Medicine and Health Sciences Commons^™

Frozen By Worry And Fatigue? A Mixed Methods Approach To Understanding The Lived Experiences Of Freezing Of Gait, Sarah M. Ghose

Theses and Dissertations

This study utilized a mixed methods emergent, phenomenological approach to (1) understanding the lived experience of freezing of gait for individuals diagnosed with Parkinson’s Disease and (2) determining the role of anxiety and sleep in freezing of gait outcomes. Participants included 13 adults diagnosed with Parkinson’s Disease (N=14 for qualitative data, N=13 for quantitative data; 23.1% female-identifying, 76.9% male-identifying) who were predominantly white (92.3%) with an average age of 69 years (SD = 6.73 years). Data collection consisted of semi-structured interviews, self-report measures, actigraphic sleep data, and salivary alpha amylase biomarker collection. Results are organized into …

Systematic Review Regarding The Use Of Mindfulness-Based Mobile Applications To Reduce Psychological Symptoms And Enhance Well-Being Among General And Clinical Population Adults: Benefits, Limitations And Future Directions, Brian Clawson

Theses and Dissertations

Mindfulness is now utilized throughout Western Society and is part of the growing behavioral health, self-help, and wellness movements. Mobile applications have become increasingly popular for a wide variety of uses related to physical health, mental health, and self-improvement. Therefore, mindfulness-based mobile applications have promise both as stand-alone tools for end-users seeking self-help resources and as clinician-recommended adjunctive tools to enhance the process and outcomes of professional therapy. This systematic review identified, reviewed, and synthesized the findings from studies (n = 29) concerning the impact of mindfulness-based mobile applications on specific aspects of psychological functioning in both the general population …

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 …

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 …

Anxiety And Social Withdrawal Among Children: Associations With Emotion Awareness And Emotion Regulation Strategy Use At The Intra- And Interpersonal Levels, Janae Ellen Teer

Theses and Dissertations

Anxiety and social withdrawal are two frequently experienced internalizing conditions among children. These early-onset challenges are associated with numerous maladaptive outcomes in the academic, social, and psychological domains (Levitt & Merrill, 2009; Long, 2018; Sanchez et al., 2018; Shernoff et al., 2017). While identifying anxious and socially withdrawn children in the classroom is difficult as symptoms generally occur internally, distinguishing between the conditions is perhaps more challenging as the two are closely associated, oftentimes overlapping constructs (Barzeva et al., 2019; Rubin et al., 2009). Particularly, it is unclear whether anxiety and social withdrawal are similarly or differently associated with key …

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 …

The Relationship Between Stress, Anxiety, Depression, Coping And Satisfaction With Care Among Family Of Adult Acute Care Trauma Patients, Ashalata Ann Pereira

Theses and Dissertations

Background: Surprisingly few studies have considered the impact of trauma on adult family members of those admitted to the acute care, rather than ICU. Throughout the course of hospitalization, as patients move through different levels of care, family members must learn to adapt to, and cope with changes in care delivery. Purpose: To explore the literature to understand the state of the science, to assess the psychosocial and functional impact on family of adult trauma in acute care, and to identify predictors of coping and satisfaction with care provided to meet their needs. Design: The Lazarus & Folkman (1984) Stress, …

The Intergenerational Effects Of Adverse Childhood Experiences On Children’S Emergency Department Utilization And Depression And Anxiety In South Carolina, Eboni E. Haynes

Theses and Dissertations

Adult exposure to adverse childhood experiences (ACEs) is common in the U.S., with over half of adults reporting exposure to at least one ACE. Childhood trauma is associated with risk factors for premature death, disability, poor physical and mental health, and lower quality of life in adults. Traumatic experiences also influence parenting behaviors later in life, placing offspring at an increased risk of ACE exposure. Few studies have explored the intergenerational effects of ACEs on the health and well-being of offspring. This study sought to identify whether associations existed between caregiver ACE exposures and emergency department (ED) utilization for sick …

Disordered: Conversations About Mental Health And Society, Rachel Brown

Theses and Dissertations

Disordered is a collaborative, participatory street art project designed to destigmatize mental health challenges like depression and anxiety, and reframe health as a societal issue. Through social practice and guerrilla strategies, Disordered intervenes in public spaces, creating conversations, stickers and metal signs to inspire personal, social and political transformations.

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 Relationship Between Auditory Habituation And Anxiety In Autism Spectrum Disorder, David Nicholas Top

Theses and Dissertations

Many individuals with autism spectrum disorder (ASD) have atypical sensory processing and behaviors including sensory sensitivity and low registration of sensory stimuli as well as sensory seeking and avoiding behaviors. Additionally, many individuals with ASD have clinically distressing levels of anxiety. Previous research suggests that there is a link between abnormal sensory processing, anxiety, and ASD. The purpose of this study was to experimentally observe auditory sensory processing using pupillometry methods, between ASD, control, and high-anxious control groups. While a difference in tonic pupil size was observed, there were no reactivity or habituation differences between the groups. There were no …

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 …

A Brief Rational Disputation Exercise Enhances Cardiovascular, Anxiety, And Affective Recovery Following Worry-Recall, Michelle Rosalie Di Paolo

Theses and Dissertations

Rational Emotive Behavior Therapy (REBT) (Ellis, 1958), educates a client on the relationship between one’s irrational beliefs (IBs) and the dysfunctional emotional/behavioral consequences of maintaining those beliefs such as symptoms of anxiety, depression, and sleep dysfunction (Ellis, Gordan, Neenan, & Palmer, 1997), symptoms also commonly correlated with high trait perseverative cognition (PC; Verkuil, Brosschot, de Beurs, & Thayer, 2009). In addition to symptoms of anxiety and depression, high levels of PC, a construct comprised of measures of trait worry and rumination, have been linked to acute cardiovascular (CV) health concerns that overtime when left unmitigated may lead to chronic conditions …

The Relationship Between The Poor Parenting In Childhood And Current Adult Symptoms Of Anxiety And Depression: Attachment As A Mediator, Kayla Lynn Burningham

Theses and Dissertations

Both anxiety and depression have been shown to be a result of early negative attachment experiences. The quality of parenting is one variable that affects attachment security, therefore correlating with the development of anxiety and depression in adulthood. The purpose of this study was to examine the mediating effect of attachment in the relationship between mother and father's parenting in childhood and adult symptoms of anxiety and depression. The study focused on 680 married or remarried heterosexual couples that took the RELATE questionnaire between 2011 and 2013. Results indicated insecure attachment mediates the relationship between poor parenting and symptoms of …

Effects Of Dietary Preference On The Experience Of Anxiety, Depression And Acute Stress Response, Shaun Stearns

Theses and Dissertations

Research has demonstrated that high saturated fat and low carbohydrate consumption may provide physiological benefit in the treatment of major neurological disorders, though not much research has explored if these benefits extend to the experience of anxiety, depression, stress and physical symptoms. The purpose of this study was to explore the relationship between fat consumption and negative emotional/physiological states (anxiety, depression, stress and physical symptoms). This study also explored how fat consumption can alter one's response to an acute stress. Participants completed an online survey indicating their food preferences and their responses to a number of self-report scales such as …

Treatment Outcomes For Mood Disorders With Concurrent Partner Relational Distress: A Comparison By Treatment Modality And Profession, Holly Pack

Theses and Dissertations

Mood disorders are often linked with concurrent partner relational distress. The present study compared the cost effectiveness of treating mood disorder alone versus when the condition is comorbid with partner relational distress. Cigna, a leading health insurance management company in the US, provided outpatient data. Participants included patients with solely a mood disorder diagnosis (n = 72,712) and those with both a mood disorder and a comorbid partner relational distress diagnosis (n = 113, including 69 females and 44 males). These participants were treated in outpatient settings throughout the US. These numbers are surprisingly low considering the extensive literature showing …

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 …

Integration And Impact Of Stress Management And Resiliency Training (Smart) In A Nurse Residency Program: A Feasibility Study, Sherry Chesak

Theses and Dissertations

Nursing is recognized widely as a highly stressful profession, and the time of orientation is identified as the most stressful time in a nurse's career. Innovative strategies are needed to assist new registered nurses in the management and prevention of stress as a result of transitioning into the complex and challenging healthcare environment. The purpose of this study was to assess the feasibility and impact of integrating a Stress Management and Resiliency Training (SMART) program within a nurse residency program for new nurses at an academic medical center. Additional aims were to assess the effects of the program on participants' …

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 …

Intrinsic Religiosity And Adolescent Depression And Anxiety: The Mediating Role Of Components Of Self-Regulation, Brent Charles Black

Theses and Dissertations

This study examined the possible mediating role of the emotional, behavioral, and cognitive components of self-regulation as they relate to adolescent intrinsic religiosity and the internalizing problems of teen depression and anxiety. The sample included 459 adolescent respondents from one wave of the Flourishing Families Project, an ongoing longitudinal study. Through the use of Structural Equation Modeling, results showed that cognitive self-regulation partially mediated the relationship between intrinsic religiosity and adolescent depression. Additionally, emotional self-regulation, but not behavioral self-regulation was found to be negatively linked with both depression and anxiety. These findings provide clinicians with greater direction when working with …

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 …

The Role Of High Affinity Nicotinic Acetylcholine Receptors On Anxiety-Like Behavior: A Study In Female Mice, Jessicka Hall

Theses and Dissertations

Tobacco dependence is high in women who suffer from anxiety disorders yet little is known about the contributions of nicotinic acetylcholine receptors (nAChRs) on anxiety-like behavior. β2*nAChRs (*denotes assembly with other subunits) are the most abundantly expressed nAChRs in the brain yet little is known about the contributions of β2*nAChRs on anxiety-like behavior in female mice. In this study, antagonism and nicotine effects on anxiety-like behavior was investigated across the life span in 6, 12 and 24-month-old drug-naïve knockout (KO), heterozygous (HET) and a gain of function α6L9S mice and wild type (WT). HET mice showed increased sensitivity to di-hydrobeta-erythroidine …

Stress And Anxiety In Adhd: Links To Sensory Over-Responsivity, Stacey E. Reynolds

Theses and Dissertations

Sensory Modulation Dysfunction (SMD) is characterized by an inability to consistently and accurately grade responses to sensory information. SMD, and specifically sensory over-responsivity (SOR), has been correlated with stress and anxiety in some developmentally delayed populations and has been associated with structures and functions of the hypothalamic-pituitary adrenal (HPA) axis. Recent attention has been given to HPA functioning in children with Attention Deficit Hyperactivity Disorder (ADHD), with a majority of studies identifying blunted or diminished cortisol patterns. In contrast, elevated cortisol has been associated with anxiety and anxious behaviors in both animal and human studies. The purpose of this study …

Impact Of Combat Stress On Mental Health Outcomes: Brfss Survey Data 2006, Emily Pedneau

Theses and Dissertations

Objectives: This study sought to determine the relationship between combat experience and mental health outcomes. The study sought to determine whether age was a significant factor in poor mental health outcomes. Methods: Multiple logistic regression (n = 195,048) and multiple linear regression (n = 264,154) were performed on the 2006 Behavioral Risk Factor Surveillance System (BRFSS) survey. Veteran status and a host of demographic and health status questions were analyzed in relation to diagnosis of anxiety or depressive disorder (multiple logistic regression) and to number of days poor mental health (multiple linear regression). Results: Diagnosis of anxiety or depression was …

The Effects Of Footshock On The Reinforcing Efficacy Of Cocaine In Male Long-Evans Rats, Elizabeth S. Hendrick

Theses and Dissertations

Many links exist between cocaine abuse and stress. The literature and laboratory studies in rats suggest that this could be because stress increases the reinforcing efficacy of cocaine. Using male Long-Evans rats, experiments in this thesis tested effects of footshock on the reinforcing efficacy of cocaine using a progressive ratio schedule of reinforcement. They also examined effects of footshock on the reinforcing efficacy of a half-maximal dose of cocaine. Finally, they tested the effects of footshock on cocaine self-administration in rats initially resistant to acquisition of cocaine self-administration. Footshock did not increase reinforcing efficacy of cocaine on a PR schedule …