Digital Commons Network^™

Developing And Testing A Model Of Discrimination, Internalized Oppression, Mental Health, And Suicidality In Disabled Transgender And Gender Non-Binary (Tgnb) Individuals, Stephanie L. Cull

Theses and Dissertations

Transgender and gender nonbinary (TGNB) individuals experience high rates of discrimination and microaggressions that can lead to internalized cisgenderism and adverse mental health outcomes such as depression, anxiety, and suicidality. Individuals with disabilities similarly experience high rates of discrimination and microaggressions that can lead to internalized ableism and increased adverse mental health outcomes. Although both of these populations have been researched separately, very little extant research has explored the intersections of disabled and TGNB identities. The purpose of this study was to explore a hypothesized pathway leading from microaggressions through internalized oppression and mental health to suicidal ideation within a …

“Black Wom(B)Anhood”: An Explorative Analysis Of Black Women's Narratives Of Healthcare Encounters During And After Pregnancy, Janae A. Baker

Theses and Dissertations

This qualitative study explores the intricate dynamics of patient-provider relationships within the context of prenatal care among Black women and how these experiences may affect their perinatal mental health. The study was conducted using a methodology consisting of structured interviews with 12 participants, snowball sampling facilitated recruitment. Thematic analysis revealed six prominent themes encapsulating the multifaceted interactions between Black women and their healthcare providers during the perinatal period. The findings illuminate nuanced aspects of the patient-provider relationship, shedding light on issues such as: (a) Anticipation of Low Quality Care, (b) Lack of Communication, (c) Listening, (d) Stereotype Threat, (e) Colorism, …

Profiles Of Family Functioning In Pediatric Hematology-Oncology Patients: Longitudinal Associations With Child Well-Being, Sydney Sumrall

Theses and Dissertations

This study aims to assess 1) patterns of family functioning and 2) longitudinal associations between family functioning patterns and well-being in a vulnerable cohort of children with chronic illness. Caregivers of hematology (16.4%) and oncology (83.6%) patients ages 7-20 (N=55; M_age = 13.3 [SD = 2.7]; 52.7% female; 45.5% non-Latinx White, 38.2% Black or African American, 12.7% Latinx, 1.8% Asian, and 1.8% multi-racial,) reported on family functioning via the Family Assessment Device. Cluster analyses identified three mutually exclusive clusters: one high adaptive group, one moderate adaptive group, and one maladaptive group. Group membership was not significantly …

Sleep And Health Behaviors In A Safety-Net Primary Care Setting, Sahar Sabet

Theses and Dissertations

Nearly half of all premature deaths in the United States are attributable to preventable and modifiable health risk behaviors. For decades, the leading behavioral health contributors to morbidity and mortality are tobacco use, physical inactivity, and alcohol consumption. Medication adherence is a relatively less studied yet critical interrelated health behavior that is tied to health and treatment outcomes. Sleep, an important pillar of health, is a daily and modifiable behavior that shows promise as a health behavior facilitator. Better understanding the dynamics of these modifiable health behaviors is essential for the improvement of health promotion, particularly among underserved populations (e.g., …

Community On Campus: Examining The Impact Of Campus Climate, Belonging, And Flourishing On Bystander Behavior Among Diverse University Students, Amelia Liadis

Theses and Dissertations

This exploratory, nonexperimental study aimed to investigate the relationships among diverse undergraduate and graduate students’ perceived campus climate, flourishing, and university belonging on bystander intentions and bystander behaviors during the COVID-19 pandemic. The study’s theoretical framework combined the Theory of Planned Behavior and feminist theory, and examined intersectionality through an Identity Risk Index. Data used in the current study were originally collected as part of an institutional Healthy Minds Survey, on health behaviors of college students; responses from n = 171 of the randomly selected participants were used in the current study’s analyses. The majority of participants indicated at least …

Culturally Relevant Coping Strategies Within Bicultural Latine College Students In The Face Of Anti-Immigrant Sentiment And Policy, Cindy M. Hernandez

Theses and Dissertations

Despite their protective potential against anti-immigrant sentiment and policy, the connections between bicultural identity development and culturally relevant coping among temporarily documented Latinx college students remain unstudied. Therefore, this study (a) describes culturally relevant coping strategies used by bicultural Latinx college students, (b) examines the role cultural identity plays in bicultural Latinx college students’ coping strategies, and (c) illuminates the role institutional level systems play in liminally-documented college students’ coping with anti-immigrant sentiment and policy. Participants in this study included 16 Latine college students (M_age = 21.19, SD = 3.21) with DACA (n = 14) or TPS (n = …

Supporting The Mental Health Of Black Students: A Framework For Comprehensive School-Based Mental Health Systems, Shenita Williams

Theses and Dissertations

School-based mental health is plagued with two primary challenges: (a) design and (b) service delivery. The design of school-based mental health is often comprised of fragmented, individual programs and services, and the delivery of mental-health services and support are culturally insensitive. The purpose of this Delphi study, grounded in African-centered thought (Afrocentricity), was to identify essential components of a comprehensive school-based mental-health system necessary to adequately address and support the mental health of Black students in K–12 public school settings. Through the cultural lens of Black experts, the needs of Black students along a continuum of mental health was highlighted. …

Racism Experiences And Mental Health: An Examination Of Direct, Vicarious, And Appropriated Racism Experiences On Mental Health Symptom Expression, Christina Barnett

Theses and Dissertations

The current study aimed to corroborate existing models of racism-related experiences by creating an explanatory model that operationalized direct, vicarious, and appropriated racism experiences. This study explored whether the factors of direct and vicarious racism experiences influenced mental health outcomes via appropriated racism experiences in a sample of Black women. This association was not present. However, results showed a positive association between vicarious and direct racism experiences, as well as predictive relations between direct and vicarious racism experiences and depression and trauma symptoms. Results, limitations, implications, and recommendations for future research are included.

Keywords: vicarious racism, appropriated racism, direct racism, …

Sleep Self-Efficacy, Loneliness, And Physical Activity: Assessing The Pathways Between Sleep Quality And Mental Health Using Structural Equation Modeling, Amber M. Fox

Theses and Dissertations

Although there is robust empirical support that poor sleep contributes to declines in mental health, explanations of this relationship remain unclear. The purpose of the present study was to examine the pattern of associations between sleep quality, sleep self-efficacy, loneliness, physical activity, and mental health among U.S. adults across the lifespan, and whether they differed by gender or age group. A structural equation model with invariance analysis was developed and examined data from 2,300 adults (M_age = 44.1, SD = 16.78) participating in the online study Investigating Sleep Longitudinally Across Normal Development (ISLAND). Sleep quality was measured by …

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.

The Role Of Community Belongingness In The Mental Health And Well-Being Of Black Lgbtq Adults, Keith Justin Watts

Theses and Dissertations

The impact of racial and sexual minority stigma, prejudice, and discrimination on the mental health and well-being of Black and LGBTQ individuals, respectively, has been well documented in the literature. Research on these relationships for Black LGBTQ individuals who are multiply marginalized due to their position at the social intersections of gender identity, sexual orientation, and race/ethnicity is less common. Belongingness to identity-based communities can protect against the negative impact of these minority stressors for Black and LGBTQ individuals and aid coping processes. However, Black LGBTQ individuals often experience stigma and discrimination in their racial, sexual, and gender minority communities …

Access To Behavioral Health Services: Supply, Coverage, And Health Insurance Literacy, Heather Saunders

Theses and Dissertations

This dissertation examines policy and individual barriers to behavioral health (BH) service utilization. The full reach of federal policies like the Affordable Care Act (ACA) and the Comprehensive Addiction and Recovery Act (CARA) may be limited by state policies and the supply of the workforce available to deliver these services. Further, individual factors, such as low health insurance literacy, may influence patterns of behavioral healthcare utilization. Despite efforts to increase access to behavioral health services, treatment rates remain low, suggesting that barriers remain. To explore the effectiveness of these policies and examine remaining barriers, this dissertation explores three main research …

Modeling Substance Use And Mental Disorder Comorbidity Using Latent Variable And Network Approaches, Courtney T. Blondino

Theses and Dissertations

Introduction. Substance use disorder (SUD) is a common condition that affects millions of Americans. Addressing SUD has been complicated by comorbid mental disorders and co-occurring substance use. Consequently, detailing and addressing SUD and comorbid SUD represent an important goal to improve the health of Americans.

Objective. The research goal of this dissertation was to characterize the comorbidity between substance use, including tobacco use, and mental disorder symptoms measured as negative affect and externalizing symptoms in a population-based sample using latent variable and network approaches.

Methods. Waves 1 – 3 from the Population Assessment of Tobacco and Health Study were used. …

Strengthening Mental Health Diagnostic Detection In Integrated Primary Care, Julia Brechbiel

Theses and Dissertations

Primary care behavioral health (PCBH) is crucial for providing mental health treatment to underserved, minority, and uninsured populations. There is a lack of knowledge about accurate mental health diagnoses at PCBH. Underdetection of mental health symptoms has the potential to worsen racial and socioeconomic disparities. Using an expert review process, I developed an abbreviated diagnostic clinical interview (ADCI) for integrated primary care. Next, patients (N = 82) completed the interview after attending PCBH appointments. According to the interview, 63.4% of participants met criteria for a diagnosis, while 64.7% received a diagnosis from their provider. A large portion of patients …

Interpersonal Trauma And Mental Health Among Lgbq+ College Students: Examining Social Support And Trauma-Related Drinking As Mediators, Eryn Delaney

Theses and Dissertations

Despite the increased risk of childhood, adulthood, and lifetime interpersonal trauma among LGBQ+ individuals, existing research that has examined the influence of interpersonal trauma on mental health has primarily focused on LGBQ+ adolescents and samples of LGBQ+ community-based adults, and less on LGBQ+ emerging adults in college. Additionally, limited work has focused on mechanisms that might explain the relations between these variables. Thus, the current study tested the relations between interpersonal trauma (i.e., childhood sexual abuse, adulthood sexual victimization, and lifetime physical assault and IPV) and mental health outcomes (i.e., anxiety symptoms, depressive symptoms, and PTSD symptoms), and examined social …

The Student Experience Of Higher Education During The Covid-19 Pandemic: How Class And Race Shape Socially Distanced Learning At A Public University, Alice M. Quach

Theses and Dissertations

While prior research has examined trends toward growing uncertainty and precarity for young adults within the economy and higher education, the COVID-19 pandemic appears to be exacerbating these existing inequalities and risks. Drawing from 30 semi-structured in-depth interviews with college students at a large Southern and urban public university, this study examines how the COVID-19 pandemic is affecting students’ learning experiences, and how those experiences are differentially shaped, in turn, by their class and race. This exploratory research illuminates our understanding of the multiple mechanisms by which the COVID-19 pandemic is shaping existing inequalities in the higher education system, mostly …

Reducing Disparities In Smoking For Adults With Mental Illness: Are U.S. Tobacco Prevention Policies Effective?, L. Morgan Snell

Theses and Dissertations

One in five people in the U.S. are estimated to experience “any mental illness” (AMI); however this group represents an estimated 40% of the annual, adult cigarette consumption in the U.S. Tobacco prevention policies have been successful at reducing smoking prevalence among the U.S. population as a whole, however it is unclear whether these efforts have had significant impact on tobacco use rates among individuals with AMI. The three papers that comprise this project combined longitudinal, nationally-representative data and online behavioral experiments from U.S. adults to compare demand for cigarettes among adult smokers with and without AMI. Taken together, our …

“Is Therapy For Me?” Perceptions Of Therapy Inclusivity And Willingness To Seek Help Among Black Emerging Adults, Randl B. Dent

Theses and Dissertations

Mental health issues are prevalent among Black emerging adults; however, they tend to underutilize mental healthcare services. The goals of the current study were to examine whether: (1) perceived therapy inclusivity would predict willingness to utilize mental healthcare services and (2) the relationship between perceived therapy inclusivity and willingness would be moderated by two indices of racial identity (i.e., centrality and private regard). Results provide evidence that greater perceptions of therapy inclusivity are associated with greater willingness to seek mental health services even after controlling for factors, such as gender, self-stigma, and previous mental healthcare utilization. Additionally, there was no …

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 …

The Intersection Of Social Stress, Mental Well-Being, And Sexual Health Among Black Women In Emerging Adulthood, Brandi Galloway

Theses and Dissertations

With an estimated 37,000 new HIV infections each year, HIV continues to be a major public health concern. HIV affects some populations more than others. Young Black women, in particular, are disproportionately affected by HIV. While being a woman does not typically increase a person’s HIV risk, being Black and being a woman does.

Data indicate that individual-level factors do not fully address the differences in HIV and STIs between Black emerging adult women and their White counterparts. Thus, it is critical to better understand contextual factors such as social stress and mental-wellbeing which might better account for these disparities. …

A Phenomenological Study Of Nonbinary Resilience And Mental Health, Calvin J. Hall Iii

Theses and Dissertations

Nonbinary individuals, or those who do not exclusively identify with a male or female gender, have gained increasing recognition and representation within the past ten years. Despite these steps forward, nonbinary individuals still experience higher rates of sexual assault, police brutality/harassment, job-related discrimination, and erasure when compared to binary transgender individuals, or gender-diverse individuals who exclusively identify as male or female. These disparities in violence, discriminatory practices, and erasure have been linked to exceptionally high rates of depression and anxiety in nonbinary people within the U.S. Thus, efforts to improve nonbinary mental health are critically needed. Previous research finds that …

Analysis Of Stigmatic Content In State Mental Health Legislative Proposals, David L. Conley

Theses and Dissertations

Despite the proven effectiveness of mental health interventions, services remain limited across the country. Social workers have repeatedly advocated for increased funding, but mental healthcare gaps persist. Disparities could be addressed through the policy process, but critical proposals often do not pass. One of the biggest barriers is the concept of stigma, which could extend into legislatures and influence mental health-related policy outcomes as a form of structural stigma. Factors that influence legislator voting behavior are found in the literature, but studies have not explicitly focused on structural stigma or mental health-specific policy outcomes. Thus, the present study aimed to …

Identifying Targets For Quality Improvement In A Community Child Mental Health Agency, Natalie K. Finn

Theses and Dissertations

The implementation of evidence-based practices has great potential to improve the quality of children’s services; however, with a large variety of available practices, it can be challenging to select targets for quality improvement in community-based treatment. This study used a method called relevance mapping to identify how thoroughly evidence-based programs could cover a specific population of children seeking services at a large public agency and identify practice elements relevant to these clients. A therapist survey was used to examine current practice at the agency. Eight therapists at the agency reported on their practice delivery for 141 clients. Results from relevance …

Racism, Healthcare Provider Trust, And Medication Adherence Among Black Patients In Safety-Net Primary Care: A Strength-Based Approach, Mickeal Pugh Jr

Theses and Dissertations

Integrated primary care has been incorporated into a variety of healthcare settings. The benefits of these services are empirically supported by a plethora of studies, which highlight the integration of behavioral and physical healthcare to be beneficial for both patient and healthcare providers. Integrated care models are typically incorporated in Veterans Affairs hospitals, general primary care facilities, and community clinics. Community-based clinics, such as safety-net clinics, typically serve underrepresented populations, and research has shown several mental and physical health disparities to exist among minority populations. Further, the minority stress model posits that distal and proximal minority-based stress processes can result …

From Sunrise To Sunset: A Lifespan Approach To Understanding The Mental Health Of A Subset Of American Farmers, Janna L. Imel

Theses and Dissertations

Prior research has indicated higher risk of suicide for farmers and identified depression and anxiety as mental health concerns, though the majority of research was conducted in the 1980s-1990s. In today’s economic, social, and political climate, farmers are exposed to situations and stressors reminiscent of the 1980s Farm Crisis. An added risk is the aging workforce of farmers, as age-related conditions can make farming even riskier. This study investigated the mental health of a subset of American farmers by exploring farm-related stressors, coping mechanisms, and mental health outcomes. Dispositional mindfulness was explored as a specific coping mechanism. Participants (N …

Translational Insights Into The Genetic Etiology Of Mental Health Disorders: Examining Risk Factor Models, Neuroimaging, And Current Dissemination Practices, Jessica L. Bourdon

Theses and Dissertations

Psychiatric genetics is a basic science field that has potential for practical application and effective translation. To date, translational frameworks utilized by this field have been linear (e.g., sequential) in nature, focusing on molecular genetic information. It is proposed that non-linear (e.g., socio-ecological) frameworks are a better way to immediately translate non-molecular genetic information. This dissertation explored the translation of psychiatric genetic information in two ways. First, a survey was sent to academic stakeholders to assess the state of the science regarding the translation of genetic information to the clinical care of mental health disorders. Findings from this indicate a …

Mental Health Difficulties And Service Use Of Incarcerated Women: The Influence Of Violence Perpetration And Victimization, Rachel C. Casey

Theses and Dissertations

The present study aimed to expand the knowledge base regarding incarcerated women’s experiences with violence and their mental health with the goal of identifying avenues for more tailored, compassionate responses to their mental health difficulties in both macro and direct practice contexts. To achieve this aim, a secondary data analysis was performed using data from the Survey of Inmates in State Correctional Facilities (SISCF) completed by the Bureau of Justice Statistics (BJS) in 2004. Six research questions pertaining to women’s experiences with violence and their mental health difficulties and service utilization guided the inquiry, which involved univariate, bivariate, and multivariate …

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 …

The Role Of Afrocentric Features In Mental Healthcare Utilization And Counselor Preferences In Black College Students, Randl B. Dent

Theses and Dissertations

Though mental health issues are prevalent in Black young adults, they underutilize mental healthcare services. This research examined the role of feature-based discrimination in mental healthcare (under)utilization. Study 1, a secondary analysis of the National Longitudinal Study of Adolescent to Adult Health, provided no evidence supporting a link between skin tone and mental healthcare utilization, when controlling for depression diagnosis. However, when controlling for depression symptoms, there was a trend such that Black young adults with darker, as opposed to lighter, skin tone utilized healthcare less. Study 2, an experimental study with 33 Black college students, showed 73% of the …

Lived Experiences Of School Counselors Who Address Mental Health Needs Through Evidenced-Based Educational Programs, Kelley Yvette Olds

Theses and Dissertations

The purpose of this phenomenological qualitative study was to explore the lived experiences of school counselors who address the mental health needs of students through at least one of the following educational evidenced-based programs: Positive Behavior Intervention and Supports, Response to Intervention, Restorative Practices, and Student Assistance Program. EBPs have evolved as a staple of quality educational programming with a focus on best practices, data, and accountability. Over the past several decades, school counselors have struggled to demonstrate efficiency, accountability, and transparency consistently in counseling outcomes (Generali, Foss-Kelly, & McNamara, 2013). Recent literature in school counseling embraces the movement toward …