role in the etiology of schizophrenia, the exact role of genetics and its interaction with environmental factors in an individual’s predisposition to develop schizophrenia is poorly understood. Schizophrenia is characterized by symptoms that include positive symptoms (e.g. delusions, hallucinations, disorganized thinking and speech), negative symptoms (e.g. avolition, anhedonia, depressive-like behavior), and cognitive dysfunctions (e.g. executive functioning deficits in learning and memory, attention, and vigilance). Genomic …

Using Structural Equation Modeling To Understand The Role Of The Family In Pediatric Asthma Contexts, Nour Al Ghriwati

Theses and Dissertations

Family factors have long been associated with the psychosocial adjustment of children with chronic illnesses, such as asthma (Minuchin, 1975; Rapee, 1997). Research indicates that negative family factors may also contribute to child disease severity, via bio-behavioral mechanisms of effect (Wood et al., 2006); however, these pathways have yet to be examined with a comprehensive focus on more positive family factors. This study sought to examine whether factors such as family cohesion, problem solving abilities, and communication influence asthma symptom severity in children via their effects on child depression and anxiety symptoms. Using structural equation modeling, we identified significant indirect …

Dissociable Antidepressant-Like And Abuse-Related Effects Of The Noncompetitive Nmda Receptor Antagonists Ketamine And Mk-801 In Rats., Todd Hillhouse

Theses and Dissertations

The noncompetitive NMDA receptor antagonist ketamine produces rapid and sustained antidepressant effects in patients suffering from major depressive disorder. However, abuse liability is a concern. To further evaluate the relationship between antidepressant-like and abuse-related effects of NMDA receptor antagonists, this study evaluated the effects of ketamine, MK-801, and phencyclidine in male Sprague-Dawley rats responding under two procedures that have been used to assess antidepressant-like effects [differential-reinforcement-of-low-rate (DRL) 72 s schedule of food reinforcement] and abuse-related drug effects [intracranial self-stimulation (ICSS)]. Under DRL 72 s, ketamine produced an antidepressant-like effect by increasing reinforcers, decreasing responses, and producing a rightward shift in …

A Longitudinal Study Of The Bidirectional Relations Between Internalizing Symptoms And Peer Victimization In Urban Adolescents, Tess Drazdowski

Theses and Dissertations

The purpose of this study was to examine the bidirectional relations between anxious and depressive symptoms and two forms of peer victimization (i.e., overt and relational) within a sample of 358 predominantly African-American adolescents living in low-income urban areas across four years. Longitudinal path analyses tested progressively complex models for each type of victimization. For both overt and relational victimization the autoregressive model where only previous levels of each construct predicted future levels of the construct was the most parsimonious explanation. The best fitting model for both types of peer victimization suggested that internalizing symptoms helped to further explain future …

Follow-Up Evaluation Of Treatment For Anxiety And Depression Provided In A University-Based Primary Care Clinic, Renée M. Grinnell

Theses and Dissertations

Although integrated primary care psychology services are becoming increasingly common, the literature lacks adequate research support for the longitudinal durability of treatment effects following the conclusion of brief primary care interventions. This study served as a follow-up program evaluation of psychological services for depression and anxiety provided at the Medical College of Virginia’s Ambulatory Care Center in Richmond, Virginia. Data were collected on 47 adult primary care patients who received treatment for depression and/or anxiety between six and 18 months prior to the follow-up telephone call. Data were collected on the trajectory of depression scores throughout and following treatment, treatment …

Evaluation Of Psychological Services For Anxiety And Depression Provided In A University-Based Primary Care Clinic, Elizabeth J. Sadock

Theses and Dissertations

Primary care clinics are increasingly integrating psychological services into their service programs, however few studies have used a comparison group to demonstrate the effectiveness of these services. This study evaluated the psychological services provided at the Ambulatory Care Clinic (ACC) at the Virginia Commonwealth University Health System (VCUHS) by comparing changes in 147 patients’ PHQ-9 depression scores and GAD-7 anxiety scores over time to the scores of 139 patients at the Hayes E. Willis Health Center, a comparison clinic with demographically similar patients but no integrated psychological services. Assessment data were collected from participants in the ACC at VCUHS during …

Resilience In Parkinson’S Disease: An Empirical Examination Of Age-Related Components Of The Construct, Andrea Garroway

Theses and Dissertations

Although Parkinson’s disease (PD) is commonly characterized by motor symptoms and physical limitations, there is growing recognition of nonmotor and mood symptoms associated with the disease as well. There has been limited research exploring how individual coping might affect the relationships between PD symptoms and mental health outcomes. The resilience construct was originally developed within the child literature, and it is often used in conceptualizing how people have adaptive or positive outcomes when facing adversity. Current resilience measures may not adequately assess the construct within an older population, however, given the unique emotion regulation and coping skills seen in late …

Dispositional Mindfulness In People Diagnosed With Cancer: The Relationship To Depressive Symptoms And Well-Being, Karen Kersting

Theses and Dissertations

Coping with a cancer diagnosis is known to be a stressful experience that can be related to declines in personal well-being and increases in distress. Dispositional mindfulness is known to be related to depressive symptoms and well-being. The primary purpose of this study was to examine the relationship between mindfulness and experiences of depressive symptoms and well-being in people recently diagnosed with cancer. Seventy-four participants who were diagnosed with cancer in the last 12 months completed an initial self-report survey, and 43 of those completed another survey 3 months later. Cross-sectional regression analysis showed that higher levels of mindfulness were …

Relations Of Depression, Social Support, And Socio-Demographic Factors On Health Behaviors Of Mothers With Premature Infants Hospitalized In A Neonatal Intensive Care Unit (Nicu), Surbhi Kanotra

Theses and Dissertations

The present study examined the relationships of depression, social support, and socio-demographic factors on health behaviors of mothers with preterm infants hospitalized in the neonatal intensive care unit (NICU). In addition, the study also assessed the moderation effect of social support on the relationship between depression and health behaviors. Eighty-nine mothers with hospitalized infants in the central Richmond area participated in the study. Analyses found that mother’s education level and her marital status to be significantly associated with her health behaviors. Mothers with a higher level of education and those who were married, were less likely to smoke and more …

Neuroprotective Effects Of Postinjury Lithium Treatment: Determining The Optimal Dosing Paradigm And Assessing Potential Mechanisms Of Action, Katharine Eakin

Theses and Dissertations

Traumatic brain injury (TBI) has a dramatic impact on our society in terms of mortality, morbidity, and inherently high financial costs. Formidable research efforts are being addressed to the identification of neuroprotective agents capable of ameliorating the neurological outcome after TBI. Preclinical studies have recently demonstrated lithium to be a promising neuroprotective agent for both acute ischemic brain injury and chronic neurodegenerative disease. In light of these encouraging data, we designed a lateral fluid-percussion injury (FPI) study aimed at investigating the role of early post-traumatic administration of lithium as a strategy for reducing TBI-induced motor and cognitive deficits. The optimal …

Does Mindfulness Reduce Negativity Bias? A Potential Mechanism For Reduced Emotional Distress, Laura Kiken

Theses and Dissertations

The present research examined if mindfulness reduced negativity bias on measures of attitude formation and cognitive style, as a potential explanation for the beneficial effects of mindfulness on emotional disturbance. Two studies were conducted. Study One was correlational and found that trait mindfulness inversely correlated with measures of negative cognitive style, and that the latter partially mediated an inverse association between mindfulness and predisposition to depression and anxiety. Further, correlations between mindfulness and both positive attitude formation and optimism hinted at a potential positivity bias. Study Two extended these findings using a randomized experimental design comparing a mindfulness induction to …

Efficacy Of A Brief Intervention For Insomnia Among Psychiatric Outpatients, James Nile Wagley

Theses and Dissertations

Psychiatric patients are particularly affected by symptoms of insomnia. Because insomnia is often secondary to other conditions and was once thought to be less treatable, this condition has received little attention in terms of treatment and research. Additionally, psychiatric patients have typically fewer resources to seek treatment. Generally, insomnia is treated with medications that may have biological side effects and offer little restorative sleep. Behavioral or cognitive interventions have often been overlooked. This experiment uses profile analysis to test the hypothesis that psychiatric outpatients randomized to a treatment group would have decreased levels of sleep difficulties (measured by PSQI) when …

Intrapersonal Grief As A Clinical Entity Distinct From Depression: Does It Exist Among A Medically Ill Parkinson's Disease Population?, Rashelle Brown Hayes

Theses and Dissertations

There has been growing support for the idea that complicated grief symptoms following bereavement are independent of symptoms of depression and anxiety. However, the loss of a loved one is not the only or the most frequent type of loss to be encountered. The onset of an insidious medical illness may trigger a mourning process for the lost function or body part that is posited to also involve feelings of grief. While the risk of depression is high among a medical or rehabilitative population, the impact of grief over functional losses has never been empirically investigated as a contributing factor …

Posttraumatic Growth Among College Students At A Large Urban University: The Role Of Social Support And Unsupportive Social Interactions, Wendy E. Balliet

Theses and Dissertations

The objective of this study was to investigate the association between both social support and unsupportive interactions and psychological outcomes, in a sample of college students who recently had experienced a stressful event. The research design was cross-sectional, and data were collected from 142 college students. As hypothesized, a significant positive association was found between unsupportive interactions received by participants and depressive symptoms. Contrary to hypotheses, no significant associations were found between unsupportive interactions and positive emotion or posttraumatic growth. Additionally, no significant relationship was evident between received emotional support and the outcome variables. Exploratory analysis revealed that positive reappraisal …

Binge Eating In Ethnically Diverse Obese Adolescents, Clarice K. Gerke

Theses and Dissertations

Rates of pediatric obesity in America are reaching epidemic proportions. Studies using both community and treatment-seeking samples of obese adolescents indicate that a subset engage in binge eating behaviors. This study investigated the prevalence and severity of binge eating behaviors among 86 primarily African American 11 to 17 year old adolescents seeking outpatient treatment for obesity. This study also examined the associations of stressful experiences (specifically, weight-related teasing, trauma, and daily hassles) with binge eating, as well as potential mediators and moderators of these relationships. Twenty-eight percent of the sample reported at least one episode of binge eating in the …

Measuring Therapist Adherence To A Manual-Based Treatment Tested In A Community Setting: The Pascet Manual Adherence Scale (P-Mas), Alyssa M. Marder

Theses and Dissertations

The goal of the current study was to develop and test a rigorous measure of therapist adherence to a cognitive-behavioral, manual-based treatment for childhood and adolescent depression. This project employed data from the recently completed UCLAYouth Anxiety and Depression Treatment study. This study aimed to advance the literature by devoting the full focus of the project to the development of a manual-based measure that would demonstrate interrater reliability across multiple raters. This study reported on the psychometric development of the PASCET Manual Adherence Scale (PMAS) (e.g. scoring strategy, item development, reliability), a unique measure of therapist adherence that represents the …

Residual Symptoms After Treatment Of Chronic Depression: A Comparison Across Treatment Modalities, Katherine L. Schaefer

Theses and Dissertations

Despite the development of several effective treatments for depression, symptoms often persist in a number of individuals. Unfortunately, these residual symptoms are associated with several negative outcomes, including persistence of depressive illness. Few studies have examined the exact nature of individual residual symptoms across specific treatment modalities, and studies have failed to distinguish between depression courses. The current study expands on previous findings by examining, among a chronically depressed population, differences in individual residual symptoms and clusters between treatment modality (medication, psychotherapy, combination) and treatment response (full response, partial response). Five hundred and nineteen chronically depressed participants completed the study. …

Supportive And Unsupportive Responses From Parents As Moderators Of The Relationship Between Stressful Events And Negative Outcomes In Adolescents, Karen A. Muehl

Theses and Dissertations

The objective of this study was to investigate the relationship between stressful events in adolescents and negative outcomes of substance use, depressive symptoms, and anxiety symptoms. Parental support and unsupportive parental responses were examined as moderators of this relationship. The research design was cross-sectional, and self-report data were collected from 100 adolescents in the 8th and 9th grades. As hypothesized, significant positive associations were found between perceived stressors and each of the three negative outcomes, as well as between unsupportive parental responses and the outcomes. Also consistent with hypotheses, and previous literature, was the finding of a significant inverse association …

Innovative Interventions For Disordered Eating: A Pilot Comparison Between Dissonance-Based And Yoga Interventions, Karen S. Mitchell

Theses and Dissertations

Disordered eating, including bingeing, dieting, purging, and clinical and subclinical forms of anorexia nervosa, bulimia nervosa, and binge eating disorder, is prevalent among college-aged women. To date, few interventions have successfully reduced risk factors related to disordered eating. One promising intervention utilizes principles of cognitive dissonance to reduce thin-ideal internalization among women at risk for eating disorders. Additionally, the benefits of yoga, including increased awareness of bodily processes, offer hope that this practice might reduce disordered eating symptomatology. The current study compared cognitive dissonance and yoga interventions for disordered eating attitudes and behaviors. Hierarchical regression analyses revealed that there were …