Medicine and Health Sciences Commons^™

Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard

Doctoral Dissertations

Background – Obstetric fistula is a childbirth injury caused by prolonged labor that leads to stillbirth and incontinence, spurring social exclusion and isolation. These layers of trauma put women with fistula at great risk for psychological suffering, which has profound negative socioeconomic impacts on them, their families, and communities. This study captured treatment as usual at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), the country’s largest provider of fistula care.

Method – Improving holistic fistula treatment requires engaging the clinicians who care for women with fistula. This study aimed to investigate the training, beliefs, and treatment approaches of nurses and …

The Grindr Complex: The Behavioral Health Impact Of Sexual Racism On Latinx Men Who Have Sex With Men, Luisalfredo Plascencia

Doctoral Dissertations

Given the social history surrounding the issue of HIV/AIDS in the LGBTQ+ community and the unique and intersectional experiences that Latinx Men who have Sex Men (MSM) have in their community, this dissertation’s research will contribute to the growing work on sexual racism and how it correlates with various elements of behavioral health. The study investigated the moderation impact of Latinx cultural values of caballerismo and familismo on the relationship between experiences sexual racism to mental health symptoms. The study also examined the moderation of caballerismo and familismo and psychological flexibility on the relationship between experiences of sexual racism to …

Patient Reported Outcomes In Sickle Cell Disease Examined Within A Conceptual Model, Swapandeep Mushiana, Marsha Treadwell Phd, Sherif M. Badawy Md, Ms, Liliana Preiss Phd, Allison King Md Mph Phd, Barbara Kroner Phd, Yumie Chen Bs, Jeffrey Glassberg, Victor Gordeuk Md, Nirmish Shah Md, Angie Snyder Phd Mph, Theodore Wun Md

Doctoral Dissertations

Objective: To examine the relations between patient reported outcomes (PROs) within a conceptual model for adults with sickle cell disease (SCD) ages 18 – 45 years enrolled in the Sickle Cell Disease Implementation Consortium (SCDIC) registry. We hypothesized that patient and SCD related factors and barriers to care would independently contribute to functioning as measured using the PRO domains. Additionally, pain and other SCD related complications are expected to impact the relation between the variables. Methods: Participants completed a 48-item survey that included socio-demographics and PRO measures, such as social functioning, pain impact emotional distress, and cognitive functioning. …

Clinical Work With Adult Male Incest Survivors: Therapeutic Themes And Perspectives, Kathryn B. Rosenberg

Doctoral Dissertations

For psychotherapists, encountering clients who have experienced sexual trauma or abuse is inevitable, whether or not the abuse is disclosed to the therapist; however, mental health professionals receive extremely limited (if any) training on how to identify or effectively support adult clients who are survivors of childhood sexual abuse (CSA). Many people who experienced CSA, especially those who identify as male, remain isolated and invisible in their suffering as adults even within therapeutic spaces, facing what feel like insurmountable barriers – both internal and external – to getting help. When sexual abuse is intrafamilial, these barriers are both amplified and …

Efficacy Of Integrated Mental Health Care With Dual Diagnosis Patients And Their Utilization Of Psychiatric Emergency Services, Denton Scott

Doctoral Dissertations

Historically, patients with dual diagnosis have been subjected to ineffective treatment and negative attitudes from healthcare providers. Further, these patients are plagued with myriad afflictions that exist beyond substance abuse and mental illness. The treatments and collateral damage associated with the diagnosis impose excessive healthcare costs and can be of significant detriment to society. Largely, patients suffering from dual diagnosis do not receive adequate treatment. As such, psychiatric emergency services are frequently utilized as an alternate treatment, wherein the main focus of care is on the substance abuse alone. This study argues that solely treating the substance abuse is not …

Evaluating The Effectiveness Of Peer Engagement And Knowledge (Peak): A Community-Based Group Intervention For Youth In Hawai‘I, Jennifer T. T. Ho

Doctoral Dissertations

This study is a program evaluation with a mixed methods design that evaluated the effectiveness of Peer Engagement and Knowledge (PEAK), a six-week community-based group intervention that incorporates mindfulness-based interventions (MBIs) to address multiple health behaviors for multiracial youth in Hilo, Hawai‘i. A total of 51 youth, ages 12-23 years old, participated in this study which included pre-/posttest analyses of health risk factors such as substance use and depression and health promoting factors such as resilience, self-esteem, and mindfulness. Responses from two subsets of participants, who engaged in a focus group (n = 11) and composed gratitude letters ( …

Maternal Postpartum Depression And Father Involvement Across The Transition To Parenthood, Katie Newkirk

Doctoral Dissertations

Maternal postpartum depression is a common complication of childbirth that affects the whole family. Fathers’ greater involvement in childcare can buffer children from the negative effects of mothers’ depression, and aid in mothers’ recovery, so it is important to understand under what conditions fathers become more or less involved when mothers are depressed. Prior research has supported both a compensation hypothesis, whereby fathers compensate for the effects of mothers’ depression on mothers’ parenting by being more involved in parenting, and a spillover hypothesis, whereby mothers’ negative emotionality causes fathers to pull back from family life and be less involved in …

Structurally Rich Movement: Measuring Movement For Empirical Psychology And Examining The Dynamic Complexity Of Affect Regulation In Behavior, Michael Timothy Finn

Doctoral Dissertations

Movement not only permeates human life, but structures dimensions of experience. Phenomenological theory points to the dynamic congruency of movement and emotion, via the body schema, as shaping affectivity. For psychology, this calls for an understanding of behavior beyond being discrete events, but also manifesting kinetic melodies. Yet there is a gap in existing methodology for empirically studying the three-dimensional characteristics of human movement continuously across segments of the body. A potential line of research in this area, implicit affect regulation capacities, was described to inform the selection of instrumentation, measurement, and calculations of dynamic structure that would, theoretically, best …

A Program Evaluation Of A Drug And Alcohol Family Treatment Program, Katrina Ramirez

Doctoral Dissertations

The current study is a program evaluation at John Muir Behavioral Health, Center for Recovery. The research determined the effectiveness of the program at Center for Recovery that is offered to patients that struggle with substance use disorder and their families. The purpose of this study is to assess patients’ behavioral, cognitive and social/environmental factors as it relates to their commitment to sobriety and examine how the involvement of family members influences the patient’s recovery process. I utilized a mixed methodology of quantitative and qualitative interviews of patients and family members. The findings suggest depressive symptoms were negatively correlated with …

Testing A Skills Training Course For Use In A Peer-Delivered Mental Health Intervention, Samantha L. Bernecker

Doctoral Dissertations

Millions of people who could benefit from mental health services do not receive treatment. If non-professional peers could learn to administer basic psychotherapeutic interventions to each other, taking turns as care provider and care recipient, this unmet need for mental health care could be partially filled. This study sought to test whether non-professionals could learn supportive psychotherapy skills from a massively scalable, free online course. Thirty pairs of individuals who were experiencing psychological distress or who wished to increase their mental well-being were enrolled in the study, and 19 pairs completed the prototype online course. Objective raters assessed participants’ skills …

Dissociation And Sexual Trauma: The Moderating Role Of Somatization, Amineh Abbas

Doctoral Dissertations

This study examined various types of trauma, with an emphasis on sexual trauma across the lifespan, in a clinical sample of male and female adult outpatients assessed for trauma, somatization, and dissociation. Two hundred forty-five adult outpatients at the University of Tennessee Psychological Clinic were administered the Dissociative Experiences Scale (DES), the Traumatic Experiences Checklist (TEC), and Symptom Checklist-90-Revised (SCL-90-R), as part of the routine intake procedure. Of those individuals, 200 patients completed the questionnaires correctly and were included in the final study sample. The experience of sexual trauma indeed accounted for additional variance in somatization scores over and above …

Evidence Based Practice Implementation: Perceptions And Expectations Of Master Of Social Work Students, Mholi Kent Vimba

Doctoral Dissertations

Abstract

Efforts to develop sustainable Evidence-Based Practice (EBP) implementation strategies in work settings have been generally unsuccessful. Scholars have focused on perceptions of workers already in work settings to identify implementation barriers and facilitators. None have focused on perceptions of social workers in training. This nationwide non-probability correlational study assessed Master of Social Work (MSW) students’ perceptions of EBP using a self-administered online survey. A total of 212 (57%) completed this survey with 164 (43%) timed out.

Perceptions were assessed using three sets of questions corresponding to the independent variables: EBP knowledge, attitude toward EBP and EBP self-efficacy. A …

Behavioral Activation Of Religious Behaviors: Treating Depressed College Students With A Randomized Controlled Trial, Maria Elizabeth Anne Armento

Doctoral Dissertations

Abstract

Although spiritual or religious behaviors are sometimes targeted within behavioral activation protocols (Hopko & Lejuez, 2007; Hopko, Lejuez, Ruggiero, & Eifert, 2003), the efficacy of a protocol that exclusively develops a religiously-based behavioral repertoire has not been investigated. This randomized controlled study investigated the efficacy of a brief protocol for religious action in behavioral activation (PRA-BA) relative to a no-treatment “support” condition among mild to moderately depressed undergraduate students (n = 50). PRA-BA consisted of an individualized one-session intervention and 2-week activation interval. Clinical outcomes assessed depression, environmental reward, anxiety, and quality of life. Repeated measures ANOVAs indicated …

Evaluation Of A Sleep Hygiene Program To Improve Inmate Sleep Quality, Jennifer F. Hodges-Crowder

Doctoral Dissertations

Research investigating the effectiveness of treatments for inmates with poor sleep quality appears minimal. Some difficulties related to poor sleep quality can be addressed effectively with little time and expense. Studies show that psychoeducational interventions are effective in reducing sleep complaints and improving sleep quality in a variety of populations including college students and adults. However, the effect of sleep hygiene interventions on inmate sleep complaints is unknown. Thus, the purpose of this study was to evaluate a psychoeducational intervention program aimed at improving prison inmate sleep habits, length, and quality.

Participants of this study were inmates at a department …