Medicine and Health Sciences Commons^™

Does What Doesn’T Kill You Make You Stronger? Examining The Effects Of Resilience And Functional Outcomes On Post-Traumatic Growth In Adults With Acquired Disability, Dominique Renee Ghirardi M.S.

Theses and Dissertations

Disabilities acquired in adulthood are often unexpected and disruptive because a loss of functioning can affect one’s ability to maintain employment, pursue their interests, and participate in social activity without assistance or accommodation. This is especially true for those who experience a life-altering injury or develop a chronic health condition between the ages of 18 and 64, as they likely have not planned for the financial and social adjustments that life with a disability involves. However, factors such as post-traumatic growth can reveal the extent to which someone experiences personal growth and improvement in the wake of a traumatic and …

Investigating The Longitudinal Relationship Between Social Motivation And Depression In Autistic Adults, Robyn H. Himelstein

Theses and Dissertations

Autism affects individuals across the lifespan, yet there tends to be limited research and services for autistic adults. This is especially concerning given that autistic adults have high mental health needs, with depression being one of the most common and clinically significant co-occurring conditions. We explored the longitudinal relationships between social motivation, social access (i.e., having opportunities for meaningful social interactions), loneliness, and depression in N=303 autistic adults ages 18-65. Participants completed online surveys about social behavior and wellbeing three times over 3–4 months. We hypothesized that an interaction between higher social motivation and lower social access at Time 1 …

The Emergence And Predictive Utility Of Early Markers Of Social Anxiety In Young Children With Fragile X Syndrome, Conner James Black

Theses and Dissertations

Fragile X syndrome (FXS) is a monogenic neurodevelopmental disorder characterized by elevated rates of intellectual disability, autism, and anxiety. Social anxiety affects approximately 60 percent of individuals with FXS and is cited as one of the most impairing comorbid disorders in FXS; however, little is understood about the developmental patterns of social anxiety markers in young children with FXS. The current study investigates cardiac and behavioral markers of social anxiety across the first five years of life and tests the predictive utility of these variables on social anxiety symptomatology. Participants included 80 children with FXS and 50 neurotypical controls. Participants …

Contingency Management For Opioid Use Disorder: Early Treatment Adherence And Mood, Shelby Renee Goodwin

Theses and Dissertations

Opioid use results in potentially devastating consequences, but medications for opioid use disorder, such as buprenorphine, serve as effective ways to curb cravings and withdrawal, helping an individual reduce their use. Unfortunately, around half of patients discontinue buprenorphine treatment within 30 days and co-occurring conditions such as mood symptoms may serve as additional barriers and decrease engagement. This study sought to examine contingency management (CM; incentives for meeting behavioral goals) as a potential intervention to increase early treatment engagement, as well as the role of total depression, anxiety, and stress (mood) severity in the efficacy of contingency management. New patients …

Evaluating The Acute Effect Of Vaping On Food Intake, Gabrielle Maldonado

Theses and Dissertations

Background: Weight control is a common motive for continued cigarette smoking, and weight concerns pose a barrier to quitting. These effects are driven in part by nicotine’s ability to reduce overall appetite and ultimately body weight. Electronic nicotine delivery systems (ENDS) have been marketed and used for weight control, suggesting that the use of these products potentially may share similar effects as well as barriers to quitting as observed for cigarette smoking. However, little to no controlled clinical lab evidence exists supporting ENDS use for weight control. The present study tested the influence of an ENDS on acute eating behavior …

Exploration Of Dimensional Structure Of Major Psychiatric Disorders Reveals Relationship With Substance Use And Personality, Noah Berley

Theses and Dissertations

Objective: Using a mixture of statistical techniques like structural equation modeling, confirmatory, and exploratory factor analyses, we aimed to determine the genetic factor structure among Externalizing, Internalizing, and Psychotic spectrum disorders through methods that evaluate GWAS-based correlations. Additionally, a subsequent factor analysis based on the most suitable psychiatric model was conducted to understand how non-clinical behavioral traits align with this factor structure.

Methods: Publicly available GWAS summary statistics for twelve major psychiatric disorders, six substance use measures and two personality domains were incorporated into structural equation models. Using the GenomicSEM software package, GWAS-based correlations were estimated between all twelve disorders …

Analysis Of Referrals To Trauma Psychology And Subsequent Development And Proof-Of-Concept Study Of Provider Mental Health Training At A Level I Trauma Center, Samantha Mladen

Theses and Dissertations

Introduction: Millions of people are traumatically injured each year, with a significant portion going on to develop negative mental health sequelae. Many Level I trauma centers are integrating psychologists to provide acute assessment and intervention to patients at risk for poor outcomes. However, medical providers receive very limited training in how to best refer patients to mental health services and may benefit from such education.

Objective: To characterize current patterns of referral to trauma psychology at a Level I trauma center and to develop, refine, and test proof-of-concept for a new training for referring providers.

Method: One year of patient …

Family-Based Support As Social Determinants Of Health Protective Factor On Depression Of Parents Of Children With Autism Spectrum Disorder, Bisola E. Duyile

Theses and Dissertations

All parents experience challenges in their caregiving roles (Barańczuk & Pisula, 2020). However, parents raising a child/children with disabilities experience different social barriers (Oliver, 1996) that may also contribute to additional stressors in their caregiving role (Tomeny, 2016). Although these parents, on average, have reported greater symptoms of depression than parents of typically developing children, research shows that parents who reported receiving social support had lower symptoms of depression and stress (Das et al., 2017; Singh et al., 2017). Through the social determinants of health (SDOH) framework (ODPHP, 2022), the present study investigated informal/family-based support and its protective impact on …

Parent-Child Relationships And Parental Distress As Moderators Between Chronic Illness And Psychological Problems In Emerging Adults., Abigail Kukay

Theses and Dissertations

The current study aimed to better understand how parental functioning and parent-child relationships might moderate the effects of chronic illness on psychological problems in emerging adulthood. Three hypotheses were made: (1) the presence and severity of chronic illness would associate positively with emerging adult psychological problems, (2) parental distress would moderate the effects between chronic illness presence/severity and emerging adulthood psychological problems, and (3) parent-child relationship quality would moderate the effects between chronic illness presence/severity and emerging adult psychological problems. Data analysis consisted of testing interaction effects, pairwise parameter comparisons, and multiple group analysis. The three-way interaction between endorsing a …

Technology Use In Schizotypy Utilizing The Domains Of Technology Use Survey (Dotus), Devin Massaro

Theses and Dissertations

The diathesis stress model for schizophrenia posits that genetics and prenatal factors confer vulnerability (diathesis) for mental illness which then may be activated through exposure to environmental stressors during life. One component of our contemporary environment involves technology use which has demonstrated risk and beneficial capabilities in regards to the schizophrenia spectrum. Using an online and in-person survey, this study aimed to elucidate the manner in which time spent on technology related to schizotypy, problematic technology use (PTU), and health behaviors in 227 undergraduate students (aged 18-30). We hypothesized that levels of schizotypy, as well as time spent on social …

Testing Models Of Context-Dependent Outcome Encoding In Reinforcement Learning, William M. Hayes Iv

Theses and Dissertations

Previous studies of reinforcement learning (RL) have established that choice outcomes are encoded in a context-dependent fashion. Several computational models have been proposed to explain context-dependent encoding, including reference point centering and range adaptation models. The former assumes that outcomes are centered around a running estimate of the average reward in each choice context, while the latter assumes that outcomes are compared to the minimum reward and then scaled by an estimate of the range of outcomes in each choice context. However, there are other computational mechanisms that can explain context dependence in RL. In the present study, a frequency …

A Technology-Based, Mixed Methods Approach To Examining The Psychosocial Determinants Of Maternal Health Disparities, Hannah M. Ming

Theses and Dissertations

Background: Exposure to racism and discrimination in the U.S. increases Black women’s risk for experiencing maternal health disparities. Additionally, racism and discrimination affect maternal psychosocial well-being, creating evidence for a biopsychosocial relationship between racism and maternal health outcomes. However, current research does not define the psychosocial Black maternal self well. Given the dynamic relationship between racism, psychosocial well-being, and Black maternal health outcomes, research must comprehensively examine the Black maternal self. The operationalization of a comprehensive construct for Black maternal psychosocial well-being can improve understanding of the relationship between racism, psychosocial well-being, and Black maternal health outcomes.

Purpose: …

A Novel Approach To Reducing Adiposity Among Young Men, Jean M. Reading

Theses and Dissertations

Background

Lifestyle intervention is the first line treatment for obesity. Yet, young men are underrepresented in lifestyle interventions, which is posited to be the result of unmet needs and overall low concern for weight management. The aims of this dissertation are to:

Papers 1 and 2: Test the preliminary efficacy, feasibility, and acceptability of a self-guided lifestyle intervention for young men.

Paper 3: Explore the behavioral and physiological factors associated with changes in adiposity among young men and women enrolled in a more intensive lifestyle intervention.

Results

Papers 1 and 2: The self-guided intervention produced modest weight …

Examination Of Common And Rare Variant Genetic Architecture Of Psychiatric Disorders, Mohammad Ahangari

Theses and Dissertations

Psychiatric disorders are often heterogenous in their manifestation and genome-wide association studies have identified many common risk variants involved in their polygenic architectures with varying degrees of pleiotropy. In recent years, large-scale biobanks have also begun sequencing the genome of their participants to elucidate the role of rare risk variation in the genetic architecture of complex phenotypes, including psychiatric traits. This dissertation sought to better understand the role of both common and rare risk variation in the genetic architecture of psychiatric disorders with a particular focus on schizophrenia and alcohol problems. In the first three analyses, we focused on characterizing …

Leaving Part Of Myself Outside The Door: An Exploration Of Pitfalls And Promising Practices For Black Millennial Survivors Of Racism, Sheriece L. Hooks

Theses and Dissertations

Experiences of racism and discrimination are a prominent concern within the Black community and often cause symptoms of stress or trauma for those who endure it. However, there are limited research studies which examine best practices and pitfalls for treating individuals of this population who struggle with race-based stress or trauma. This study uses a phenomenological approach to examine the therapy experiences of six clients, identifying as Black or African American, when discussing stress or trauma related to racism. Results identified several pitfalls, such as experiences of racism, color blindness, inattention, and countertransference, as well as promising practices, such as …

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 …

Disparities Between Native Americans And Whites In Trajectories Of Functional Independence And Life Satisfaction Over The 5 Years After Traumatic Brain Injury, Jack Watson

Theses and Dissertations

A traumatic brain injury (TBI) can have a host of negative consequences including impairments to motor and cognitive function and can result in a decrease in quality of life (i.e., life satisfaction). TBI is one of the leading causes of death and disability worldwide and disproportionately affects Native Americans, who have the highest rates of TBI among all races in the U.S. and elevated likelihood for fatality and severe complications. The current study used a subsample of the national TBI Model Systems Database of 80 demographically and injury severity matched Native American and White individuals (total n = 160) to …

Defiantly Childlike: Using Aesthetic Resistance To Heal, Sarah K. Reagan

Theses and Dissertations

This thesis examines an alternative processing mechanism surrounding the act of healing after traumatic experiences in life. Using a methodology of iterative patterning and tool-pathing, a collection of inflatable garments and wooden mannequins analyzes defense mechanisms learned in early childhood development. This work highlights an essential body of recent scholarship that takes cuteification seriously to restore a childlike approach to mastering fear. This paper will review the definitions of cuteness and childlike humor and then describe how visual culture has implemented these components to subvert established power.

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 Influence Of Comorbid Gad On Er Utilization In Urban Youth With Asthma, David A. Karpe

Theses and Dissertations

Current literature indicates a strong association between asthma and the early onset of comorbid generalized anxiety disorder (GAD) in minors and their primary caregivers. Studies show that asthma prevalence increases with certain demographic factors, such as ethnicity, socioeconomic status, and housing quality. Evidence also suggests that GAD influences decision-making, especially when deciding to utilize emergency room (ER) services for asthma-related concerns. This study analyzed the effect of comorbid GAD on minors with asthma and ER utilization. The data were provided by an earlier Stress & Justice Study (S&J) baseline survey, an investigation aimed at understanding the impact of parental criminal …

Direct And Indirect Effects Of Alcohol Craving And Demand On Obsessive And Compulsive Drinking Characteristics: The Role Of Impulsivity, James V. Turner Iv

Theses and Dissertations

This study’s goal was to test a novel model of obsessive-compulsive thoughts about drinking. Young adults completed tasks measuring potential drinking characteristics. Findings indicated demand was related to higher OCTD, a significant effect of CIC on OCTD via demand, and that the relationship was particularly strong for impulsive individuals.

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 …

Investigating Cannabinoid Type-1 Receptor (Cb1r) Positive Allosteric Modulators (Pams) In Mouse Models Of Overt Cannabimimetic Activity, Subjective Drug Effects, And Neuropathic Pain, Jayden Elmer

Theses and Dissertations

Chronic pain affects between 20 and 30 percent of the adult population in western countries and represents a wide array of specific etiologies (Berge, 2011). Neuropathic pain secondary to traumatic nerve injury, chemotherapeutic toxicity, or diseases (e.g., diabetes mellitus) is often refractory to conventional analgesics, with patients receiving less than 50% pain relief compared to placebo (Finnerup et al. 2010). The endocannabinoid system has shown potential as a therapeutic target for neuropathic pain wherein CB1 agonism via administration of exogenous agonists or pharmacological blockade of endocannabinoid catabolic enzymes exhibits efficacy in reversing allodynia in the chronic constriction injury (CCI) model …

Opioid System's Involvement In Ketamine's Antidepressant-Like Effects, Fan Zhang

Theses and Dissertations

Depression is one of the most debilitating disorders in the world. The currently available medications typically have a 2-4 week delay in their therapeutic effects and are ineffective for about 40% of patients. In 2000, a subanesthetic dose (0.5 mg/kg i.e.) of the dissociative anesthetic ketamine was reported to have both rapid and robust antidepressant effects in in treatment-resistant depressed patients. However, the mechanisms responsible for ketamine’s antidepressant effects remain unclear. In 2018, a clinical study reported that pretreatment with the nonselective opioid antagonist naltrexone attenuated the rapid antidepressant effect of ketamine in depressed patients. The current study investigated the …

We All Feel Feelings, Ben Ohene

Theses and Dissertations

Consisting of three illustrated books, We All Feel Feelings is designed as a vehicle for the discussion of emotional and mental health with young boys. These books will help foster a mindset of openness and acceptance through different methods of displaying and understanding emotions.

Peer Intervention With Suicidal Disclosures On Social Media: Does The Bystander Effect Play A Role?, Carissa M. Orlando

Theses and Dissertations

Suicide is an increasing public health concern in adolescents and young adults, and many individuals discuss mental health concerns with friends in lieu of professional avenues. Thus, peers can serve as valuable gatekeepers for friends experiencing suicidality. The prevalence of social networking websites means that individuals are likely to encounter suicidal disclosures on the internet, but little research has investigated if young adults possess the skills and motivation to intervene in these contexts. Additionally, there have been virtually no investigations into how the presence of other online users impacts intervention behavior—in short, if there exists a bystander effect. This study …

Feasibility And Preliminary Outcomes Of A Brief Mindfulness-Based Intervention (Bmbi) To Decrease Stress And Improve Well-Being In Secondary School Teachers, Alex M. Roberts

Theses and Dissertations

Teachers often experience symptoms of stress and burnout due to the chronicity of their occupational demands. These symptoms can negatively impact teachers’ coping abilities and have implications for their physical and psychological health. Research indicates that mindfulness-based interventions (MBIs) have potential to help alleviate these symptoms of stress and burnout. Increasing numbers of MBIs for teachers have been implemented in the past five to ten years. However, few teacher-focused MBIs measure intervention feasibility and little data exist informing how to design and implement feasible MBIs in this context while simultaneously maximizing their potential positive effects. The current study examined the …

The Moderating Effects Of Parenting Factors And Perceived Stress On African American Adolescent Weight Related Outcomes, Colby Kipp

Theses and Dissertations

African American adolescents experience a higher prevalence of obesity than nonminorities with approximately 40% being overweight or obese. Chronic stress, both among parents and adolescents, may be important to consider when assessing the factors that influence adolescent weight status. Baseline data were collected from one hundred forty eight African American adolescents (M_age = 12.93, SD = 1.75; M_BMI% = 96.7, SD = 3.90) and their caregivers (M_age = 44.5, SD = 8.6; M_BMI = 37.63, SD = 8.21) enrolled in the Families Improving Together (FIT) for Weight Loss trial. Adolescents self-reported their perceptions of …

Anger Regulation And Psychosis: Mechanisms Of Impact And Implications For Therapy, Naama Hofman

Theses and Dissertations

Paranoia is strongly associated with anger. This relationship is found across the psychosis spectrum, including individuals at high risk of developing psychosis. The relationship is commonly addressed in the measurement of anger but is rarely addressed in clinical studies. This study explored the relationship between anger regulation and paranoid ideation as well as factors that mediate and moderate this relationship. Specifically, the study examined whether the influence of anger regulation cognitive-behavioral interventions on paranoid ideation changed as aspects of emotional awareness changed. It also examined whether interventions for anger regulation that target different phases of anger generation impacted paranoid ideation …

Effects Of (R,S)-Ketamine And (2r,6r)-Hydroxynorketamine: A Preclinical Study, Remington Rice

Theses and Dissertations

In 2017, 7.1% of US adults were diagnosed with depression, and 50% of patients received medication to treat their depression. Depression can cause severe interruptions in an individual's cognitive functioning and behaviors like sleeping, eating, working, and socializing. Unfortunately, approximately 40% of patients do not respond to treatment with monoaminergic medications (e.g. Prozac) and therapeutic effects may be delayed 2-8 weeks. Due to these therapeutic shortcomings, faster acting and more efficacious treatments are needed. Recent preclinical findings indicate potential for glutamatergic drugs like (R,S)-ketamine and (2R,6R) hydroxynorketamine to produce more rapid and longer-acting therapeutic effects. The antidepressant effectiveness of (R,S)-ketamine …