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Out From Under: Wellness Design And Alternative Therapies For Anxiety And Depression, Emily J. Adams

Theses and Dissertations

This study explores a facility that combines wellness design strategies with alternative therapies that are not commonly available in the U.S., with the goal of supporting adults with anxiety and/or depression who are not comfortable seeking traditional care.

Chronic Adolescent Stress As A Predictive Factor For The Risk Of Developing Ptsd-Like Symptoms In Adulthood, Grace K. Young

Theses and Dissertations

Post-traumatic stress disorder is a stress and trauma based psychological disorder that is defined by the DSM-IV as an anxiety disorder that affects approximately 7.8% of people in the United States. PTSD is when those who suffer a traumatic event have intense and distressing feelings, emotions, and memories for a prolonged period of time after the event. A prominent feature of PTSD is the impaired ability to properly extinguish a fear response after a dangerous trigger or stressor is no longer present, also known as safety learning. Stressors are threats perceived within the environment that activate a response within the …

Challenges Among Latine Daca Recipients And Anxiety: A Systematic Meta-Analytic Review, Isis A. Garcia-Rodriguez

Theses and Dissertations

Immigrant-origin Latine young adults (ILYAs) face a challenge that is specific to their developmental period. As ILYAs transition from high school to beyond (e.g., workforce, college, etc.), they begin to grapple with participating in normative experiences for all young adults in the U.S. (e.g., obtaining a driver’s license, getting their first job at 16). The lives of ILYA, particularly those who are DACAmented or DACA eligible, are characterized by the legal and social contradiction that arises from growing up in the U.S. yet facing barriers to full participation in U.S. society. The nonexistent synthesis of the exponentially growing literature in …

Viral Injection Of Rna Polymerase Ii-Interacting Protein Rprd2 In The Nucleus Accumbens Induces Anxiety-Like Behavior In Mice, Hannah E. Woolard

Theses and Dissertations

Anxiety and its related disorders have become increasingly prevalent as more awareness and acceptance of mental illnesses have come to fruition, especially in the light of the ongoing COVID-19 pandemic. Anxiety can affect anyone regardless of their age, sex, or social status and is currently the most commonly diagnosed mental illness worldwide (Bandelow & Michaelis, 2015). While there are several effective treatments available, the underlying brain mechanisms that cause anxiety are still largely unknown and further research continues to piece together the complex pathophysiology behind this disease. The use of laboratory animal models, such as mice, to induce and observe …

Impact Of The Covid-19 Pandemic On Child Anxiety Symptoms: The Influence Of The Caregiver-Child Relationship, Rebecca Hoppe

Theses and Dissertations

Research suggests that youth are dealing with a myriad of worries during the COVID-19 pandemic (Ellis et al., 2020), which highlights the need for investigations focused on child anxiety. However, to date little research has examined children’s anxiety in the COVID-19 pandemic nor the potential protective effects of the caregiver-child relationship. Therefore, this research aimed to contribute to the literature by investigating the influence of COVID-19 related stressors in younger children and leveraging children’s report of their own attachment security within their relationship with their caregiver and mental health. The current study used a national, quantitative survey of young children …

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 …

Sleep Behaviors And Thoughts As Links Between Social Rhythmicity And Mental Health Outcomes, Sahar Sabet

Theses and Dissertations

Social rhythmicity refers to the regularity with which one engages in social and lifestyle activities. Considerable research has recognized that social rhythms have important implications for health and well-being. For example, disturbances in social rhythms are one potential factor that may contribute to the development of anxiety and depressive disorders. Existing research on social rhythm irregularity has heavily focused on its link with bipolar disorder and, to a lesser extent, with depression. Less is known about the association of social rhythms with anxiety or with subclinical levels of depression. Furthermore, it is unclear how social rhythms are tied to mental …

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 Effect Of Virtual Reality Glasses On The Behavior Of Children With Autism Spectrum Disorder In The Dental Setting, Robert Lunka

Theses and Dissertations

Purpose: The study investigated if viewing a simulated dental exam on virtual reality glasses between two visits would desensitize participants with autism spectrum disorder to the dental environment and improve their anxiety and behavior.

Methods: This randomized prospective cohort study compared behavior between a Control Group and Experimental Group who wore the glasses between visits. Blinded raters watched video recordings of participants and assessed behavior using the Venham scale. Heart rate and post-visit questionnaires completed by guardians were also analyzed.

Results: Five subjects were enrolled (two in the Control and three in the Experimental groups). The median heart rate at …

To Find A Stairwell, Cait Porter

Theses and Dissertations

To Find a Stairwell is an exploration and written supplement to my painted works and how it relates to loss, depression, and compulsive tendencies. Through examples of my own paintings and the research and influences leading my education is an articulate web chronicling two years of work from a focus in abstract painting to a place where representation and abstraction intersect.

Anxiety In Menopause: A Qualitative Inquiry, Eleanor Bremer

Theses and Dissertations

Background: Anxiety is one of the mood symptoms experienced by menopausal women; however, anxiety symptoms during menopause have received little attention in the literature despite the potential impact on quality of life. Many of the tools used to evaluate and measure anxiety associated with menopause assume that menopausal anxiety shares similar criteria as anxiety disorders and this may not be entirely true. There are very few studies that have assessed anxiety in the context of menopause leaving the concept of menopausal anxiety not well defined and raising the question: Is menopausal anxiety a unique and distinctly different syndrome? The purpose …

Anxious?: Re-Designing Women’S Jewelry To Help Manage Symptoms Of Anxiety Disorders, Nourbanu Feras Hijazi

Theses and Dissertations

Anxiety is a common and often stigmatized condition. Destigmatizing mental disorders can positively impact people’s interaction and communication with others and can prompt conversations in which people share their experiences with mental health, leading to improved societal understanding and perception.

My design solution tackles behavioral symptoms of anxiety, specifically two conditions that fall under obsessive-compulsive behavior: Dermatillomania and Trichotillomania. By redesigning women’s jewelry to specialized accessories, my intention is for these objects to help destigmatize these conditions and relieve symptoms of maladaptive behaviors and hurtful impulses. By redirecting these irresistible urges to an external artifact, the objects are designed to …

What Lies Beneath, Meg Wachs

Theses and Dissertations

What is the very first thing you notice about a person? Appearance? What if the first thing you saw was everything that they were trying to hide? We would see every flaw but we would also see every truth. What Lies Beneath is an exploration of interior and exterior and an exposure to the dark and abject inside all of us; the parts we keep hidden and the things that build up until they have no place else to go. Rooted in an examination of the human psyche, my thesis explores the difference between the facade we project to the …

Sticking To The Recipe: How Do Adherence And Differentiation To A Cbt Protocol Affect Client Outcomes In Youths With Anxiety?, Ruben G. Martinez

Theses and Dissertations

Objective: Understanding the pathways through which treatments work to change symptom and diagnostic outcomes is important to the development and delivery of evidence-based treatments. This study assessed the extent to which adherence (therapist’s delivery of prescribed therapeutic interventions) and differentiation (therapist’s delivery of non-prescribed therapeutic interventions) to Coping Cat, a CBT program, affected client symptom and diagnostic outcomes. Method: The Therapy Process Observational Coding System for Child Psychotherapy – Revised Strategies Scale (McLeod et al., 2015) was used to characterize therapeutic interventions delivered within and outside of the Coping Cat program with youths aged 7-15 receiving treatment in one efficacy …

Longitudinal Bidirectional Relations Between Subtypes Of Anxiety And Callous-Unemotional Traits In Early- To Mid-Adolescence, Stephanie A. Hitti

Theses and Dissertations

Callous-Unemotional (CU) traits are characterized by limited empathy, lack of guilt or remorse, and callous use of others. They are a risk factor for adult psychopathy, especially when comorbid with conduct problems. Thus, efforts to identify risk factors and consequences of CU traits have been prominent. One construct that may act as both a risk factor for and consequence of CU traits among youth is anxiety. While the most consistent finding is in this literature is a negative relation between CU traits and anxiety, findings have been mixed. The present study examined bidirectional relations between three subtypes of anxiety (i.e. …

Impact Of Chemotherapy On Nicotine Dependence, Yasmin Alkhlaif

Theses and Dissertations

Although cigarette smoke has been implicated in a causal relationship with various types of cancers, around 62% of all cancer patients are current smokers, recent quitters, or former smokers. While most patients who are smokers are motivated to quit after cancer diagnosis, 25 -30% of these patients continue to smoke. Furthermore, most quitters relapse after 2-3 years of post-chemotherapy. This represents a major health concern since several clinical studies revealed that perpetuation of smoking in cancer populations attenuates patient's well-being and quality of life. Smoking may impair healing, attenuate the efficacy of chemotherapy, increase the disease complications and diminish survival …

Alpha6 Beta2 Subunit Containing Nicotinic Acetylcholine Receptor Contributions To Abuse-Related Effects Of Nicotine And Alcohol, Alexandra M. Stafford

Theses and Dissertations

Pharmacotherapies for tobacco and alcohol cessation are only modestly successful, so it is important to better understand mechanisms underlying their use and abuse. The overarching goal of this research is to assess a6b2 subunit containing nicotinic acetylcholine receptor (a6b2*nAChR; *denotes possible assembly with other subunits) contributions to abuse-related effects of nicotine and alcohol. In the absence of a6b2*nAChR-selective agonists, a6b2*nAChR gain-of-function (a6L9’S) mice provide a tool for selective activation of a6b2*nAChRs. Using the a6L9’S mice together with nicotine doses sub-threshold for stimulation of native nAChRs, these studies tested the hypothesis that activation of a6b2*nAChRs is sufficient to promote neurochemical and …

Synchrony And Concordance: A Multilevel Analysis Of The Effects Of Individual Differences During A Co2 Challenge, Rachel E. Wallace

Theses and Dissertations

Emotion theories posit that emotion systems (e.g., behavior, self-report, physiology) should be related when an emotion is being elicited because this serves an adaptive purpose and allows the individual to respond appropriately to the present situation. Oftentimes, this coherent relationship is not found, and research has hypothesized that the type of analyses used and lack of examination of individual differences could be affecting this relationship. Most studies examine the relationship between emotion systems between-subjects when within-subjects analyses may be more appropriate. The present study examined the relationship between self-reported distress (SUDS) and heart rate, and whether trait differences of anxiety …

Comfort Toys: Coping Tools For Children With An Epileptic Parent, Benjamin Evjen

Theses and Dissertations

When a caregiver suffers from epilepsy, a child can often feel frightened, vulnerable, and alone whenever a seizure occurs. In my thesis project I intend to help children negotiate this struggle with the use of therapeutic toys. Through play, children can navigate feelings that are often overlooked by adults. The visual appeal, simplicity, and materials used in their creation help facilitate comfort through sensory cues. By applying coping mechanisms to deal with stress caused by the passage of time, provide tactile comfort, and equip the child with tools to take action, their emotional needs are met. These toys address an …

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 …

Therapist Adherence To Cognitive Behavioral Therapy For Anxious Youth Across A Case, Julia R. Cox

Theses and Dissertations

The field has developed many evidence-based treatments (EBTs); the integrity of EBTs being delivered, however, has been studied less than rigorously. Because many treatment manuals are developed to be delivered session-by-session, one way to assess treatment adherence, specifically, is across the course of the case: do therapists deliver treatment components in the order prescribed? The goals of this study were to characterize how therapists deviate from prescribed order and how adherence to order relates to child characteristics. Therapy process data were collected from a subsample of children (N = 33, aged 7-15) that received cognitive behavioral therapy (CBT) to address …

Adherence To And Competence In Cognitive Behavioral Therapy For Youth Anxiety: Psychometric Evaluation, Cassidy C. Arnold

Theses and Dissertations

Treatment integrity—the extent to which a treatment is delivered as it was intended—has long been recognized as critically important in treatment evaluation research, but has garnered increased attention in recent years within the context of dissemination and implementation science. However, the field’s development has been hindered by inadequate measurement tools. This project is focused on developing and evaluating the psychometric strength of two measures of treatment integrity. To evaluate the psychometric strength of the Cognitive-Behavioral Therapy for Youth Anxiety Therapist Adherence Scale (CBAY-A)and the Cognitive-Behavioral Therapy for Youth Anxiety Therapist Competence Scale (CBAY-C), 954 psychotherapy sessions from two treatment evaluation …

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 …

Beta 2 Nicotinic Acetylcholine Receptor Contributions To Anxiety-Like Behavior, Shawn Anderson

Theses and Dissertations

Nicotine is a major psychoactive ingredient in tobacco that is thought to promote smoking behavior via nicotinic acetylcholine receptors (nAChRs) in the brain. Given reports that people smoke to relieve anxiety and that anxiety precipitates relapse, the overarching goal of this dissertation research is to assess beta 2 subunit containing nAChR (beta2*nAChR) contributions to anxiety-like behavior. Nicotine’s activity at beta2*nAChRs is concentration-dependent, with high concentrations facilitating activation followed by rapid desensitization and low concentrations preferentially desensitizing beta2*nAChRs; hence, activation or inhibition of beta2*nAChRs may support smoking behavior. Rodent studies reveal that nicotine affects anxiety-like behavior dose-dependently: low doses promote anxiolysis- …

Genetic Dissection Of Quantitative Trait Loci For Substances Of Abuse, Jo Lynne Harenza

Theses and Dissertations

It has been reported that an individual’s initial level of response to a drug might be predictive of his or her future risk of becoming dependent, thus basal gene expression profiles underlying those drug responses may be informative for both predicting addiction susceptibility and determining targets for intervention. This dissertation research aims to elucidate genetic risk factors underlying acute alcohol and nicotine dependence phenotypes using mouse genetic models of addiction. Phenotyping, brain region-specific mRNA expression profiling, and genetic mapping of a recombinant inbred panel of over 25 mouse strains were performed in order to identify quantitative trait loci (QTL) harboring …

Visual Attention Bias And Body Dissatisfaction In Eating Disorders, Janet Lydecker

Theses and Dissertations

Eating disorders, such as anorexia and bulimia nervosa, have profound negative effects on the quality of life of both affected individuals and their families. Behavioral approaches such as cognitive-behavioral therapy (CBT) are commonly used for the treatment of these disorders. CBT teaches skills to restructure maladaptive thought patterns as a method of altering feelings and behaviors. However, even after CBT, 50-70% of women with bulimia and 67-87% of women with anorexia report continued eating disordered thoughts, feelings and behaviors. Measuring underlying cognitive processes such as orienting, maintaining, and executive attention in individuals with eating disorder symptomatology might be an important …

On The Genetic And Environmental Associations Between Body Composition, Depression Symptoms And Smoking Behavior., Roseann Peterson

Theses and Dissertations

Obesity is a serious public health crisis and recent estimates of its incidence are the highest in United States history, with 35% and 17% of American adults and children affected, respectively. The clinical definition of adult obesity is operationalized as a body mass index (BMI) greater than 30 kg/m2. Although the prevalence of common obesity has increased dramatically over the past 30 years–largely thought to be due to changes in the environment, such as high calorie diets and sedentary lifestyles—twin and family studies have shown consistently that relative body weight is under considerable genetic influence in both children and adults, …

Symptom Clusters In Lung Cancer Patients, Debra Rattican

Theses and Dissertations

SYMPTOM CLUSTERS IN LUNG CANCER PATIENTS By Debra Rattican, PhD, RN A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2012 Major Director: Debra E. Lyon, PhD. Professor and Chair Family and Community Health Nursing The purpose of the study was to examine selected relationships among symptoms common to individuals with lung cancer. The specific aims were: 1) To examine the relationship between the symptoms of dyspnea and anxiety in patients with lung cancer. 2) To examine the relationships among the symptoms of dyspnea, anxiety, and …