Digital Commons Network^™

Kaleidoscope Wellness | Destigmatizing Mental Health For Teens By Design, Rhode L. Baptiste

Theses and Dissertations

Motivation

Mental health is a global public health crisis. (Marcus et. al, 2012; WHO, 2020). Although there is a growing acceptance of the complexities surrounding mental illness, care delivery for adolescents with mental health concerns remains highly stigmatized, which contributes to delays in care (Hoisington et. al, 2019; Burns & Birrell, 2014). Half of all mental illnesses can be detected prior to the age of 14 (National Alliance for Mental Health, 2020). While research exploring how the physical health care environment impacts health and well-being for patients has evolved immensely over the past two decades, research on how facility design …

Alcohol Use Subgroups Among Rural Middle School Students: The Impact Of Community Violence Exposure, Courtney B. Dunn

Theses and Dissertations

A substantial portion of early adolescents initiate alcohol use. This represents a significant public health concern due to its association with a variety of adverse consequences. Although person-centered analytic approaches such as latent class analysis have been used to describe heterogeneity in adolescents’ alcohol use, most prior studies have focused on high school or older samples. This may obscure patterns of alcohol use that emerge during early adolescence. The current study identified and described subgroups of adolescents based on their alcohol use in a racially diverse sample of rural middle school students. Because research and theory indicate that exposure to …

E-Cigarette Use And Perceptions Among Adolescents With Attention-Deficit/Hyperactivity Disorder: The Role Of Parental Messages About Tobacco, Mayra S. Ramos

Theses and Dissertations

Adolescents with attention-deficit/hyperactivity disorder (ADHD) are at increased risk of using e-cigarettes compared to their neurotypical peers. Parent-adolescent communication about tobacco use and number of ADHD symptoms can influence adolescents’ perceptions of e-cigarettes and their e-cigarette use. Adolescents with ADHD (n = 80) completed questionnaires assessing parental messages about tobacco use; e-cigarette harm perceptions; susceptibility to use e-cigarettes; and e-cigarette use. Parents reported on messages about tobacco use, adolescent’s ADHD symptomatology, and completed demographic questionnaires. Twenty-percent of adolescents reported e-cigarette ever use. Adolescent girls were significantly more likely to report higher e-cigarette harm perceptions than boys. Parents reported providing messages …

The Influence Of Peers On Adolescents' Physical Aggression: The Moderating Roles Of Parental Messages Supporting Fighting And Nonviolence, Jasmine Coleman

Theses and Dissertations

There is substantial support for the link between peer factors and adolescents’ aggression. Less is known about protective factors that may mitigate the relation between peer factors and aggression. Parental influences, such as parental messaging supporting fighting, have been directly associated with aggression. What remains unclear is the extent to which parental messages supporting fighting and nonviolence might serve as protective factors in relations between negative peer interactions and aggressive behavior. The purpose of this study was to investigate longitudinal effects of peerson adolescents’ physical aggression and to examine the extent to which parental messages supporting fighting and nonviolence moderated …

Social Capital And The Higher Education Academic Achievement Of American Students: A Cross-Classified Multilevel Model Approach To Understanding The Impact Of Society On Educational Outcomes, Olubowale Emiola Oyefuga

Theses and Dissertations

In recent years, especially after the publication in 2000 of Robert Putnam’s book Bowling Alone: The Collapse and Revival of American Society, there has been a heightened interest in the concept of social capital. Many scholars have made the connection between social capital and education by examining its effects on educational outcomes. However, a lot still needs to be understood. The aim of this dissertation is to provide a better understanding of the influence of social capital on the higher education academic achievement of American students. Using data from Waves I, II, and IV of the National Longitudinal Study …

The Impact Of Social Determinants Of Health On The Efficacy Of School-Based Interventions For Adolescents With Adhd, Cathrin D. Green

Theses and Dissertations

Adolescents with Attention-deficit/hyperactivity disorder (ADHD) often experience impairment in academic functioning in the school and home environment. Because of this, many school- and clinic-based interventions have been developed to target these problems. Initially, clinic-based interventions were mainly used; however, these interventions were associated with many barriers to care, such as lack of transportation, financial resources, and time. Therefore, school-based interventions were developed to address these barriers. However, there has been minimal research evaluating the role of social determinants of health on the efficacy of school-based interventions. In a sample of 222 adolescents with ADHD randomly assigned to receive either a …

Effects Of Cumulative Risk On Asthma Outcomes In Urban Children And Adolescents, Samantha A. Miadich

Theses and Dissertations

Pediatric asthma disproportionately affects racial/ethnic minority children and children living in low-income, urban areas. Many families living in low-income, urban areas experience a number of stressors that can place children/adolescents at risk for worse asthma outcomes. This study examined the impact of a cumulative risk model of stressors (e.g., ED visits, quick-relief medication use, lung function, asthma control, QOL) in urban children (7-12 years) with persistent asthma. This study further aimed to examine both the original cumulative risk model and an adolescent-specific cumulative risk model as predictors of asthma outcomes in a sample of 60 adolescents (13-17 years). Asthma-related caregiver …

Building A Bond: Longitudinal Relations Between Interpersonal School Climate, Student Awareness And Reporting Of Violence, And Peer Victimization And Aggression In Adolescents, Kathryn Behrhorst

Theses and Dissertations

High prevalence rates and negative outcomes of peer-based aggression and victimization during early adolescence underscore the need to identify causes and consequences of these outcomes. Limited research has examined the impact of environmental and contextual factors, such as school climate, on peer aggression and victimization. Few studies have addressed relations between school climate and specific subtypes of physical and relational aggression and victimization. Although school climate has been assessed via interpersonal subsystems (i.e., student-student and student-teacher relationships), little research has incorporated the role of student awareness and reporting of violence and safety concerns. Further, studies are needed that consider the …

An Examination Of The Technical And Relational Hypotheses Of Motivational Interviewing In A Sample Of African American Adolescent Girls Seeking Obesity Treatment, Rachel L. Boutte

Theses and Dissertations

Adolescent obesity has increased exponentially over the past three decades in the United States. In response, behavioral interventions have been developed and implemented to address this epidemic; however, treatment adherence is often suboptimal. Motivational interviewing (MI) is a directive, person centered approach to reducing patient ambivalence about change, which has been shown to increase engagement in obesity interventions. The current study investigated the underlying process of MI by exploring two different, but related pathways that explain how change happens (e.g., the technical and relational hypotheses) in the context of a multidisciplinary obesity intervention with African American adolescent girls (N …

Identifying Profiles Of Resilience Among A High-Risk Adolescent Population, Anna W. Wright

Theses and Dissertations

The purpose of the present study was to determine whether distinct patterns of adolescent adjustment existed when four domains of functioning were considered. The study included a sample of 299 high-risk urban adolescents, predominantly African American, ages 9-16 and their maternal caregivers. Cluster analysis was used to identify patterns of adjustment. Logistic regression analyses were used to explore whether variations in levels of five theoretically and empirically supported protective factors predicted cluster membership. A four-cluster model was determined to best fit the data. Higher rates of goal directedness and anger regulation coping predicted membership within the highest functioning cluster over …

Examining Genetic And Environmental Influences On Alcohol Use And Externalizing Behaviors In African American Adolescents, Neeru Goyal

Theses and Dissertations

The aim of this thesis is to expand our understanding of the etiology of alcohol misuse and related disorders in African Americans using genetically informative study designs. Specifically, we take advantage of the candidate-gene approach and polygenic score analysis to extend the literature specific to African American populations. Chapter 2 explores gene x environment (GxE) interactions through the candidate gene approach to explore the relationship between two genes chosen on their potential relevance to stress response and adolescent alcohol use and misuse, among African American youth living in highly impoverished neighborhoods, as moderated by stressful life events. Chapter 3 implements …

Positive Illusory Bias In Adolescents With Adhd: Prevalence, Stability, And Accuracy Of Reporters, Elizaveta Bourchtein

Theses and Dissertations

The positive illusory bias (PIB) – over-reporting levels of self-competence compared to other raters – has been demonstrated in youth with attention-deficit/hyperactivity disorder (ADHD), despite increased impairment rates. However, due to inconsistent definitions of the PIB, conflicting findings have emerged regarding prevalence of the PIB in youth with ADHD and whether parent or child report is actually “biased” and driving the PIB. Additionally, stability of the PIB across time is unknown. The present study used person-centered methodology cross-sectionally and longitudinally to evaluate the prevalence of the PIB in adolescents with ADHD. Results revealed a cross-domain global PIB group at baseline …

Stakeholder Views On Behavioral Health Care In The Pediatric Primary Care Setting: A Qualitative Approach Towards Integration Of Care, Alexis Quinoy

Theses and Dissertations

The pediatric primary care setting has been discussed as playing a central role for the identification and treatment of behavioral and mental health disorders in youth. Although this setting is in a unique position to provide these services, there are many barriers to the integration of mental health care and pediatric primary care. The aim of this study is to examine perspectives of multiple stakeholders (i.e., patient, parent, nurse, resident, faculty, clinic director) in a pediatric primary care setting to explore barriers, behavioral and mental health needs, and facilitators to the integration and provision of mental health care for children …

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 …

The Relation Between Peer Victimization And Changes In Trauma Symptoms In Adolescents, Anh-Thuy H. Le

Theses and Dissertations

Peer victimization has been shown to negatively impact youth functioning and may be especially damaging during adolescence, given the increased importance of peers. However, there is a dearth of longitudinal research examining trauma symptomatology as an outcome of peer victimization with low-income, ethnic minority adolescents. The present study investigated this relation in a predominantly African American sample of 684 students assessed at five time points between the fall of their sixth grade and seventh grade school years. Growth mixture models grouped participants with similar victimization trajectories, and latent growth models related growth trajectories of physical and relational victimization to changes …

“Cause That’S The Only Skills In School You Need” A Qualitative Analysis Of Revenge Goals In Poor Urban Youth, Lena Janina Jäggi

Theses and Dissertations

Ample research shows that revenge goals are correlated with maladjustment and retaliation is an important factor driving youth violence. Still, in environments with limited institutionalized interventions revenge might be an indispensable tool to maintain social equilibrium. This qualitative secondary analysis of 50 (30 Boys) revenge scenarios from a larger longitudinal study (N=358 dyads of youth/maternal caregiver) expands existing one-dimensional knowledge of revenge from closed-answer vignettes to the rich real world experience of 10-16 year old youth from an urban community sample. Key findings showed significant qualitative differences in both cognition and emotions of revenge scenarios. Ten distinct patterns emerged and …

The Relation Between Patterns Of Beliefs About Fighting And Social Information-Processing: Differences In Cognitions, Goals, And The Response-Decision Process In Adolescents, Denicia Titchner

Theses and Dissertations

Beliefs about aggression play a key role in how youth interpret and respond to social situations and are related to aggressive behavior. Adolescents may report beliefs supporting aggression and engage in aggression due to reinforcement within their environment, rather than due to maladaptive social information-processing (SIP) biases. The purpose of this study was to examine adolescents’ patterns of beliefs about aggression and how these patterns relate to SIP. This study used latent class analysis (LCA), the Articulated Thoughts in Simulated Situations paradigm, and a Problem Solving Interview to examine differences in SIP between adolescents with varying patterns of beliefs about …

Guilt, Blame, And Responsibility: The Experiences Of Parents And Clinicians Providing Services To Adolescents With Co-Occurring Mental Health And Substance Abuse Challenges, Katherine Cohen-Filipic

Theses and Dissertations

The purpose of this study is to understand and describe the experiences of parents of, and clinicians who provide services to, adolescents with co-occurring mental health and substance use challenges, particularly as they relate to issues of guilt, blame, and responsibility. The study is based in a theoretical framework derived from Symbolic Interactionism (Blumer, 1969), Attribution Theory (Heider, 1958), and Barrett`s (1995) Theory of Guilt and Shame. The guiding question the study is: What are the experiences of parents of adolescents with co-occurring mental health and substance abuse challenges and clinicians who provide treatment services around issues of blame, guilt, …

Association Of Family Structure And Glycemic Control In Adolescents With Type 1 Diabetes: Risk And Protective Factors, Laura Jean Caccavale

Theses and Dissertations

Youth with type 1 diabetes (T1D) from single-parent families are more likely to be in poorer glycemic control (HbA1c). Demographic trends indicate more households are composed of unmarried adults and fewer youths. Family density, or a youth: adult ratio, may be a more salient factor than single-parent status in the association with glycemic control. Data from 257 adolescents aged 11-14 years (M = 12.84) at two different sites were collected as part of a randomized control trial of a treatment intervention designed to increase parent involvement and prevent deterioration of adolescent diabetes disease care. Single-parent status was determined by parental …

Adolescent Girls' Experience Of Binge And Loss Of Control Eating, Allison Palmberg

Theses and Dissertations

The current investigation used qualitative methodology to examine adolescent girls’ perceptions of control over their eating, as well as triggers, and consequences of binge and related eating behaviors. Focus groups were completed with 19 adolescent girls (aged 13-17, 58% African American, 41% White) who endorsed the behaviors. Responses to focus group questions were qualitatively analyzed using a grounded theory approach and constant comparison coding. Results reflected a fundamental lack of awareness of the loss of control (LOC) eating behaviors. Yet, the data did reflect a central theme of the need to affirm independence and autonomy through eating behaviors via three …

Adjustment Of Families With Children Adopted From Eastern Europe, Maria Kuznetsova

Theses and Dissertations

The purpose of this study was to examine the adjustment of older children and adolescents adopted from Eastern Europe and the impact of their preadoption history and family’s functioning on their adjustment. This is a follow-up study of families first surveyed in 2005 with an addition of new families. One hundred and forty-five families reporting on 194 adopted children (9 to 19 years; 104 girls) participated in this study at Time 2. The project was conducted as an internet-based survey. Parents and adopted children reported on children’s emotional, behavioral and social problems (CBCL and YSR), as well as family environment …

Managing The Healthcare Needs Of Adolescents With Autism Spectrum Disorder: The Parents' Experience, Julie Strunk

Theses and Dissertations

The purpose of this phenomenological study was to describe the experiences of parents who manage the health needs of an adolescent with Autism Spectrum Disorder (ASD). Qualitative interviews were conducted with parents from 10 families of adolescents with ASD residing in Virginia. Data were analyzed using Clark Moustakas’ method of analysis of data in which the phenomenologist asks the following questions: What are the individual’s experiences, and in what context did they experience them? This study maximized credibility by using three strategies: prolonged engagement, peer debriefing, and member checking. “Parents needing help” emerged as the essence of the parents’ experiences. …

Program Approach For Childheaded Households In Zambia, Samson Chama

Theses and Dissertations

Using an emergent design, this study developed a program approach for young people in the child headed households of Zambia. Phase I dealt with prior ethnography, Phase II focused on independent living services, and Phase III concerned translation to Zambia. A total of 36 participants from Richmond, consisting of 20 Richmond Department of Social Services workers and youth and 16 Africans, were recruited. Three major themes emerged: feasibility, content, and quality. Lessons learned about translational research highlight the need for uniformity in a cultural screen’s composition. This might enhance the richness of perspectives on young people. Lessons for the Department …

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 …