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Towards Collective Healing: Intervening Intergenerational Trauma With Koreans/Koreans, Hyunji Hannah Lee
Towards Collective Healing: Intervening Intergenerational Trauma With Koreans/Koreans, Hyunji Hannah Lee
Counseling and Psychological Services Dissertations
The experiences of historical and cultural traumas such as chronic poverty, instability, and violence have insidious and long-lasting effects up to three generations from survivors through genetic or learned transmission (Bezo & Maggi, 2015; Bradfield, 2013; Connolly 2011;Forrest-Perkins 2017). Although there has been a movement towards recognizing such traumas and their effects in psychological literature, there still remains a dearth in examination for Asian/Asian Americans and specific ethnic groups such as Korean/Korean Americans (Cai & Lee, 2022; Kim-Martin, 2021). Thus, a critical interpretive synthesis (CIS) was utilized to synthesize the current literature on AAA historical/cultural traumas and examine their effects …
An Exploration Of Eating Disorders Among Black Women Using Intersectionality Theory, Rebecca Gwira
An Exploration Of Eating Disorders Among Black Women Using Intersectionality Theory, Rebecca Gwira
Counseling and Psychological Services Dissertations
Eating disorders (ED) research conducted in the United States (U.S.) has historically underrepresented the unique experiences of racial/ethnic minority women compared to White women (Egbert et al., 2022; Gilbert, 2003). There has been a call to action (e.g., Burke et al., 2020; Simone et al., 2022) for the ED field to focus on how the oppression associated with intersections of identity, not just the identities themselves, contributes to the illness. As such, Chapter 1 of this dissertation assessed the state of current eating disorders (ED) research on mutually exclusive racial/ethnic minority groups of women, as well as the responsible use …
Expanding Our Understanding Of Help-Seeking Behavior: Implications For Older Adults At Elevated Risk Of Suicide, Afroze N. Shaikh
Expanding Our Understanding Of Help-Seeking Behavior: Implications For Older Adults At Elevated Risk Of Suicide, Afroze N. Shaikh
Counseling and Psychological Services Dissertations
Suicide is a serious public health concern, especially among older adults who present with historically high rates of suicide (CDC, 2023). Despite these disproportionate rates of suicide, little research has examined help-seeking behavior among older adults at risk of suicide (Wang et al., 2023). By furthering our understanding of facilitators and barriers to service use among older adults, we can work to inform targeted strategies to promote engagement with services. The primary aim of the present study was therefore to examine predictors of help-seeking behavior among older adults at risk of suicide using the Andersen Behavioral Model of Health Services …
Examining The Role Of The Imposter Phenomenon And Self-Esteem On The Relationship Between Perfectionism And Depression, Sarah Mclaulin
Examining The Role Of The Imposter Phenomenon And Self-Esteem On The Relationship Between Perfectionism And Depression, Sarah Mclaulin
Counseling and Psychological Services Dissertations
Perfectionism has consistently gained attention in the literature over the last several decades (Stoeber & Otto, 2006) and recent research indicates that perfectionism in individuals is on the rise (Curran & Hill, 2019). From academic pursuits among students (e.g., Rice et al., 2015) to professional performance (e.g., Bravata et al., 2019), perfectionism affects a wide range of individuals and specific areas of their lives. Perfectionism has been linked to several negative consequential physical and mental health outcomes (Molnar et al., 2020; Eley et al., 2020) including depression (e.g., Chai et al., 2020), self-esteem (e.g., Cokley, et al, 2018), and the …
Merging Black Feminist Ecologies And Psychology: Black Women Resisting The Psychological Costs Of Environmental Racism, Shola Shodiya-Zeumault
Merging Black Feminist Ecologies And Psychology: Black Women Resisting The Psychological Costs Of Environmental Racism, Shola Shodiya-Zeumault
Counseling and Psychological Services Dissertations
Environmental racism, or the disproportionate burden of environmental toxins in racially marginalized communities (Chavis, 1994), has been associated with poor mental health and wellbeing (e.g., Power et al., 2015). Though recent evidence has demonstrated that Black Americans are exposed to environmental toxins at higher rates than other racial groups (Mikati, 2018; Pinto de Moura & Reichmuth, 2019), the specific challenges that environmental racism pose specifically for Black women are understudied. Historically, Black American women have strategized and labored to bring about environmental equity and justice in their communities, and to facilitate social change (Collins, 2009; Simpson, 2011). However, inquiries into …
All-American: An Investigation Of The Relationship Between Athlete Identity, Masculinity, And Mental Health Stigma On Help-Seeking Intentions In Black College Student-Athletes, Giscard Petion
Counseling and Psychological Services Dissertations
Black male student-athletes represent a large percentage of those competing in NCAA varsity sports. Black male student-athletes are impacted by a variety of stereotypes and the pressure of achieving academically and athletically. Scholars have identified that athletes may resist mental health services because of stigma that exist in the athletic environment (Watson, 2005; Watson, 2006).Athlete identity and masculine gender socialization might play a large role in how black male student-athletes seek psychological help. This phenomenon can be explained by modified labeling theory (Link et al., 1989) and stereotype threat (Steele & Aronson, 1995). The mental health stigma that exists within …
An Exploration Of Adverse Childhood Experiences And Post-Traumatic Stress Disorder In College Students, Barbara Duran
An Exploration Of Adverse Childhood Experiences And Post-Traumatic Stress Disorder In College Students, Barbara Duran
Counseling and Psychological Services Dissertations
The Center for Disease Control and Prevention (CDC) previously released a statement calling for researchers to undertake research initiatives that shed light on the effects of adverse childhood experiences (ACEs) on health and mental health outcomes and to work towards ACE prevention and treatment (Center for Disease Control and Prevention, 2020). ACEs have also been documented to predict symptoms of Post-Traumatic Stress Disorder (PTSD; Ferrara & Panlilio, 2020). One potential important implication of ACEs and PTSD is cognitive impairment. Extant literature suggests that experiencing ACEs predicts cognitive struggle. Aglan et al. (2010) demonstrated that individuals with a history of childhood …
Development Of The Racial Allyship Characteristics Scale: Measuring White Allyship From The Perspective Of People Of Color, Cassandra Hinger
Development Of The Racial Allyship Characteristics Scale: Measuring White Allyship From The Perspective Of People Of Color, Cassandra Hinger
Counseling and Psychological Services Dissertations
Scholars and activists of color have urged White allies to engage in racial justice work led by the voices of Black, Indigenous, and People of Color (BIPOC). However, to date, most research on racial allyship has centered exclusively on the perspective of White allies themselves. To address this gap in the literature, Chapter 1 utilized constructivist grounded theory methodology to expound on the characteristics of racial allies as described by BIPOC. Chapter 2 utilized the qualitative themes that emerged from Chapter 1 to develop the 27-item Racial Allyship Characteristics Scale (RACS) across two studies. In Study 1, exploratory factor analysis …
Predictors Of Clinical Mental Health Counseling Students’ Attitudes Toward Working With Clients With Substance Use Disorders, Lauren Flynn
Predictors Of Clinical Mental Health Counseling Students’ Attitudes Toward Working With Clients With Substance Use Disorders, Lauren Flynn
Counseling and Psychological Services Dissertations
With over 40 million Americans aged 12 and older meeting the criteria for a Substance Use Disorder (SUD) in 2020, and drug overdose deaths reaching record highs that same year, the treatment of persons with SUDs has become a focal point of the counseling profession (CDC, 2021; SAMHSA, 2021). There is a growing need for clinical mental health counselors (CMHC) trained to treat SUDs (The United States Bureau of Labor Statistics, 2022). However, negative attitudes and stigma toward substance-related addiction serve as a deterrent for counselors working in substance-treatment settings (Murphy, 2022). Addressing substance-related attitudes in counseling students is critical …
Just-Ish?: Alternative Justice Attitudes: A Randomized Control Trial, Iman Abdulkadir Said
Just-Ish?: Alternative Justice Attitudes: A Randomized Control Trial, Iman Abdulkadir Said
Counseling and Psychological Services Dissertations
Responses to harm and crime in the United States typically utilize the criminal legal system’s retributive approach, which often contributes to cycles of harm rather than facilitating healing (Davis, 2019; Lenzen & Stahler, 2020). In response, alternative responses to harm like transformative and restorative justice are growing in popularity (Fileborn & Vera-Gray, 2017). These approaches to justice are often conflated, but rarely compared (Nocella & Anthony, 2011). First, a systematic literature review of transformative and restorative justice utilizing a qualitative content analysis (QCA) identified the two interventions' definitions, comparisons, and perceived attitudinal outcomes. The major themes of healing for both …
Investigating How School Counselors Using #Scchat On Twitter Advocate For Marginalized Student Populations: A Social Network Analysis, Adrianne Robertson
Investigating How School Counselors Using #Scchat On Twitter Advocate For Marginalized Student Populations: A Social Network Analysis, Adrianne Robertson
Counseling and Psychological Services Dissertations
Advocacy work for marginalized student populations can help eliminate systemic barriers in schools. School counselors interact with millions of P-12 students daily and have the unique skills to advocate for marginalized students (U.S. Department of Education, 2019; Edirmanasinghe et al., 2022). Social media platforms such as Twitter allow school counselors to advocate outside of the school setting. It also allows them to obtain professional development and connect to other professionals (Schultz, 2022). In this study, the researcher seeks to learn how school counseling professionals' use of Twitter changed over ten years when using the #scchat hashtag and how their advocacy …
Examining The Interaction Between Mental Health Stigma, Covid-19 Traumatic Stress, And Race In Predicting Help-Seeking, Jaleh Davari-Dhariwal
Examining The Interaction Between Mental Health Stigma, Covid-19 Traumatic Stress, And Race In Predicting Help-Seeking, Jaleh Davari-Dhariwal
Counseling and Psychological Services Dissertations
Mental health stigma is a major barrier to seeking professional psychological services (Corrigan, 2004). Black college students in particular endorse higher rates of mental health stigma and also have fewer positive attitudes toward seeking mental health help (Cheng et al., 2013; Kuo et al., 2006). As a result, Black young adults underutilize mental health services at higher rates than older Black individuals and White young adults (SAMHSA, 2015). The Black community has also experienced greater adversity from the pandemic, having more coronavirus cases, hospitalizations, and deaths compared to White people in the United States (CDC, 2020). This has led to …
Dual Diagnosis And Bias In Counselor Education And Supervision, Jamian Coleman
Dual Diagnosis And Bias In Counselor Education And Supervision, Jamian Coleman
Counseling and Psychological Services Dissertations
Individuals living with a dual diagnosis (e.g., substance use disorder [SUD] and the co-occurrence of a psychiatric disorder) experience numerous challenges to treatment due to the complexity and overlapping nature of symptomology, psychosocial contextual factors, and limited effective evidence-based treatment options (Cochran et al., 2007; Flanagan et al., 2016). Due to the high prevalence rates of clients living with a dual diagnosis, it is likely that counselors-in-training (CITs) will work with a client dealing with a dual diagnosis as early as their practicum or internship experience (Brown et al., 2002; Salyers et al., 2006). I utilized an analogue experimental research …
Does Humility Help In Cross-Cultural Adaptation?: Exploring Effects Of Humility Alongside Acculturation And Enculturation, Aaron Mclaughlin
Does Humility Help In Cross-Cultural Adaptation?: Exploring Effects Of Humility Alongside Acculturation And Enculturation, Aaron Mclaughlin
Counseling and Psychological Services Dissertations
Now 40-years old, John Berry’s integration hypothesis of acculturation corrected many misconceptions about how to help people adjust to cross-cultural encounters. This research program has influenced many helping professionals—including counselors, educators, and policymakers—in support of people living cross-culturally. However, there are a number of issues that limit the applicability of his original theorizing on acculturation strategies for those living as a part of multiple cultural communities. In the first chapter of this dissertation, I conduct a review of longitudinal person-centered studies on acculturation orientations to critically address the helpfulness and limitations of his theory. In the second chapter, I critically …
Perceptions, Roles, And Training Of School Psychologists In Sexual Health Education For Students With Intellectual And Developmental Disabilities (I/Dd), Anne Stair
Counseling and Psychological Services Dissertations
Despite the evidence indicating that sexual health education for students results in positive outcomes for students by reducing risks, students with intellectual and developmental disabilities (I/DD) do not typically receive sexual health education. While school psychologists possess numerous skills that could contribute to sexual health education for students with I/DD, there is no existing research on this topic. This dissertation reports the results of a survey of Georgia school psychologists regarding their attitude, perception of social norms, perception of behavioral control/self-efficacy, and training/familiarity in regards to implementation of and advocacy for sexual health education for students with I/DD. The survey’s …
The Role Of Self Compassion In The Relationship Between Perfectionism And Suicide, Jihee Hong
The Role Of Self Compassion In The Relationship Between Perfectionism And Suicide, Jihee Hong
Counseling and Psychological Services Dissertations
The suicide rate has been increasing in the world, both in the young and older adult population. Prolific research has investigated causes, mechanisms, and interventions to prevent suicide. Many significant contributions from psychology in providing a theoretical and empirical understanding of suicidal behavior stem from the Interpersonal Theory of Suicide (IPTS). Based on the IPTS, the current study aims to examine the hypothesized model showing the relationship between perfectionism and suicidal risk and the moderating role of self-compassion in both young and older adult samples. Before testing the model, measurement invariance between young and older adults was evaluated. Also, multigroup …
Project Heal Generational Trauma: A Mixed-Methods Participatory Action Research Study Of Generational Trauma And Healing In Millennial Black Women, Ashlei A R Petion
Project Heal Generational Trauma: A Mixed-Methods Participatory Action Research Study Of Generational Trauma And Healing In Millennial Black Women, Ashlei A R Petion
Counseling and Psychological Services Dissertations
Generational trauma (GT) is the transmission of the effects of psychologically harmful events from generation to generation through epigenetics, parenting, and other socialization factors. It has been associated with attachment issues, suicidal ideations and behaviors, dysfunctional familial relationships, cultural mistrust, and other health problems such as increased symptoms of posttraumatic stress disorder, elevated mortality rate, and substance misuse, especially within multiple marginalized populations such as millennial Black women (MBW) (Bar-On et al., 1998; Brave Heart, 1999; Mohatt et al., 2014; Wilkins et al., 2013). The current study contributes to existing literature to further understand the GT experiences of MBW and …
Improving Reading Comprehension: An Investigation Of Two Intervention Procedures And The Social Validity Of The "Ask-Read-Tell" Reading Strategy, Quynh Doan Wellons
Improving Reading Comprehension: An Investigation Of Two Intervention Procedures And The Social Validity Of The "Ask-Read-Tell" Reading Strategy, Quynh Doan Wellons
Counseling and Psychological Services Dissertations
The first chapter of this dissertation reports the results of a review of the practice and application of social validity assessments in SCD studies within the field of school psychology. Adopting similar procedures described in the Snodgrass et al. (2018) analysis, this review systematically investigated the extent to which social validity was evaluated in school psychology SCD studies, the characteristics of social validity assessments, the prevalence of assessing total construct social validity (i.e., goals, procedures, and outcomes), and the extent to which social validity findings were integrated with visual analyses to form conclusions about interventions. Although the content analysis revealed …
The Influence Of Racial Ethnic Match Between School Psychologists And Clients On Referral Outcomes, Michelle Washington
The Influence Of Racial Ethnic Match Between School Psychologists And Clients On Referral Outcomes, Michelle Washington
Counseling and Psychological Services Dissertations
Racial/ethnic incongruence (REI) describes a relationship in which there is a mismatch between individuals in terms of their racial or ethnic identification, perceived or self-reported. There is an existing body of literature about the challenges associated with teacher-student and counselor-counselee REI as well as the benefits associated with racial/ethnic matching (REM) among individuals from these groups. Within the field of school psychology, there exists theoretical arguments in favor of REM among school psychologists and students (Blake et al., 2016). Further, qualitative investigations of Black school psychologists have revealed that they identify REM between them and the students that they serve …
Utilizing The Theory Of Event Centrality As A Framework For Understanding Counselor-In-Training Burnout During The Covid-19 Pandemic, Kyndel Tarziers
Utilizing The Theory Of Event Centrality As A Framework For Understanding Counselor-In-Training Burnout During The Covid-19 Pandemic, Kyndel Tarziers
Counseling and Psychological Services Dissertations
The coronavirus pandemic (COVID-19) has been ravaging the world since 2019, resulting in deleterious impacts on mental health for the general population, as well as frontline health care workers (Centers for Disease Control and Prevention, 2020; Holmes et al., 2020). COVID-19 has proven to be especially challenging for professional counselors due to increased caseloads, more severe client concerns, and additional work responsibilities (Litam et al, 2021). These stressors put both counselors and counselors-in-training (CITs) at a heightened risk for developing burnout. In chapter 1, I utilized the framework of event centrality to better situate the impact of COVID-19 and CIT …
Academic Enabling Behaviors Of Students With An Intellectual Disability In Inclusive Postsecondary Education Programs, Katherine Mclendon
Academic Enabling Behaviors Of Students With An Intellectual Disability In Inclusive Postsecondary Education Programs, Katherine Mclendon
Counseling and Psychological Services Dissertations
Individuals with intellectual disabilities (ID) continue to be marginalized members of society, lacking access to opportunities individuals without disabilities can obtain with minimal difficulty. This is also true in higher education. In the past decade, the United States has seen an increase in the number of students with ID who participate in Inclusive Post-Secondary Education programs (IPSE). Although it is known that IPSE programs demonstrate benefits for students with ID, little is known about IPSE students’ classroom-related, non-academic thoughts, attitudes, and behaviors, which are sometimes referred to as academic enabling behaviors. According to a model proposed by DiPerna and Elliott …
The Validity Of The General Intellectual Humility Scale As A Measure Of Intellectual Humility, Charles Westbrook
The Validity Of The General Intellectual Humility Scale As A Measure Of Intellectual Humility, Charles Westbrook
Counseling and Psychological Services Dissertations
Early intellectual humility research has largely relied on questionnaires that require individuals to self-evaluate their own intellectual humility, despite concerns that people low in intellectual humility may lack awareness of their degree of intellectual humility. Because of this potential source of error, it is important that self-report measures of intellectual humility are thoroughly tested for validity. In Chapter 1, I conducted a systematic literature review of measures of intellectual humility. For each measure, validity evidence is summarized and critically evaluated. Validity evidence was found lacking with respect to addressing potentially serious problems with self-report. This finding points to a need …
The Engagement-Achievement Paradox And The Role Of Cultural Humility In The Instruction Of Diverse Youth, Emily N. Srisarajivakul
The Engagement-Achievement Paradox And The Role Of Cultural Humility In The Instruction Of Diverse Youth, Emily N. Srisarajivakul
Counseling and Psychological Services Dissertations
School engagement is a multidimensional construct that includes behavioral and emotional dimensions that affect a student’s interaction with his/her school environment (Appleton et al., 2006). School engagement has been positively correlated with academic achievement, however there is a growing body of literature that has found the opposite is true with Black/African American students (e.g., Johnson et al., 2001) who have higher levels of school engagement yet lower levels of academic achievement than their White peers (Shernoff & Schmidt, 2008). Chapter One was a systematic literature review that identified study qualities, the role of culture, and hypothesized reasons for the existence …
Pressure To Forgive: How Religious Pressure Effects Moving From Decisional To Emotional Forgiveness, Elise Choe
Pressure To Forgive: How Religious Pressure Effects Moving From Decisional To Emotional Forgiveness, Elise Choe
Counseling and Psychological Services Dissertations
Forgiveness and religion/spirituality have been studied together throughout the years. Most studies have claimed that religious/spiritual beliefs and values promote forgiveness and increase psychological well-being. However, reviews of the literature and a meta-analysis have found that these claims and results are tenuous. In Chapter 1, a narrative review of the literature on forgiveness and religion/spirituality was conducted. In the current review, I outline how well the field has answered lingering questions in the past several years. Weaknesses within the field, such as the over-reliance on cross-sectional study designs and the lack of programmatic work, are noted. The current state of …
Examining The Role Of Trait Resilience And Self-Compassion In Adaptive Responses To Stress: A Physiological Stress Response Study, Karen M. Shebuski
Examining The Role Of Trait Resilience And Self-Compassion In Adaptive Responses To Stress: A Physiological Stress Response Study, Karen M. Shebuski
Counseling and Psychological Services Dissertations
Psychological resilience is concerned with adaptive functioning in the face of stress, adversity, or trauma (Davydov, Stewart, Ritchie, & Chaudieu, 2010; Windle, 2011). Trait level psychological resilience refers to characteristics that may predispose adaptive responses to stress, trauma, and adversity (e.g., Connor & Davidson, 2003). Despite work suggesting the benefits of trait resilience (e.g., Hu, Zhang, & Wang, 2015), there are multiple self-report measures in existence with no identified measurement standard (Windle et al., 2011). Given differing conceptualizations of trait resilience, physiological measurement of stress response represents a viable and objective approach to examine psychological resilience (Walker, Pfingst, Carnevali, Sgoifo, …
Does Math Anxiety Moderate The Effect Of An Online Arousal Reappraisal Intervention On Math Performance?, Zachary Taber
Does Math Anxiety Moderate The Effect Of An Online Arousal Reappraisal Intervention On Math Performance?, Zachary Taber
Counseling and Psychological Services Dissertations
Math anxiety has been consistently associated with lowered math performance and achievement regardless of skills and abilities. These decrements in math performance and achievement and accompanying avoidance of opportunities to improve math skills can have outsize influence on the school and career path of college students. In the following chapter, we conducted a systematic review and meta-analysis of the last 30 years of intervention literature for math anxiety, focusing on math performance as an outcome of interest. For the nine studies that fit the inclusion criteria we summarize the effect sizes, though moderator analyses were not conducted due to low …
Development Of The Posttraumatic Play Screening, Galina K. Tobin
Development Of The Posttraumatic Play Screening, Galina K. Tobin
Counseling and Psychological Services Dissertations
With exposure to potentially traumatic events occurring at high rates (Norris & Slone, 2013), many counselors will inevitably work with children who have experienced trauma. Researchers and clinicians have repeatedly found children who have experienced trauma often demonstrate specific behaviors and themes through their play (Gil, 2017; Chazan & Cohen, 2010; Schaefer, 1994). The combination of a child’s affect, play themes, and play behaviors can indicate possible posttraumatic stress (Cohen et al., 2010). The Posttraumatic Play Screening instrument (PTPS) was developed with the aim of providing clinicians a screening instrument for posttraumatic play following a single play therapy session. The …
Practicing What We Preach: Exploring The Relationships Among Spiritual Competence, Spirituality In Supervision, Cultural Humility, And Spiritual/Religious Integrated Counseling, Nicolas Williams
Counseling and Psychological Services Dissertations
Despite efforts made by the counseling profession to integrate spirituality/religion (S/R) into therapy and training, S/R is often neglected in counselor education programs (Bishop, et. al. 2003; Crabtree et al., 2020; Polanski, 2003). Accordingly, counselors in training (CIT) often lack the necessary training and spiritual competence to effectively integrate S/R in counseling practice. Previous researchers have found that discussing S/R in supervision increases the likelihood that CIT will integrate S/R with counseling clients (Garner, et. al., 2017; Gilliam & Armstrong, 2012), however supervisors often avoid integrating S/R in supervision due to their personal assumptions, attitudes, and beliefs about the role …
Evaluation Of Intensive Behavioral Interventions For Severe Avoidant/Restrictive Food Intake Disorder In Young Children, Emily K. Rubio
Evaluation Of Intensive Behavioral Interventions For Severe Avoidant/Restrictive Food Intake Disorder In Young Children, Emily K. Rubio
Counseling and Psychological Services Dissertations
Children with avoidant/restrictive food intake disorder (ARFID) may refuse to consume an adequate variety and/or volume to maintain expected physical growth and cognitive performance (Kerwin, 1999; American Psychiatric Association, 2013). This disorder can result from complicated medical histories or diagnoses of autism or related disorders and is distinct from eating disorders which include obsessive thoughts about food and body image. These children often are medically and physically able to consume food or liquid by mouth but may engage in inappropriate mealtime behavior (IMB; e.g., turning head, hitting spoon) to escape or avoid eating. Behavioral interventions like positive reinforcement and escape …
Optimizing The Aging Services Network To Identify And Respond To Older Adults At Risk Of Suicide, Mary Chase Breedlove Mize
Optimizing The Aging Services Network To Identify And Respond To Older Adults At Risk Of Suicide, Mary Chase Breedlove Mize
Counseling and Psychological Services Dissertations
The population of older adults (65+) is increasing, and this growth is accompanied by increased mental health concerns such as social isolation and suicide, which are argued to be exacerbated by the COVID-19 pandemic. In chapter 1, I sought to discover if Aging Service Network (ASN) volunteers obtain and utilize suicide-intervention skills with older adults after receiving a 14-hour evidenced based training and identify characteristics of volunteers who perform suicide interventions as a result of being trained. In chapter 2, I sought to identify baseline relationships among suicide desire, chronic pain, social connections, perceived social support, loneliness, and depression among …